Women's Health Physiotherapy via Telehealth: What the Evidence Shows and Why Location Should Not Be a Barrier

James Combes, Director and Head Physiotherapist, Telephysio Australia

Women's health physiotherapy | Pelvic floor physiotherapy telehealth | Online women's health physio rural Australia | Pelvic floor dysfunction telehealth | Bulk billed women's health physio

At Telephysio Australia, we offer gap-free, bulk-billed physiotherapy for patients referred by their GP under a chronic care plan (GPCCMP, TCA, or EPC). For eligible patients, that means no out-of-pocket cost for your session, whether you are in a capital city or a remote community hours from the nearest specialist.

Women's health physiotherapy covers some of the most common and impactful health issues facing Australian women at every stage of life. Despite this, it is one of the least-accessed areas of allied health care, particularly for women living in rural and remote Australia, where specialist physiotherapy services are hard to come by.

Research is increasingly showing that telehealth is an effective way to bridge that gap. This post explains what the evidence actually shows, which conditions are suitable for online physiotherapy, and why where you live should not decide whether you get good care.

What is women's health physiotherapy?

Women's health physiotherapy, sometimes called pelvic health physiotherapy, is a specialist area of practice. It focuses on assessing and treating conditions that affect the pelvic floor, bladder, bowel, and musculoskeletal system throughout a woman's life. Conditions commonly treated include:

Urinary incontinence covers leaking with coughing, sneezing, or exercise (stress incontinence), sudden strong urges to go to the toilet (urgency incontinence), and a mix of both.

Pelvic organ prolapse is a feeling of heaviness or bulging caused by the pelvic organs dropping due to weakened pelvic floor support.

Pelvic pain includes ongoing pelvic pain and pain linked to conditions like endometriosis.

Antenatal and postnatal physiotherapy covers preparation for birth, recovery after vaginal birth or caesarean section, and management of abdominal separation (diastasis recti abdominis).

Pelvic floor dysfunction refers to weakness, overactivity, or poor coordination of the pelvic floor muscles.

Menopausal musculoskeletal health includes joint pain, pelvic floor changes, and exercise guidance to support bone health.

These conditions are far more common than many women realise, and their effects on daily life can be significant. According to the 2023 National Women's Health Survey, conducted by Jean Hailes for Women's Health and funded by the Australian Government, 47% of Australian women have experienced pelvic pain in the last five years. Almost half of those women said they had to take a break from or stop work, study, or exercise because of it (Jean Hailes for Women's Health, 2023).

When it comes to incontinence, the most recent Deloitte Access Economics report, commissioned by Continence Health Australia, found that in 2023 more than 7.2 million Australians were living with incontinence. That is equivalent to 1 in 3 people aged 15 and over. Women are twice as likely as men to be affected. The total cost of incontinence to Australia in 2023 was estimated at $100.4 billion, made up of $66.6 billion in direct financial costs and $33.8 billion in lost wellbeing (Deloitte Access Economics, 2024).

For many of these conditions, physiotherapy is the recommended first-line treatment. This is particularly true for pelvic floor muscle training for urinary incontinence (Dumoulin et al., 2018). The key question this post addresses is whether physiotherapy can be delivered effectively via telehealth.

Why women in rural and remote areas miss out

For women living outside major cities, accessing specialist women's health physiotherapy is genuinely difficult. A 2024 study by Dwyer and Lin, published in the Australian and New Zealand Continence Journal, looked at a dedicated pelvic health physiotherapy service in the Kimberley region of Western Australia. Drawing on Australian Institute of Health and Welfare data, the study found there are fewer than half the number of employed physiotherapists per 100,000 people in very remote areas (45.5 full-time equivalents) compared to major cities (101.5 full-time equivalents). Access to pelvic health physiotherapy specifically, which requires additional post-graduate training on top of standard physiotherapy qualifications, is likely much more limited.

The real-world impact of this was clear in the study's findings. Most patients who accessed the service had been dealing with their symptoms for more than a year before they were seen. A 12-month audit in the Northern Territory, referenced in the paper, found that female urinary incontinence made up just 3% of gynaecology consultations despite being common, and only 19% of those who were suitable for conservative management, including physiotherapy, were formally referred.

Dwyer and Lin noted that telehealth is one option for connecting women in remote areas with physiotherapists who have specialist pelvic health training based elsewhere, and pointed to evidence that it can be effective and cost-effective for managing pelvic floor conditions. It's worth noting that the authors were also candid about the limits of this approach in their own setting: when telehealth was used out of necessity in the Kimberley during COVID-19 restrictions, they observed reduced attendance, and some patients chose to wait for an in-person appointment rather than proceed by telehealth. Their overall conclusion was that a dedicated, locally based pelvic health physiotherapist was the most effective model where one could be resourced, with telehealth serving as a way to extend access where it can't.

A 2021 survey by McPherson and Nahon, also published in the Australian and New Zealand Continence Journal, set out specifically to investigate the barriers and limitations of telehealth delivery for pelvic health physiotherapists working in regional, rural, and remote Australia. Of the physiotherapists surveyed, 74% reported using telehealth to deliver care. Their findings support telehealth as a workable option for many patients, while also surfacing real constraints clinicians face, including questions around the safety and effectiveness of remote assessment and inconsistent internet access in remote communities.

What the research tells us about telehealth women's health physiotherapy

Pelvic floor muscle training for bladder leakage

Pelvic floor muscle training is the recommended starting point for treating stress and mixed urinary incontinence. A natural question is whether this training can be effectively taught and supervised via a video call, given that a physiotherapist cannot check pelvic floor muscle technique through internal examination remotely.

A 2025 randomised controlled trial by Lima and colleagues, published in the International Urogynecology Journal, looked at this directly. The trial enrolled 50 women with stress urinary incontinence. Half received a 12-week pelvic floor muscle training program via video consultation, and the other half received an educational program via video consultation. Bladder symptoms were measured using a validated questionnaire called the ICIQ-SF. The pelvic floor training group had significantly lower symptom scores compared to the education-only group (average scores of 6.2 versus 12.5, where lower scores mean fewer symptoms, p less than 0.001). The training group also had fewer leakage episodes, used fewer pads, and reported better satisfaction, confidence, and quality of life. The researchers concluded that pelvic floor muscle training delivered via telehealth is an effective treatment option for stress urinary incontinence.

A systematic review by da Mata and colleagues (2021), published in the International Urogynecology Journal and available on PubMed (PMID: 33175229), looked at what the research as a whole showed about telehealth for female pelvic floor rehabilitation. Women who received pelvic floor rehabilitation remotely showed meaningful improvements in bladder symptoms, pelvic floor muscle strength, and quality of life. The authors were careful to note that the evidence is still building and more research is needed, which is worth keeping in mind. The review included four studies, two of which were randomised controlled trials, and the conclusions were deliberately measured.

Recovery after birth

Pelvic floor problems after having a baby are very common. The Continence Foundation of Australia reports that 1 in 3 women who have had a baby will experience urinary incontinence. Without treatment, problems that persist beyond three months after birth are associated with a higher risk of long-term symptoms.

A 2025 randomised controlled study by Ozdincler, Korkmaz Dayican, and Ozyurek, published in the journal Telemedicine and e-Health (Volume 31, Issue 7), enrolled 58 women aged 18 to 35 who were six to eight weeks post-birth. Half did pelvic floor muscle training via telerehabilitation, and half did the same program supervised in person. Both groups did 45 to 50 minutes of training, two days a week for eight weeks. Both groups showed significant improvements in pelvic floor muscle function, pelvic floor symptoms, and quality of life. The telerehabilitation group achieved outcomes equivalent to the in-person group.

For a new mum, particularly one living in a regional or remote area, being able to access this kind of support without needing to travel or arrange childcare makes a real difference to whether she gets help at all.

How telehealth compares more broadly: attendance, adherence, and satisfaction

A 2024 systematic review from the University of Queensland's RECOVER Injury Research Centre, published in the Journal of Physiotherapy (Simmich, Ross, and Russell), compared real-time video physiotherapy with in-person physiotherapy across a range of conditions. The review searched five major academic databases and included multiple studies across attendance, adherence, and satisfaction. It found that telerehabilitation led to 8% higher attendance at appointments and 9% higher adherence to home exercise programs compared to in-person care. Patient satisfaction was similarly high for both. The researchers noted that the certainty of evidence is currently low to very low due to variation across studies and risk of bias, which is an honest and important caveat to include.

For Australian patients specifically, a 2023 survey study by Thomas and colleagues, published in the Journal of Medical Internet Research, surveyed 1,820 Australian adults about their telehealth experiences. Among the 1,114 who had used telehealth, 57% said they would not have been able to access their appointment at all without it. 87% felt they got the information they needed, and 69% were satisfied with their consultation (Thomas et al., 2023). For someone in a rural or remote area who might otherwise go without care entirely, these numbers reflect something important: telehealth is not just a convenience, it is often the only option.

Which conditions are suitable for telehealth?

It is important to be honest about where telehealth works well and where it has limits.

Telehealth works well for:

Pelvic floor muscle training for bladder leakage, including guiding technique, building a home exercise program, and progressing treatment over time. This applies where a woman is able to identify and perform a voluntary pelvic floor contraction with guided instruction, as was the case in the Lima et al. (2025) trial.

Recovery after birth, including return-to-exercise guidance, management of abdominal separation, postnatal pelvic floor training, and support following caesarean section.

Bladder and bowel retraining, including advice on fluid intake, voiding habits, urgency strategies, and bowel health. These are largely education-based and suit online delivery very well.

Pregnancy physiotherapy, including management of pelvic girdle pain, safe exercise guidance, and birth preparation.

Chronic pelvic pain support, including pain education, gentle movement guidance, and self-management strategies.

Menopausal musculoskeletal health, including exercise programs for bone density, joint pain management, and pelvic floor rehabilitation.

Where telehealth has limits:

An internal pelvic floor examination, which gives the physiotherapist objective information about muscle tone, strength, and coordination, cannot be done via telehealth. For some patients, particularly where the diagnosis is unclear, an initial in-person assessment may be clinically appropriate. Your physiotherapist will discuss this with you openly if it applies to your situation.

Common questions

Can a physiotherapist properly assess pelvic floor problems over video?

For many conditions, yes. This is particularly true where the main focus is on teaching pelvic floor muscle training, providing education, building an exercise program, and supporting self-management. The Lima et al. (2025) trial enrolled women who were able to perform a pelvic floor contraction with verbal guidance and self-palpation, which is a reasonable starting point for telehealth delivery. Where an internal assessment is needed, your physiotherapist will let you know and can discuss options with you.

Does Medicare cover women's health physiotherapy via telehealth?

Standard private physiotherapy is not covered under Medicare. However, if you have a chronic condition and your GP has set up a GP Management Plan (GPCCMP), you may be eligible for up to five Medicare-rebated allied health sessions per year through the Chronic Disease Management program. Telephysio Australia provides these sessions completely gap-free and bulk-billed, so eligible patients pay nothing out of pocket. Ask your GP whether this applies to you.

I live in a rural or remote area. Can I still access women's health physiotherapy?

Yes. Telehealth physiotherapy is available to anyone in Australia with a smartphone, tablet, or computer with a camera and internet connection. As the research by Dwyer and Lin (2024) and McPherson and Nahon (2021) shows, women in rural and remote areas are exactly the group who face the biggest shortage of specialist pelvic health physiotherapy locally, and who have the most to gain from telehealth access.

How do I get started?

If you have a chronic condition, speak with your GP about whether a GP Management Plan and a referral for allied health sessions is right for you. If you already have a referral, or you would like to book a private session, you can book directly at telephysioaus.com.

A note on the research

Every study referenced in this blog post is published and peer-reviewed. All specific figures come directly from the original source documents and are attributed to them. We encourage you to look them up if you would like to read further.

It is also important to be upfront about what the evidence does and does not show. The research on telehealth for women's pelvic health is growing, but it is not as large as the evidence base for in-person physiotherapy or for telehealth in other areas of physiotherapy. The da Mata et al. (2021) review included just four studies. The Lima et al. (2025) trial had 50 participants. These are genuinely useful findings and consistent with a broader positive trend in the literature, but they should be read proportionally. The evidence is encouraging, and it continues to grow.

Summary

Bladder leakage, pelvic floor problems, recovery after birth, pelvic pain, and menopausal musculoskeletal health are among the most common health issues affecting Australian women, and among the most undertreated, especially outside major cities. Physiotherapy is the evidence-based, first-line treatment for many of these conditions. The current research supports telehealth as an effective and well-accepted way to deliver pelvic health physiotherapy, with peer-reviewed randomised trials showing meaningful improvements in bladder symptoms, pelvic floor function, and quality of life.

In very remote Australia, there are fewer than half the number of physiotherapists per person compared to major cities, and physiotherapists with specialist pelvic health training are scarcer still. Where a dedicated, locally based pelvic health service can be resourced, that remains the ideal. But where it can't, which is the reality for most remote communities, telehealth is a genuine, evidence-backed way to access timely care rather than a fallback of last resort.

At Telephysio Australia, we provide gap-free, bulk-billed physiotherapy for eligible patients referred by their GP under a chronic care plan (GPCCMP), with no out-of-pocket cost for those who qualify. To find out whether you are eligible, speak with your GP, or visit us at telephysioaus.com.

References

Continence Health Australia (formerly Continence Foundation of Australia). Key statistics on incontinence. Based on: Deloitte Access Economics. The Economic Cost of Incontinence in Australia. Continence Health Australia; 2024. Available at: continence.org.au

da Mata KRU, Costa RCM, Carbone EDSM, Gimenez MM, Bortolini MAT, Castro RA, Fitz FF. Telehealth in the rehabilitation of female pelvic floor dysfunction: a systematic literature review. International Urogynecology Journal. 2021;32(2):249-259. doi: 10.1007/s00192-020-04588-8. PMID: 33175229.

Dumoulin C, Cacciari LP, Hay-Smith EJC. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database of Systematic Reviews. 2018;10(10):CD005654. doi: 10.1002/14651858.CD005654.pub4.

Dwyer S, Lin I. Evaluation of a pelvic health physiotherapy service in remote Australia. Australian and New Zealand Continence Journal. 2024;30(3):60-72. doi: 10.33235/anzcj.30.3.60-72.

Jean Hailes for Women's Health. Pelvic Pain in Australian Women: A Report from the 2023 National Women's Health Survey. Jean Hailes for Women's Health; 2023. Available at: jeanhailes.org.au

Lima TVO, Borges Moura AP, Monteiro Carbone E, Gimenez MM, Bortolini MAT, Castro RA, Fitz FF. Pelvic floor muscle training by telehealth to treat female stress urinary incontinence: a randomized clinical trial. International Urogynecology Journal. 2025;37(4):935-944. doi: 10.1007/s00192-025-06336-2.

McPherson K, Nahon I. Telehealth and the provision of pelvic health physiotherapy in regional, rural and remote Australia. Australian and New Zealand Continence Journal. 2021;27(3):66-70. doi: 10.33235/anzcj.27.3.66-70.

Ozdincler AR, Korkmaz Dayican D, Ozyurek B. The effects of pelvic floor muscle training applied via telerehabilitation during the postpartum period: a randomized controlled study. Telemedicine and e-Health. 2025;31(7). doi: 10.1089/tmj.2024.0540.

Simmich J, Ross MH, Russell TG. Real-time video telerehabilitation shows comparable satisfaction and similar or better attendance and adherence compared with in-person physiotherapy: a systematic review. Journal of Physiotherapy. 2024. doi: 10.1016/j.jphys.2024.06.001.

Thomas E, Lee CMY, Norman R, Wells L, Shaw T, Nesbitt J, Frean I, Baxby L, Bennett S, Robinson S. Patient use, experience, and satisfaction with telehealth in an Australian population (Reimagining Health Care): web-based survey study. Journal of Medical Internet Research. 2023;25:e45016. doi: 10.2196/45016. PMID: 37590037.