Functional Infertility

Are you trying to get pregnant and there is no success? Gynecologist didn’t find any health problems, but your attempts are without results? In this article we will try to explain the infertility problematics from the physiotherapeutic point of view, we will explain you the close connection between infertility and physiotherapy, and together we will find a problem how to quickly solve this problem!


By general term “infertility” it is understood in medicine as a condition when the woman is unable to get pregnant for over a year during a regular (2x per week and more) sexual intercourse. The reasons can be varying:

  • Organic cause - hormonal influence, uterine problems, ovaries, endometriosis (condition during which the tissue that normally grows inside the uterus grows outside it).
  • Functional cause - disorders of the movement system, psychological disorders (disorders of a psychological origin caused by mental process).

It would be also ideal if your partner would take fertility tests as well!


Pelvic muscles play a big role in the functionality of the female reproductive system - pelvic floor. We often meet with spasms in the pelvic floor area, which can reflexively pull the muscle fibres, and rotate the whole pelvis, and muscles have to overcome a big pressure, which has effect on the tension setting in the pelvis.

Second key role in this problem has diaphragm - the breathing stereotype/pattern and setting of the intra abdominal pressure. In most cases we discover incorrect coordination between the muscles of the diaphragm, pelvic floor muscles, and paravertebral muscles (muscles alongside the spine) and abdominal muscles.


Both of the mentioned causes above are closely related. In clinical finding and diagnosis we often meet with women who suffer from pain in the tailbone area, as a place of attachment of most of the muscles of the pelvic floor in the area of symphysis (fibrocartilaginous fusion between two bones). It is also a common place of occurrence of the trigger points, which are very sensitive points that get irritated by touch. These trigger points can be also found in the area of the attachment of the gluteal muscles, inner rotators of the hip joints and adductors of the hip joints, inner side of the thighs. Manifestation of the functional sterility can be also weakened buttocks muscles and standing for a long time on one spot which the patients can’t withstand. In such moments the function of the buttocks is taken over by the muscles along the spine which automatically get overloaded. These disorders of the movement system usually lead to functional blockages, especially in the transition to the thoracic and lumbar spine, cervical spine and even in the area of the tailbone. Blockages in the spine can often cause headaches, which often affects the patients.

Wrong breathing stereotype/pattern leads to pulling the abdominal wall in. Dysfunction of the diaphragm causes overload of the abdominals, where we can often find the trigger points.

Disorders such as infertility also carry with itself very strong psychological problems and stress. These factors can be always manifested on the movement system and it is important to count on it in the therapy, because they can worsen the current situation.


Thorough anamnesis absolutely fundamental for a correct diagnosis of a functional infertility, correct kinesiological examination (sum of methods used by the physiotherapist in order to determine the diagnosis), ultrasound can also be effective because it can reveal the exact condition of the soft tissues.


There are many ways how to treat the dysfunctions in modern physiotherapy. Basic approach is affecting the soft tissues and relaxing them. The areas which need to be focused on are pelvis, thoracic, lumbar and cervical spine and chest as a whole. For a correct setting of the breathing stereotype/pattern and function of the chest, it is important to relax the soft tissues in the thorax area on the level of the skin, subcutaneous tissue, fascia of the muscles. Integral part of the therapy of the chest is also activation of the deep stabilizing system (muscles that partake in keeping the correct body posture against the gravitational pull) and correcting the function of the diaphragm, which also involves important correction of the whole breathing stereotype/pattern. Activation of these muscles leads to straightening of the spine, stabilization of the whole trunk and correct coordination of the deep and surface muscles. With mobilizing techniques focused on the lumbar and thoracic spine along with ribs, we will achieve the harmonization of the muscle tension. On the other hand by relaxing the rest of the soft structures we can reach reflexive relief and blockages. The pelvis area often responds this way along with the SI joints (sacroiliac joints/ joints between the sacrum and pelvis).

          YTRelaxace horních vláken trepézu (1)YTProtaženíí prsních svalů (1) YT Mobilization ribs


Ludmila Mojžíšová is connected to the treatment of functional infertility. She incorporated mobilization techniques into the therapy, relieving the muscles of the pelvic floor per rectum (examining the rectum with a finger) and composition of exercises for daily use. The exercises have a purpose to to set a correct coordination of the abdominal and buttocks muscle groups along with pelvic floor muscles. More about method: Method of Ludmila Mojžíšová.

YTMojzisovaYT shifted pelvisYT big StretchYT YarnYT relaxing buttocksYT stretching thighsYT mobilizing lower backYT Rotating the backYT Bending back


The treatment procedure that we apply is naturally based on the through anamnesis and kinesiological examination (summary of methods used by physiotherapist in order to determine the diagnosis). Every method and procedure described above are in our facility a matter of course. We also use radial shockwave therapy for a fast effect and relief, which has a benefit of penetrating deep into the soft tissues where it immediately startups regeneration process, activation of the cell metabolism, intensive blood supply followed by quick relief in the area of the treated tissues. This method is ideal especially because it has a deep effect in the position of the muscles of the pelvic floor, which are therefore easier to reach. Another place where radial shockwave can be applied are the muscles of abdomen, abdominals, and deep muscles connecting the pelvis with lower ribs. Radial shock wave therapy can penetrate even there and effectively and quickly relieve the tissues and support the bloodstream in the area.


  • Radial shockwave therapy
  • Method of Ludmila Mojžíšová

Author: FYZIOklinika physiotherapy Ltd., Prague, Czech Republic
Source: KOLÁŘ, P. et al., Rehabilitace v klinické praxi. Praha: Galén, 2012. ISBN: 978-80-7262-657-1., Clinical experience in diagnosing and therapy with focused shock wave therapy.

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