Pelvic Floor PT: What It is, Who Needs It, and How It Helps
Have you noticed changes in your core or pelvic floor lately—things just feeling a little “off” down there? Maybe you’ve wondered if pelvic floor physical therapy could actually help, or if this is simply your new normal.
You might even be exploring pelvic health PT as a proactive way to strengthen, protect, and prevent issues in the future.
The truth is, everyBODY has a pelvic floor, and understanding how it works is key to long-term core and pelvic health. In this blog, we’ll dive into what you need to know so you can feel informed, confident, and empowered in caring for your body.
Let’s go!
What is Pelvic Health Physical Therapy?
What IS your pelvic floor?
What diagnoses are treated in pelvic floor PT?
What results can I expect from participating in pelvic floor PT?
What can I expect during a pelvic floor PT evaluation?
How long should I expect to be participating in pelvic floor PT?
Synergy Pelvic Physio’s approach to pelvic floor PT
Exercise and pelvic health
Wondering if you have pelvic floor dysfunction? There is a screening tool for that!
What is Pelvic Health Physical Therapy?
Pelvic health physical therapy is a specialization of physical therapy where we focus on all areas around the pelvis. This includes, of course, the pelvic floor, but also encompasses our abdominals, hips, the organs around our pelvis, as well as our posture and the entirety of how our core works.
This specialization may be referred to as pelvic floor PT, pelvic health PT, or pelvic physio. Some practices may refer to it as women's health PT, and these therapists often only treat clients with female body parts in their practice.
Now, a couple things to point out
Not all pelvic floor PTs are trained in internal evaluation and treatment. While this is not a requirement for pelvic floor PT, internal work can allow us to evaluate and treat certain muscles not accessible any other way.
It’s important to remember that everyone has a pelvic floor—which also means everyone has the potential to experience pelvic floor dysfunction. Unfortunately, this concept still isn’t widely recognized, and men in particular are often overlooked. If you’re experiencing symptoms that may be related to pelvic floor dysfunction, it’s important to advocate for yourself and reach out to a qualified provider for an assessment.
What Is Your Pelvic Floor?
The pelvic floor is a group of small muscles on the underside of our pelvis. There are different layers of these muscles and a number of different functions, the most common of which we will discuss below.
The more superficial layers of the pelvic floor act as ‘squeezers’ to contract around our urethra, vagina (if you have one), and anus to help hold things in. On the flip side - they also need to be able to relax to let things out.
The deeper layer of our pelvic floor acts more supportive and provides a ‘lift’ when contracting. It helps support our organs and is a very important part of our core.
Our pelvic floor also has an important role in sexual function, aiding in pleasure, orgasm, and ejaculation.
If any of these muscles become strained, overworked, or weakened, they will not function like normally should. This is when you can start to see some of the symptoms listed below.
What Diagnoses and Symptoms are Treated by Pelvic Floor PT?
Some of the more common diagnoses and/or symptoms are listed below, but so much can happen in the pelvic region that affects the pelvic floor!
Urinary issues - leakage, frequency, urgency - can be common… but not normal and can wreak havoc on our day to day activities. We want to be able to laugh with our friends, go on a hike, or even struggle with a cough and not have to worry if our bladder will cooperate.
Prolapse - Symptoms of prolapse are not always obvious to us. We could feel a heaviness or pressure feeling, sometimes a feeling like a tampon is falling partway out. We could feel no symptoms of a prolapse, but it still be a contributing factor to our urinary or bowel symptoms. Pelvic floor PT can help with prolapse a number of ways. If we strengthen our pelvic floor it can help with support. Practicing strategies to reduce the downward pressure on our organs and pelvic floor can be a game changer. Also, devices such as a pessary can help physically support our prolapse and, in turn, help significantly reduce symptoms caused by the prolapse. At Synergy Pelvic Physio, I am trained to fit pessaries and excited to offer them as an adjunct to treatment when appropriate.
Pregnancy and Postpartum – Pelvic floor physical therapy can play a vital role throughout this journey for many different reasons. If you’re experiencing pain during pregnancy, PT can help relieve discomfort and improve function. From a birth-prep perspective, therapy focuses on proprioception and coordination—essentially teaching your brain and pelvic floor muscles to work together more effectively. This can make a huge difference during labor, especially when it comes to learning safe and effective pushing mechanics that are tailored to your body.
Pelvic floor PT also provides strategies to help minimize tearing during delivery, along with safe core exercises that maintain strength and reduce the risk of abdominal separation (diastasis recti). Postpartum, therapy continues to be incredibly valuable. At around 6 weeks, we can perform an internal assessment to address scar tissue, restore muscle function, and support your recovery after the many changes your body has been through.
Core stability and strength - Whether you are returning to activities postpartum, trying to get back in shape, or recovering from a diastasis, learning proper core activation is incredibly important.
Bowel issues - incontinence, urgency, and constipation all can be affected by the pelvic floor. Whether we are directly working with the pelvic floor to improve these symptoms, or learning helpful day-to-day strategies to reduce them, pelvic floor PT can be a gamechanger!
Pain - whether it is pelvic pain, tailbone, pain with intimacy, pain with urination or defecation, even hip pain (check out this blog post about hip pain!), pelvic floor PT can be incredibly helpful for this.
What Are Some Results I Can Expect from Participating in Pelvic Floor PT?
Stop leaking with activities
Decreased heaviness feeling in the pelvis
Painfree sex
Improved bowel movements with less straining
Less pain in pelvic region
Improved ability to activate your core and support your whole body
Ability to sit without tailbone pain
Improved preparedness and outcomes for birth
Improved pelvic floor recovery and easier return to activities postpartum
Improvement in c-section scar mobility and pain
Improvement in abdominal strength and gained knowledge of safe exercises for diastasis recti
Do I Need a Referral to See a Pelvic Floor Physical Therapist?
The state of South Carolina has Direct Access for physical therapy. This means you can call, make an appointment, and start seeing a physical therapist without needing a referral from your provider. We do like to communicate with your provider most closely related to your symptoms (Primary care physician, Urologist, Gynecologist, Urogynecologist, Gastroenterologist, Colorectal specialist, etc..) so they are apprised to the progress you are making.
What Can I Expect From a Pelvic Floor PT Evaluation?
At Synergy Pelvic Physio, our evaluations and treatments are all one hour long and always 1:1. At the beginning of your evaluation, we will chat about some of the answers from your intake form and may ask follow up questions to delve a little deeper.
Next is our physical assessment. External areas to assess will include, but are not limited to, diaphragm, abdominals, hip, and back musculature. Certain pelvic floor muscles we can assess externally, but most of the deep layers of our pelvic floor need an internal assessment to truly assess strength, coordination, tension holding, or overactivity. We want you to feel completely comfortable, so this is 100% optional and never performed without your consent. If you are not completely comfortable with an internal assessment on the first day, there is a lot we can assess and work on externally. You can always change your mind to go forward with this at a later date.
After our assessment, we will sit back down to discuss our findings and game plan to reach our goals, and of course a few homework items to work on to expedite reaching these goals.
How Long Should I Expect to be Participating in Pelvic Floor PT?
This depends on many things including how long you have had your symptoms, how consistent you are with attending your visits, and your home exercise program. If you are regularly attending your visits and doing your homework, you will see progress much quicker than if you are not consistent. Most pelvic floor conditions take a few months, but some chronic pain conditions can take longer to treat. Once we are able to start to see some symptom improvement and you have a good home program established to help with carryover between sessions, we will start spacing visits out more.
What is Synergy Pelvic Physio’s Approach to Pelvic Floor PT?
I believe in treating each person individually. There is no specific recipe for each diagnosis, just like there is no person exactly like another. Each person is assessed as a whole - I don’t just look at your pelvic floor, even if your only symptom is stress incontinence. So many things can be contributing to your symptoms up the chain that if we only address your pelvic floor, we could be missing one of the main contributing factors!
Exercise and Pelvic Health
Our pelvic floor is a super important part of our core, which is interesting because I think most of us just picture our abdominals when we think of our core. Our core strength can be a big determining factor when considering our exercise performance.
There are 2 great analogies when it comes to our core - one is of a canister and the other a balloon. So many of our pelvic floor symptoms are related to pressure and how adequately we ‘manage’ these pressures. These analogies give great visuals to better understand this concept. Click here to learn more about these two analogies and how our pelvic floor works with our core!
OK, back to our core..
I often have people asking me how they can stop leaking with jump roping, especially double-unders. A lot of factors come into play here - what are the downward pressures being sent through our body onto our bladder and pelvic floor? How strong is our pelvic floor to help counteract these pressures? What is our posture or form when jump roping? What is the positioning of our bladder and uterus? With regards to this last question, it is not uncommon for our bladder to drop a bit over time - whether it is from childbearing or extra pressures on our bladder over time. It can drop enough to affect your ability to hold your bladder without ever having the typical symptoms of heaviness or something ‘falling out’ that you tend to hear about.
Our hips can have a big impact on our pelvic floor function! If we have a weakness or muscle imbalance somewhere in our hips, our pelvic floor tends to overwork to pick up the slack causing symptoms elsewhere. To read more about the impact of our hips on our pelvic floor click here!
If your goal is to improve your exercise performance, it is crucial to look at your core and pelvic floor function!
Wondering if you have Pelvic Floor Dysfunction?
Click here for access to a quick screening tool that can help you determine if your pelvic floor is contributing to your symptoms!