Unlocking the Benefits of Pelvic Health Physical Therapy: Understanding The Pelvic Floor and Beyond
Jenny Donahue, DPT, Director of Clinical Operations
January 9, 2025

Let's talk about something super important but often whispered about – the pelvic floor muscles. It's time to shine a spotlight on how physical therapy (PT) can help improve pelvic health, and overall quality of life.

Who Can Benefit from Physical Therapy for the Pelvic Floor?

Spoiler alert: It's MORE people than you think. Pelvic health therapy isn't just for one specific group – we all have a pelvic floor.

Postpartum

Pregnancy and birth create lasting changes in your body that can continue long after delivery. That's why we say "Once you're postpartum, you're ALWAYS postpartum." Some changes might need extra care and support - whether that's right after birth or years later. This is completely normal, and physical therapy can help your body feel stronger at any stage of motherhood.

Menopause Transitions

Peri and post-menopausal people experience hormonal shifts that can impact the pelvic floor and pelvic health. Targeted physical therapy  provides crucial support during these changes.

Anyone Experiencing Intimacy Challenges or Painful Sex

Research shows nearly 1 in 4 women experience pain during intimacy. It's crucial to understand: pain is not a normal experience, and there are effective ways to address it.

Anyone experiencing incontinence.

Bladder control and urinary challenges are more common than many realize, and the pelvic floor is a crucial component of most. This is another one where leaking urine of any amount (yes, even when you sneeze) is common, but abnormal and something that pelvic health therapy can help address. 

Understanding the Pelvic Floor: Your Body's Hidden Powerhouse

Picture your pelvic floor as an intricate hammock of muscles stretching across the base of your pelvis – a complex, supportive network that does so much more than you might imagine. Just like a building's foundation keeps everything stable and supported, these incredible muscles create your foundation for everyday function. These muscles work in harmony with other supporting muscles to make up your “core”.

The pelvic floor is a group of muscle and connective tissue that span the bottom of the pelvis. It plays many critical roles:

  • Provides structural support for pelvic organs, including the bladder, rectum and uterus.
  • Controls when you pee, poop or pass gas
  • Maintains core stability in tandem with the diaphragm, abdominal and spinal muscles
  • Supports sexual function
  • Supports vaginal delivery during childbirth

Research from the National Institutes of Health highlights that these muscles work around the clock, contracting and relaxing to support daily functions that we often take for granted. When these muscles become weak, tight, or dysfunctional, it can lead to a range of challenges from incontinence to pelvic pain.

What to Expect in an Initial Physical Therapy Session for Pelvic Floor Symptoms?

Let's talk about what happens in your first PT visit. Think of it as a getting-to-know-you chat, but for your body. This isn't just about muscles – it's about understanding your entire body as an interconnected system. In your first session you’ll:

  • Start with an in-depth conversation about  what's bothering you and your symptoms. This is one of the, if not the most, important parts of the first session.
  • Analyze how your body moves and discuss why you may be experiencing your symptoms - this may involve squats, single leg balance, breathwork or other movements that might be contributing to what you’re feeling.
  • Work together to create a plan based on what you’ve shared and what your PT observes. This plan will be tailored to you in a way that fits your life and goals.

PT is a personalized treatment— it’s about giving you the tools and knowledge to understand your unique body better and develop strategies. Your PT will help you build the tools (both physical and mental!) to tackle whatever challenges come your way.

What is an internal exam? 

Let's talk about something that often comes up when discussing pelvic health physical therapy. You might have heard someone say (or wondered yourself), "Isn't pelvic health physical therapy where the doctor sticks her finger up my vagina?" It's a fair question, and we're here to explain what this field of healthcare and the internal exam is really all about.

What happens in the internal exam?

During this assessment, your physical therapist inserts one gloved finger into your vagina or anus to examine tension, muscle strength, coordination, and function - typically while you lay on a treatment table. Think of it like a check-up specifically focused on your pelvic floor muscles - these muscles play a key role in everything from bladder control to core stability.

Is it always needed?

Not at all! When internal exams are part of treatment, they're just one small piece of a much bigger picture. No muscle or muscle group operates in isolation and an evaluation of your pelvic floor muscles while you’re laying down doesn’t provide much information about what your body does in standing or in motion. The best approach is a  a comprehensive approach, looking at you as a whole person. Your PT will  analyze your movement patterns, investigate what's causing your symptoms, and even look at your breathing patterns. (Fun fact: the way you breathe can significantly impact your pelvic floor!)

What if the internal exam makes me uncomfortable?

Your comfort is a top priority. We encourage you to share any concerns or relevant history with your PT. They’ll work with you to provide treatment within your comfort zone. Remember - there are always alternatives, and your PT is here to work with you to find the best approach for your needs.

How is the internal exam done at Kins?

At Kins, we do things a bit differently - all appointments are virtual. If your provider thinks an external or internal exam would be helpful, they'll guide you through performing one yourself. This approach has a big benefit: you'll learn what healthy pelvic floor function should feel like while maintaining complete control of your experience.

Practical Considerations: Costs and Access

While approximately 80% of pelvic health physical therapy providers can be out of network, Kins works with commercial insurance and Medicare, reducing your out-of-pocket expenses to address your pelvic floor symptoms.

Virtual Physical Therapy: Healing from Wherever You Are

Virtual physical therapy has emerged as a powerful, convenient and effective mode of care. By leveraging technology, patients can receive dedicated one-on-one time with their physical therapist, enjoy flexible scheduling, and discuss sensitive health matters from the comfort of their own home. Virtual PT gives you the best of both worlds - you can get expert care from anywhere, plus enjoy the extra comfort of being in your own space.

Taking the First Step

Your journey to improved pelvic health and wellness is just beginning. Book an appointment online to explore your options and start your path to recovery.

*Disclaimer: Always consult with healthcare professionals for personalized medical advice.*

Share this article