Pelvic Floor Physical Therapy: The Benefits and What to Expect
If you're considering pelvic floor physical therapy, chances are you probably have questions about what it involves and whether it's right for you. Like most of my clients, you might wonder why you would see a physical therapist who you thought only treated backs, shoulders and knees? What makes us different? Pelvic floor physical therapists have the same training plus specialized education in pelvic health beyond what is taught in physical therapy school.
What is the Pelvic Floor and What Does it Do?
Think of your pelvic floor like a hammock of muscles inside your vagina or anus. These muscles, known as the levator ani or the pelvic floor muscles serve four main functions:
Bladder and bowel control: keeping urine or stool in and letting it out at the right time
Supporting your organs: holding everything up and where it should be out of sight
Working with your core to keep your body strong and ready for painfree movement.
Making sure sex is comfortable and enjoyable
Here's something interesting - these muscles need to know when to squeeze AND when to relax. It's like a dance: squeeze to hold everything in when you're not ready to go, relax to let things flow when you are ready. And the same applies during intimate moments- these muscles need to know when to engage to enhance pleasure and when to relax for greater comfort during insertion.
When is Pelvic Floor Physical Therapy Beneficial?
Let’s start off by saying, even though many of these pelvic floor concerns are common, they are not normal. You are not the only woman experiencing uncomfortable or awkward moments even if they are not typically discussed over lunch with friends or even with your gynecologist.
When is Pelvic Floor Physical Therapy Beneficial?
Let’s start off by saying, even though many of these pelvic floor concerns are common, they are not normal. You are not the only woman experiencing uncomfortable or awkward moments even if they are not typically discussed over lunch with friends or even with your gynecologist.
Bladder or Bowel Problems: Including Incontinence, Urgency and Frequency
Problems affecting your bladder and bowel may appear in many ways and occur at any age. You might experience urine leakage ranging from small dribbles when laughing to urgent bathroom runs. Some people feel a strong urgency to urinate or have a bowel movement, while others find themselves visiting the bathroom frequently. You might even feel like you need to go again after emptying or notice stool smearing after bowel movements. These are all signs that your pelvic floor needs attention.
Treating Pelvic Pain and Sexual Function with Pelvic Floor Physical Therapy
Pelvic pain is another common concern bringing people to pelvic floor PT and is often described as burning, scraping, dryness, or an aching sensation. You might feel it inside the vagina, anus or outside around your pelvic bones and abdomen. Some common triggers for pelvic pain are tight clothing, periods, sitting, stress and the most common-vaginal penetration. Many women experience pain during penetration with a pelvic exam, while using a tampon or menstrual cup, or during sex. While some women will use a pad instead of a tampon, avoiding intimacy with your partner is something affecting your relationships and is missed by both of you.
Pregnancy and Post Partum Pelvic Floor Rehabilitation
Women often seek help from pelvic floor physical therapists to address body changes occurring with pregnancy. You may be dealing with difficulties controlling your bowel or bladder, or need help recovering from your vaginal delivery or C section. We help prevent and treat perineal tearing, abdominal separation, and support your body’s recovery process. After baby care with pelvic floor physical therapy ensures your body returns back to its pre-pregnancy state, and addresses not only your pelvic floor, but your spine and abdominal wall.
How Pelvic Floor PT Helps with Chronic Conditions and Surgical Recovery
Your body is incredibly resilient, and pelvic floor physical therapy supports you in the healing process. Many women find resolution of symptoms associated with conditions like prolapse, where pelvic organs need additional support, or endometriosis, which can cause persistent pain and digestive issues. Conditions such as vulvodynia, vaginismus, and pelvic floor dysfunction respond well to specialized physical therapy treatment, bringing relief when other approaches haven't helped.
Just as you wouldn't expect your knee to fully recover from surgery without rehabilitation, the same principle applies to stomach, intestinal, and gynecological surgeries. Whether you've had a hysterectomy, bladder sling procedure, hernia repair, or other pelvic surgery, your body needs support to heal optimally. Pelvic floor physical therapy helps restore proper muscle function, improve tissue and scar mobility and teach you how to move freely again. By addressing these needs early, you will be able to return to your daily activities with greater comfort and confidence.
What to Expect at Your First Pelvic Floor Therapy Visit
Your initial visit typically consists of four main parts:
Detailed History: This is your chance to share your experiences and what you want to accomplish in physical therapy. Here are a few recommendations. Think big because you may be surprised by the positive impact of treatment. Remember we have heard it all so do not feel embarrassed. Take time to tell your story, every one is different and we want to hear about you.
External Assessment: Consider this the time where your pelvic floor therapist is learning about your body: how you move, breathe, and how your pelvis hips and core work together.
Internal Examination: Yes, there might be an internal exam, but no, it's not like your typical gynecological visit. There are no stirrups and no speculum. Your pelvic floor physical therapist will insert a gloved finger to examine the coordination and strength of the muscles.
Treatment Plan: Developing a treatment plan is a team effort between you and your physical therapist. It will take into consideration her findings, your goals and the best timeline for how you can reach the outcomes you are seeking.
Common Hesitations about Pelvic Floor PT: Addressing your Worries
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Let’s face it, contracting muscles you cannot see or feel is difficult. It's like trying to play piano by just pressing keys and not learning the notes. Most women need proper training to engage these muscles correctly, and sometimes Kegels aren’t even what your muscles need.
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It's important to know that pelvic health PT is relatively new, and finding specialized therapists can be challenging. Often, the pelvic floor is the missing piece in previous unsuccessful treatments - like the egg that holds the cake batter together.
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Many patients feel this way initially. We can postpone the internal exam until you're ready and start with external treatment. Always communicate your concerns, especially if you have a history of pain, trauma, or anxiety.
The Next Step towards Better Pelvic Health
If you are still unsure, reach out to a clinic that specializes in pelvic health. Many offer phone consultations so you can get to know their approach and expertise. Not all pelvic floor physical therapists have the same education or level of experience. Don't hesitate to ask friends for recommendations - you might be surprised how many women have overcome their own struggles with pelvic floor physical therapy.
Remember: you deserve to feel confident and comfortable in your body. While these symptoms are common, there's no need to accept them as your new normal. Pelvic floor physical therapy offers effective, proven solutions for pain, leaking, pressure, weakness- and so much more as it relates to your pelvic floor and body.