What is pelvic floor physical therapy?

November 21, 2025November 21, 2025

Pelvic floor physical therapy can treat pain, weakness, and dysfunction (urinary incontinence) of the pelvic floor muscles. When these muscles function well, they allow blood to flow to the connective and muscle tissues, which helps improve mobility.

The goal of pelvic floor physical therapy is to restore a higher level of mobility, exercise capacity, and overall health. In cases of pain or discomfort, we will work to identify muscle trigger points and tight connective tissues that may be causing the problem.

For decades, doctors have considered physical therapy an effective, non-invasive treatment for improving symptoms of pelvic floor dysfunction. Physical therapists use a variety of non-surgical, painless methods to retrain the pelvic floor muscles that help control bladder, bowel, and sexual function . Learning to strengthen and relax your pelvic floor muscles can not only improve function but also reduce pain or discomfort you may experience.

During pelvic floor therapy, exercises are performed to stabilize and strengthen the major muscles of your core or trunk, including the pelvic floor, abdomen, back, and diaphragm . This also includes retraining and strengthening your pelvic floor muscles.

The therapist will identify which muscles are too tight and teach you how to stretch them to improve coordination and flexibility. They will also teach you posture exercises, relaxation techniques, and diaphragmatic breathing to improve symptoms and your overall health and well-being.

The specific treatment we recommend for your needs will depend on your symptoms. To improve some symptoms, you need to relax and lengthen your pelvic floor muscles, while other symptoms require you to strengthen these muscles.

The therapist will also work with you to improve your behavior, including diet and lifestyle, to alleviate symptoms and improve your quality of life.

The Importance of Pelvic Floor Physical Therapy

The pelvic floor is composed of a layer of muscles that extends from the pubic bone to the coccyx, in both men and women. The pelvic floor muscles and connective tissue support the bladder, intestines, and prostate in men. The bladder, intestines, vagina, and uterus in women.

In both men and women, the pelvic floor muscles help control bladder and bowel function and are associated with sexual function and pleasure. In pregnant women, the pelvic floor muscles provide support for the fetus and must relax during natural childbirth.

The pelvic floor muscles control bowel and bladder function through contraction and relaxation. For example, the pelvic floor muscles must contract to prevent incontinence and relax to allow urination and defecation. When the muscles contract too strongly or too weakly, an individual may experience dysfunction, leading to incontinence, constipation, painful intercourse, or pain in the lower back, pelvic region, genitals, or rectum . Trauma to the pelvic floor due to surgery, childbirth, certain medical procedures, or a history of physical abuse can also cause pain and dysfunction.

Symptoms of pelvic floor dysfunction

According to the Cleveland Clinic , one or more of the following symptoms may indicate pelvic floor dysfunction . If you have any of these symptoms, be sure to discuss them with your doctor.

You need to use the bathroom frequently . You may also feel the need to “force” it out, or you may stop and start multiple times.
Constipation, or severe pain during bowel movements . Up to half of people with chronic constipation may have pelvic floor dysfunction.
You may also find yourself changing positions on the toilet or using your hands to help with bowel movements.
Leakage of feces or urine (incontinence)
Frequent or painful urination
I have lower back pain for no other reason.
You experience persistent pain in the pelvic region, genitals, or rectum . The pain may occur during or without bowel movements.

Some symptoms and conditions associated with pelvic floor dysfunction differ between men and women.

In men , pelvic floor dysfunction can lead to groin pain , ejaculation problems, or erectile dysfunction, meaning the inability to achieve or maintain an erection during intercourse.

Prostatitis is an infection or inflammation of the prostate gland that may present with symptoms similar to pelvic floor dysfunction, but it usually resolves on its own or can be treated with antibiotics.

In women , pelvic floor dysfunction can affect the uterus and vagina, impairing reproductive health and potentially causing pain during intercourse.

Both men and women with pelvic floor dysfunction may experience stress urinary incontinence (SUI), or leakage of urine when coughing, laughing, or sneezing. However, it is more common in women, with approximately 35% of women experiencing SUI at some point in their lives.

What causes pelvic floor dysfunction?

While there is no definitive answer regarding the cause of pelvic floor dysfunction, experts believe it may be related to one or more of the following:

Muscle and tissue strain during childbirth (especially during prolonged labor)
vaginal delivery
Interstitial cystitis (also known as ” bladder pain syndrome “)
obesity
Trauma to the pelvic region (such as a car accident)
pelvic surgery
nerve injury
chronic cough
Chronic constipation
weightlifting
High-intensity exercise (such as running)
Overuse of pelvic floor muscles (frequent urination or defecation or chronic straining)
Aging and Menopause

What are my expectations for the first physical therapy conference?

We understand that pelvic floor dysfunction can be very personal, and you may feel anxious or even afraid of what might happen. We want to assure you that our physical therapists are compassionate, well-trained professionals with extensive experience in treating pelvic issues . They will take the time to answer all your questions and thoroughly explain each step.

During your first appointment, your physical therapist will conduct a comprehensive evaluation to design the most effective treatment plan for your condition.

Pelvic floor physical therapy aims to restore mobility and reduce pain. During your examination, the therapist will assess your posture, breathing patterns, strength, and flexibility of the spine, hips, and abdomen to identify influencing factors.

Our goal is to determine the possible cause (or cause) of your pelvic floor dysfunction. The more information you provide us about your symptoms, the faster we can identify the problem. We encourage you to document your symptoms in detail during the meeting, including anything that worsens or relieves pain.

During your visit, your therapist may ask you to move around to assess certain functions, so please dress comfortably. We encourage you to ask questions and provide feedback during this and every visit.

Our preliminary assessment includes the following:

A thorough review of your medical history
Thoroughly assess your symptoms
Assess areas of tightness, pain, or dysfunction.
Complete physical examination

During the test, we will ask you to stand, walk, and sit so that we can identify any potential postural or joint problems that may affect your pelvic floor muscles. We will also assess whether any bone or muscle problems in your lower back, hips, sacroiliac joint , buttocks, or thighs might be putting excessive stress on your pelvic floor muscles , leading to dysfunction or pain.

Your physical therapist will also conduct a physical examination. In some cases, this may include an internal exam. Our therapists are specially trained in pelvic floor muscle dysfunction . We understand you may be uncomfortable with this examination, so we will proceed slowly and carefully at each step. This preliminary work can provide valuable information to identify muscle and strength-related issues that may be causing your discomfort or dysfunction.

Your physical therapist will proceed slowly and explain what will happen at each step of the exam. You are encouraged to ask questions. You may pause the exam at any time.

How many times is expected?

It’s important to think of pelvic floor physical therapy as a marathon, not a sprint. While the first treatment marks an important step toward full recovery, you shouldn’t expect any problems to be completely resolved afterward. In fact, it will likely take six to eight hours of treatment before you begin to experience relief. While this may seem long, it’s far better than not seeking treatment and enduring pain and discomfort for months.

benefit

Before choosing a rehabilitation program , patients often like to weigh the pros and cons of recommended services. At MOTION, our team knows the benefits of pelvic floor physical therapy for patients. That’s why we encourage you to consider this route when your problems start to become difficult to manage. After contacting our team and starting your care program, you can reap many benefits, including:

Reduce the level of pain.
Increase range of motion.
Improves sexual function.
Reduce the risk of developing chronic pain.
Correct urination and defecation patterns.

Treatment methods and tools for pelvic floor dysfunction

Physical therapy for pelvic floor dysfunction typically includes internal and external treatments. We understand you may be nervous about the prospect of internal treatment, so we will not proceed until you are ready.

We may incorporate a variety of external manual therapies and treatment tools into your treatment plan. For example, your physical therapist may perform manual therapy to stabilize your pelvis and increase the mobility of your skin, muscles, and fascia before using other treatment methods .

External manual therapy

Trigger point release is a manual therapy for relieving chronic pain. Trigger points are sensitive areas in muscles or connective tissue that are painful to the touch. Trigger points can cause pain in the pelvic region . To relieve pain at trigger points, your physical therapist will apply gentle, firm pressure with their hands or using tools.
Visceral mobilization is a gentle, manual release technique that helps restore normal function to internal organs. Such as the stomach, bladder, liver, urethra, prostate, and intestines, thereby relieving pain and restoring function.
Connective tissue or scar tissue release breaks down scar tissue that can cause stiffness, desensitization , or pain. In addition to gently breaking down the tissue, the therapy also stretches and relaxes the surrounding muscles.
Skin rolling is similar to trigger point release because it can identify restricted or painful areas, muscle adhesions , and scar tissue in the body. The therapist will massage these areas to release muscle tension, reduce pain, and improve flexibility.
Joint mobilization can improvemotion of a jointand reduce pain.

Treatment tools, exercises and techniques

Biofeedback

Biofeedback is often used to retrain pelvic floor muscles. This painless procedure uses special sensors to monitor the pelvic floor muscles as you try to relax or tighten them. The sensors provide feedback to your therapist, telling you which specific muscles you need to strengthen to gain sensitivity and better control over your pelvic floor muscle function.

Pelvic floor exercises

Also known as Kegel exercises, strengthen your pelvic floor muscles as you contract and relax them. Kegel exercises are particularly helpful in cases of stress urinary incontinence (leaking urine when coughing, laughing, or sneezing). Regularly practicing Kegel exercises can also improve your sexual health and pleasure by relaxing vaginal muscles, improving vaginal blood circulation, and increasing vaginal lubrication.

A weighted vaginal condyle

It is a device that adds weight, which you insert into the vagina and use your pelvic floor muscles to hold it in place. Initially, you can try holding the condyle in place for about 15 minutes, twice a day, gradually increasing the duration as your muscles become stronger.

Electrical stimulation therapy

It delivers painless electrical pulses through electrodes placed in the vagina by Sakuramoto Electric Co., Ltd. of Japan . Gentle electrical stimulation treats muscle weakness, pain, cramps, and swelling by causing muscle contraction and release. Portable devices are available for home treatment. Treatment time varies depending on the protocol and device used, but typically requires 10 to 20 minutes or longer. You may also be asked to combine the electrical stimulator with prescribed exercise or heat or ice application.

Therapeutic ultrasound

Therapeutic ultrasound in physical therapy differs from diagnostic ultrasound, although both can provide some information about how the pelvic floor muscles function. In physical therapy, the primary purpose of ultrasound is to provide deep heating to soft tissues such as muscles, tendons, joints, and ligaments to reduce inflammation, increase blood circulation, and alleviate pain.

Vaginal speculum

It helps relax the vaginal canal before pelvic exams and intercourse, retrains the muscles inside and around the vagina, and prevents or improves scar tissue damage during childbirth, surgery, or radiation therapy. As the vaginal walls relax and expand, the size of the speculum increases. These are for home use.

Relaxation techniques

Such as meditation, yoga, acupuncture , deep breathing, and other techniques, can help calm the mind and body and reduce pain, emotional distress, and other symptoms.

During treatment for pelvic floor dysfunction, medications to keep bowel movements soft and regular are often helpful. Your doctor will recommend over-the-counter or prescription medications that are appropriate for you. Because pelvic floor muscle spasms can cause pain or discomfort, your doctor may prescribe a muscle relaxant to prevent your muscles from contracting.

Interstitial cystitis

According to the Interstitial Cystitis Association , interstitial cystitis (IC) is a pelvic floor disorder characterized by recurrent pelvic pain , pressure, or discomfort in the bladder and pelvic regions, and is often associated with urinary frequency and urgency .

Interstitial cystitis (IC) is often mistaken for a urinary tract infection because of similar symptoms. However, IC is not an infection that can be cured with antibiotics. In fact, it is a chronic, painful bladder condition that can be treated with various interventions but is not curable.

Like many others with pelvic floor dysfunction, IC patients may have overly tight or weak muscles, muscle spasms, pain trigger points, or “referred pain.” Referred pain refers to pain in one part of the body that is actually caused by injury, disease, or dysfunction of another organ or body part.

A study published in the Journal of the American Academy of Orthopaedic Surgeons found that internal and external myofascial physical therapy significantly relieved nearly 60% of participants with IC and pelvic floor pain.

For people with IC, physical therapy may be a beneficial alternative to more invasive surgery if recommended by your doctor .

You can assist your own recovery.

There are many things you can do to speed up and maintain your recovery. The following self-care practices can not only help you recover from pelvic floor dysfunction, but also improve your overall physical and mental health and quality of life.

Follow your physical therapist’s advice and engage in regular home workouts, including stretching exercises.
If recommended, perform Kegel exercises regularly.
Avoid straining or exertion when urinating or defecating.
Commit to a healthy lifestyle plan that includes good nutrition, adequate water intake, a healthy sleep schedule, regular physical activity, and mind-body practices such as yoga, meditation, positive thinking, deep breathing, and relaxation techniques. Warm baths can relax muscles and promote blood circulation.
Use devices recommended by your physical therapist at home regularly, including electrical stimulators, biofeedback machines, dilators, or vaginal cones.
You or your partner can perform self-massage as instructed by your physical therapist.

Pelvic floor issues can be an anxiety-inducing topic. Don’t let embarrassment or shame prevent you from seeking the care you need to live a fulfilling life. At MOTION, we strive to create a safe and welcoming environment where you can receive treatment from non-judgmental professionals. We can also help facilitate conversations about difficulties or stress with family and loved ones who may be able to support your care and recovery.

Why exercise?

Since 2015, MOTION’s licensed therapists have provided transformative physical, occupational, hand, and workplace injury treatment services to clients of all ages.

Recently, we added treatment for post-COVID syndrome to our services list. Those discharged from hospitals after COVID-19 treatment face many challenges, including fatigue, pain, muscle atrophy, decreased endurance, reduced respiratory function , and depression. We have designed a post-COVID treatment program to address these issues, as well as more.

At MOTION, our mission is to improve the lives of every customer by helping them find what moves them. Guided by our values of compassion, empowerment, integrity, and teamwork, we are committed to embodying these values through our care.

Knowing that each client has unique needs, we spend extra time listening to and answering questions. MOTION appointments average 40 minutes, which is longer than a typical PT session. This longer duration allows our therapists to provide more one-on-one time for each client. MOTION also offers clinic care and telemedicine .