What Is Pelvic Floor Therapy?

Many people don’t think about their pelvic floor until something feels “off.” Bladder leaks when you laugh. Pain during daily activities. A feeling of pressure or weakness after childbirth. While these symptoms are common, they are not something you have to live with.  

At Covenant Health Therapy Centers, our pelvic floor specialists help patients understand what’s happening in their bodies. They create personalized treatment plans to improve strength and quality of life. 

What is the Pelvic Floor? 

The pelvic floor is a group of muscles and connective tissues located at the bottom of the pelvis. These muscles support: 

• Bladder 
• Bowels 
• Reproductive organs 
• Core stability 
• Balance 
• Movement 

They play an important role in pregnancy, childbirth, postpartum recovery and sexual health. 

Physical therapist Emily Thompson, PT, DPT, says patients are often surprised to learn how much the pelvic floor does: “The pelvic floor helps maintain continence. But it also serves in dynamic support roles during load transmission and shock absorption.”  

Who Is At Risk? 

Several factors can contribute to pelvic floor dysfunction, including: 

• Pregnancy, childbirth and breastfeeding 
• Hormonal changes 
• Perimenopause and menopause  
• Aging 
• Surgery 
• Prostate growth 
• Chronic constipation 
• Certain medical conditions 
• Stress 

Pelvic floor issues aren’t limited to one group. Thompson says: “Individuals may experience pelvic health issues across the lifespan from childhood to advanced age.” 

Common Symptoms of Pelvic Floor Dysfunction 

Pelvic floor dysfunction can look different for every patient. Symptoms may include: 

• Urinary leakage or urgency 
• Frequent urination 
• Difficulty emptying the bladder 
• Bowel dysfunction or constipation 
• Pelvic pain or pressure 
• Lower back, hip or tailbone pain 
• Pain during intimacy 
• Feelings of pelvic heaviness or prolapse symptoms 
• Core weakness or instability 

Many of these symptoms are treatable with specialized physical therapy. 

Pelvic Floor Evaluations 

For many people, seeking pelvic floor therapy can feel intimidating. Thompson emphasizes that patient comfort and consent guide every evaluation. 

“I do not always recommend internal examination on the first day but will advise if warranted and at the consent of the patient,” she says.  

Instead, the initial visit often begins with a discussion of symptoms, medical history and personal goals. Thompson uses a systems-based approach that may include evaluating: 

• Sensory screening 
• Reflex testing 
• Range of motion 
• Posture 
• Endurance 
• Coordination 
• Muscle length 
• Strength 

Thompson reiterates the importance of clear communication during examinations: “My clients should not be surprised by anything that I do. I should have already described it ahead of time and in real time.” 

How Pelvic Floor Therapy Helps 

Successful pelvic floor therapy is about more than building strength. It often focuses on improving muscle coordination, movement patterns and body awareness. 

Thompson says one of the most important parts of treatment is listening. 

“I may be receiving information about a person’s bladder and bowel routine as well as intimacy or history of abuse,” she explains. “If we provide the space for listening, we may provide more individualized and sensitive interventions.” 

Treatment plans are tailored to each patient and may include: 

• Pelvic floor muscle training 
• Relaxation techniques 
• Breathing exercises  
• Core strengthening 
• Movement and posture training 
• Bladder and bowel education 
• Home exercise programs 
• Biofeedback and other therapeutic tools when appropriate  

“More than 80% of what I teach patients is coordination, whether coordinating pelvic floor and abdominal wall with or without breath cycle,” she explains. 

Consistency also matters more than technology. “A device is only as good as the consistency someone puts into it,” she says. 

Pelvic floor therapy is most effective when patients actively participate in their recovery and communicate their goals. “You are the most important part of the team,” Thompson says. “Make goals with your therapist.” 

Breaking Stigma Around Pelvic Health 

Many people delay seeking care because they feel embarrassed, assume symptoms are normal or believe problems will improve on their own. Thompson hopes to change those perceptions. Pelvic floor issues are common and treatable. 

“‘Peeing on myself’ is believed to be a global experience postpartum,” she says. “People think that’s just how it is.” But she stresses that symptoms shouldn’t be ignored.  

While symptoms such as urinary leakage are common, they should not be accepted as inevitable. Pelvic floor therapy can help many patients return to running, exercising, working, traveling and enjoying daily life. 

Expert Pelvic Floor Care Close to Home 

Covenant Health offers pelvic floor therapy across East Tennessee. Our expert therapists deliver compassionate, individualized care. Whether you’re navigating postpartum recovery, aging challenges or new symptoms, our team is here to help you move forward. 

Find a pelvic floor specialist near you today.