What Does a Pelvic Floor Therapist Actually Do?

Pelvic floor therapy might not be something you’ve thought much about, but it can have a huge impact on your overall health and well-being. While many people assume pelvic floor therapy is just for postpartum women, the truth is it’s much broader. Pelvic floor therapy can benefit anyone dealing with bladder or bowel dysfunction, pelvic pain, sexual health issues, and even core stability problems.

Understanding the Pelvic Floor

The pelvic floor is a group of muscles that sits in the bicycle seat area of the pelvis. It supports important organs like the bladder, rectum, and uterus (if you have one), and it plays a key role in maintaining bladder and bowel control, sexual function, and even core stability. Essentially, your pelvic floor is involved in how your body moves and functions every day.

When these muscles are out of balance—whether too tight, too weak, or uncoordinated—it can lead to a variety of problems, such as:

• Pelvic pain

• Bladder or bowel incontinence

• Pelvic organ prolapse

• Pain during sex

• Chronic constipation or difficulty emptying your bowels

A Holistic Approach to Pelvic Health

Pelvic floor physical therapy goes beyond just exercises like Kegels. It takes a holistic approach to your health by evaluating how your pelvic muscles interact with your entire body. In fact, a pelvic floor therapist will often start by assessing your posture, movement patterns, and breathing mechanics to understand how everything is working together. Since the pelvic floor is connected to many other systems in your body, addressing the whole picture is crucial to solving the problem at its root.

The Evaluation Process

First, we start with a comprehensive evaluation. We gather information about your symptoms, medical history, and daily activities. But it doesn’t stop there! We’ll also examine your whole body—your posture, movement strategies, breathing patterns, muscle function, and how everything is working together. After that, we’ll assess your pelvic floor directly to see how it’s functioning on its own and in connection with the rest of your body.

You might be wondering, “Why not just focus on the pelvic floor?” Well, imagine your body is like a house with a leaky roof. Fixing just one spot won’t solve the problem if the underlying structure is weak. It’s the same with the body—if other muscles are out of balance, or your core isn’t providing support, treating just the pelvic floor alone won’t bring lasting results. That’s why a holistic approach is so important. The goal is to address the root cause of your symptoms, not just patch up surface-level issues.

What does a Pelvic Exam look like?

People often ask, “What does a pelvic floor exam actually look like?” Well, it’s a bit different from a visit to your gynecologist, urologist, or gastroenterologist.

Pelvic floor exams can be done externally, focusing on the muscles, ligaments, and tissues around the pelvis, lower back, and hips. But we may also perform an internal examination—always with your consent—to get a clearer picture of how your pelvic floor muscles are functioning.

Physical therapists are experts in musculoskeletal and neuromuscular function; we’re not just looking for pain or tenderness. We’re assessing how these muscles are working: their strength, coordination, flexibility, and overall ability to support your body. This detailed evaluation helps us create a personalized plan that targets your specific concerns and restores healthy function.

What Treatment Looks Like

Once the evaluation is complete, your pelvic floor therapist will create a treatment plan tailored to your unique needs. No two bodies are alike, so your plan will be individualized based on your symptoms, lifestyle, and goals.

A typical treatment plan might include:

• Targeted exercises: These can help strengthen or relax the pelvic floor muscles, depending on what’s needed.

• Manual therapy: This hands-on treatment helps release tight muscles, address scar tissue, and improve mobility.

• Core and pelvic muscle coordination: We focus on retraining how your core and pelvic muscles work together for better support and stability.

• Posture and breathing retraining: By adjusting how you sit, stand, and breathe, we can take pressure off the pelvic floor and promote healing.

• Lifestyle modifications: Improving habits such as toileting, stress management, and daily movements will help alleviate strain on your pelvic floor.

Pain Science and Nervous System Retraining

In many cases, pelvic floor dysfunction is influenced by the nervous system. Chronic pain or discomfort can cause the brain to become hypersensitive, interpreting normal sensations as pain. Pelvic floor physical therapy often includes education on how pain works, along with techniques to retrain your brain and nervous system. This helps your brain and muscles communicate better, reducing the perception of pain and improving function.

When Should You Consider Pelvic Floor Therapy?

If you’re experiencing any of the following symptoms, pelvic floor therapy may be a great option for you:

• Bladder leakage during everyday activities, like sneezing or laughing

• Constipation or difficulty with bowel movements

• Pain during sex or tampon use

• Pelvic pain or a feeling of pressure

• Unresolved lower back or hip pain

• Recovery from prostate or gynecological surgery

• Postpartum recovery, even years after childbirth

These are just a few examples of when pelvic floor therapy might be beneficial. If any of these sound familiar, it’s worth considering a consultation with a pelvic floor therapist to see how they can help.

FAQs

• How long does pelvic floor therapy take?

The length of treatment depends on the individual and their specific condition. Some people may see improvement after a few sessions, while others may need longer-term therapy to fully resolve their symptoms.

• Is pelvic floor therapy only for women?

No! Pelvic floor therapy is for anyone who has pelvic floor muscles, which means men and children can also benefit. Conditions like urinary incontinence, constipation, and pelvic pain can affect everyone.

• Does pelvic floor therapy hurt?

Pelvic floor therapy should not be painful. While we may work with areas that are tender or uncomfortable, the goal is to reduce pain, not cause it. Your therapist will ensure that you are comfortable throughout the process.

Conclusion

Pelvic floor therapy is a powerful tool for anyone dealing with bladder, bowel, or pelvic pain issues. By taking a whole-body approach, we can address the root causes of your symptoms and help you feel strong, confident, and comfortable in your body. If any of the symptoms discussed resonate with you, don’t hesitate to reach out to us or another pelvic floor therapist near you—it might just be the solution you’ve been searching for.