Pelvic Health Physical Therapy: A Holistic and Comprehensive Guide For Cis- and Trans- Women, Men, and Non-Binary Folks Who Want to Know if Pelvic Floor PT is Right for Them
Is Pelvic Floor Physical Therapy Right for You?
What a Pelvic Floor Specialist Does, What to Expect, and How to Get Started
Have you been wondering if pelvic floor physical therapy is appropriate for you?
Do you want to understand how your posture and breathing habits support pelvic health?
Do you know what “pelvic floor dysfunction” actually means?
With so much information out there about the pelvic floor—about “good posture,” “good breathing,” and what to do about pelvic symptoms—this blog will answer your questions and clarify what pelvic floor PT is really about, and what to look for in a pelvic health specialist.
Topics in this blog:
3. What does the pelvic floor do?
4. What makes a physical therapist a pelvic floor therapist?
5. How to find a pelvic PT near you
6. Who is pelvic health physiotherapy for?
7. What diagnoses are treated in pelvic floor physical therapy?
8. A list of specific diagnoses that we treat at Bodyful
9. What are the results of pelvic physiotherapy?
10. What to expect at your pelvic floor physiotherapy evaluation at Bodyful
11. How long is treatment for pelvic floor physical therapy?
12. Bodyful Physical Therapy and Wellness approach to pelvic health
13. What does pelvic floor PT cost?
14. How is the pelvic floor part of the “core”?
15. Learn more about pelvic floor PT
16. Do you have pelvic floor dysfunction?
17. About Bodyful Physical Therapy and Wellness
What is pelvic floor physical therapy (PT)?
You may have heard interchangeable names such as pelvic floor physical therapy, women’s health physical therapy, pelvic physical therapy, pelvic physiotherapy, and pelvic health PT. These all refer to the same specialty: working with symptoms that involve the abdomen, pelvis, hips, low back, tailbone, and the nerves that travel from the low back into the legs.
A pelvic floor specialist helps address symptoms by restoring:
posture and intra-abdominal pressure management
breathing and core coordination
hip flexibility and strength
pelvic floor mobility, strength, and relaxation
All genders have a pelvis. All bodies have pelvic floor muscles. That means all bodies can experience pelvic floor dysfunction, and all bodies can benefit from pelvic floor PT when symptoms show up.
What is the pelvic floor?
The pelvic floor is a bowl of muscles at the bottom of the pelvis that supports:
pelvic organs
blood vessels
nerves
lymphatics
There are multiple layers of pelvic floor muscles—from the more superficial urethral and anal sphincter muscles to deeper muscles and connective tissues that support pelvic organs.
All genders share the same pelvic floor muscles, and this is a cis-female pelvic floor image:
The deeper pelvic floor muscles are highlighted.
Here are the superficial pelvic floor muscles for the cis-female and cis-male:
Cis-female
Cis-male
In the visuals, the pubic bone is at the top, and the tailbone is at the bottom. The hip sockets are shown on the right and left sides.
What does the pelvic floor do?
The pelvic floor has many functions:
Postural support + intra-abdominal pressure management: When your rib cage and pelvic girdle are more parallel, your diaphragm and pelvic floor work like a piston. Pressure changes from breathing, twisting, lifting, sneezing, and jumping become muscular power and support.
Sphincteric control: bowel and bladder function
Organ support: bladder, rectum, reproductive organs, and more
Blood and lymph flow: circulation and tissue health
Sexual function: arousal, orgasm, penetration, and pleasure
A healthy pelvic floor frees you up to:
lift weights, dance, hike, sprint, and move with joy
live without fear of losing control of bladder or bowels
have pain-free, pleasurable penetrative sex
breathe for performance—and for speaking or singing
move without pelvic pain
Pelvic health PT focuses on pelvic region symptoms and pelvic floor dysfunction, but the pelvic floor is never treated in isolation. It’s part of a whole-body movement and breathing system, so a pelvic therapy specialist will look above and below the pelvis to find the root cause.
What makes a physical therapist a pelvic floor physical therapist?
Physical therapists are licensed clinicians trained to evaluate and treat movement dysfunction. In the U.S., PTs graduate with a Doctor of Physical Therapy degree (DPT) and must pass the National Physical Therapy Examination and meet state licensing requirements.
To become a pelvic floor PT (also called a pelvic health specialist or pelvic therapy specialist with a board certification), a PT completes additional training, mentorship, and clinical experience focused on abdominopelvic health. This often includes coursework through professional organizations such as the Academy of Pelvic Health Physical Therapy.
Some pelvic PTs also pursue board certification through the American Board of Physical Therapy Specialties.
Important note: Not every pelvic PT is trained in internal pelvic floor examination.
And internal examination is not a requirement for pelvic health physical therapy—though it can provide useful information when appropriate, desired, and consented to.
How to find a pelvic PT near you
If you’re looking for a pelvic floor physical therapist outside of Oakland / the Bay Area, here are directories to find a licensed provider:
Pelvic Guru/Global Pelvic Health Alliance: https://pelvicguru.com/directory/
APTA Pelvic Health provider locator: https://aptapelvichealth.org/ptlocator/
Herman and Wallace practitioner directory: https://pelvicrehab.com/
If you are in Oakland or the Bay Area, Bodyful currently has pelvic health physical therapists treating in clinic. We can also offer virtual pelvic health therapy (for California residents) and wellness services for folks who cannot come into the clinic.
Who is pelvic health physiotherapy for?
Pelvic PT is for anyone with a pelvis!
Some providers focus only on women’s health or only on specific populations. At Bodyful, we aim to be inclusive for all self identified genders and identities. We treat men, women, nonbinary, transgender, intersex populations, and beyond.
We also acknowledge that financial barriers can block access to care. Consider your emotional, energetic, and financial bandwidth. It matters that you are ready and resourced to engage in the work—so you can receive the results you seek.
What diagnoses are treated in pelvic floor physical therapy?
The list is long because the pelvis is complex and connected to everything. Pelvic floor dysfunction can be influenced by posture, breathing, hip mobility, strength, balance, stress, trauma, habits, and more.
Pelvic PT commonly treats:
pelvic pain (including pain with urination, bowel movements, exercise, sex, pregnancy/postpartum, menses, and at rest)
prolapse symptoms (heaviness, pressure, “tampon feeling,” pelvic fullness)
urinary urgency, urinary leakage, fecal urgency, fecal incontinence
pregnancy and postpartum symptoms and rehab
tailbone pain
post-op gender affirmation surgery rehabilitation
post-op abdominal or pelvic surgeries (including scar work)
constipation, IBS, bloating, slow motility patterns
pain with penetrative sex, “hitting a wall,” vaginismus patterns
diastasis recti abdominis (separated abdominal muscles)
pelvic health focused and total body tailored strengthening program during your family planning
and more
The vulva is ready for penetration when it can relax with openness and is receptive. The fear of pain can cause tension and result in tightness. Gently work to gradually improve your connection to your pelvic floor muscles, condition your body, breathe during penetration, take it slowly, and specifically utilize your core support and release compensatory and habitual tension patterns.
Learn to decrease pelvic floor tightening habits in response to stress. Decrease pelvic floor and breath holding compensations during exercise. Restore your feelings of pleasure in relationship to sexual appreciation and gradually explore penetrative sex.
Diastasis recti abdominis (separated abdominal muscles) - Having a 2 to 3 finger-width separation of the abdominal muscles after pregnancy is considered normal. In other words, you can return to a strong and fully functioning core, even if the small gap does not close completely. Pelvic PT can prescribe specific and tailored exercises to strengthen your abdominal muscles after pregnancy.
Conditions We Treat at Bodyful
You are not alone!
We treat pelvic organ prolapse, incontinence, pelvic pain, SIJ/pubic symphysis/tailbone pain, pregnancy and postpartum concerns, pain with sexual intercourse, endometriosis-related pain patterns, interstitial cystitis patterns, diastasis, bowel issues, post-op rehab (fibroids/endometriosis/appendectomy/C-section/vestibulectomy), and erectile dysfunction not caused by hypertension.
We also recognize the real-life, everyday versions of these symptoms—the ones people whisper about or normalize for years.
What Results Are Possible With Pelvic Physiotherapy?
Results vary. Openness to change, beliefs, resourcing, stress, and safety in the therapeutic relationship can all influence outcomes.
Many clients at Bodyful report:
less or no leakage with activity
reduced pelvic pain
less fear of symptoms
more agency and empowerment
improved sex comfort and orgasm capacity
reduced heaviness and pressure
improved scar mobility and decreased pain
better breath + core coordination
improved bowel movements
more freedom and joy of movement
What to Expect at Your Pelvic Floor PT Evaluation at Bodyful
At Bodyful, we prioritize the quality of the therapist-client relationship.
Your comprehensive 75-minute initial evaluation gives you time to:
share your story
be heard
receive a thorough exam
experience treatment
leave with a clear plan and home resources to start with
We assess breathing, posture, movement patterns, and (with consent) touch and palpation. Common areas include the spine, diaphragm, abdominal wall, hip mobility and strength, and how you load your feet.
Internal pelvic floor assessment (vaginal or rectal) is always optional and consensual. We can also begin with external work, mirror therapy, self-touch, and orienting practices. Pelvic health PT is not an OBGYN visit. We are not here to “find what’s wrong with you.” This is a different paradigm.
How Long Does Pelvic Floor PT Take?
Treatment length varies depending on your history and presentation, but typically 4–7 sessions is recommended. Some folks need more, especially with longer-standing pelvic pain patterns.
Frequency can range from weekly to every 2–3 months depending on goals and needs.
Bodyful’s Approach to Pelvic Health
We offer trauma-informed manual therapy and somatic, neuromuscular healing for folks navigating trauma history, hypervigilance, fear of movement, pain misconceptions, stress physiology, and nervous system dysregulation. When needed, we refer to trusted providers to support integrated care.
We blend orthopedics, movement system diagnoses, somatic movement therapy, and pelvic health therapy to support transformative change—grounded in evidence-based practice and continuous learning.
What does pelvic floor PT cost?
Depending on where you go for PT, you may be able to utilize your insurance benefits. At Bodyful, we are out of network with insurance companies. We are a small business, and we could not sustain the administrative burden to get paid by insurance companies, while running a business, and providing the quality of clinical care our clients deserve.
We are also out of network so that you are aware of the cost of PT. You will not be stuck with a bill after the insurance company denies the claim.
You may have out-of-network benefits for pelvic floor PT. Our FAQ at the bottom of our pelvic floor therapy page provides some information to guide how to ask your health insurance company about this. We are also happy to provide you with a monthly superbill, or the paperwork required to submit to your insurance for reimbursement.
Do Posture and Breathing Really Matter?
Yes.
Your pelvic floor is an essential part of your core. Many “core” issues (back pain, hip pain, intra-abdominal pressure management dysfunction symptoms) involve the relationship between breathing, posture, and pelvic floor coordination.
And the brain often has very little awareness of the pelvic floor. Until you train that awareness, you may not know:
how to activate the pelvic floor
how to relax it
how long to hold activation
how to coordinate pelvic floor function with breathing
Anyone can benefit from a pelvic floor assessment—because everyone deserves to feel connected to this grounding part of the body.
When our breathing diaphragm and pelvic floor muscles are parallel to each other, the pressure changes caused by respiration, twisting, forward bending, sneezing, etc., are transferred into mechanical energy generated by support from muscles, ligaments, and tendons. This “pistoning” is similar to how a steam engine is designed.
www.rehabps.com
When we breathe well, we move well. Breathing well and the ability to shift to a supportive posture, gives our abdominal wall muscles a mechanical advantage and they form a coordinated “cylinder” of core support.
The visuals show how the pelvic floor muscles play a role in dynamic stabilization of the spine. Also, if the muscles above the pelvic floor are strong, and the abdominal pressure changes are managed effectively, then the pelvic floor does not have to compensate during sneezing, lifting, laughing, jumping, etc. Pelvic floor muscles compensations can cause a painful, tight, and dysfunction pelvic floor.
It is common to hold the breath during tasks that require abdominal muscles support. The extra tension in the diaphragm from holding the breath redistributes the strain on the abdominal muscles and pelvic floor. This habit can be the cause of pelvic floor dysfunction, low back pain, adductor muscle strains, and even knee pain.
Breath holding during tasks that require core support can lead to pelvic floor dysfunction and can unfortunately include such symptoms as urinary and fecal incontinence, SIJ pain, urinary urgency, pain in the penis, vagina, or rectum, constipation, erectile dysfunction, and tight pelvic floor muscles causing pain during penetrative sex.
How to get started
www.rehabps.com
If you’re not local, use the directories above to find a pelvic floor specialist near you.
If you are curious about working with Bodyful in Oakland or via California telehealth, you can call or text us at (510) 788-1299, book a visit, or schedule a discovery call.
Learn more about pelvic floor physical therapy
Enjoy the resources below:
We also recommend checking out the Vagina Rehab Doctor, Women of Color PFPT Directory, Dr. Catalina Lawsin (sex therapist), North American Menopause Society, pain psychology care at Menda Health, Ehlers-Danlos Society, the Polyvagal Institute, Nancy’s Nook Endometriosis Education, dietician here, and the International Pelvic Pain Society. Trauma-informed, anti-racist, somatically trained mental health providers links are here and here.
Local providers we are fond of:
Disclaimer: the providers below are NOT employees of Bodyful Physical Therapy and Wellness, nor have they been trained by Bodyful Physical Therapy and Wellness. Bodyful Physical Therapy and Wellness is not responsible for any and all actions that may occur while seeing a provider from this directory.
Dr. Ilana Harms, licensed acupuncturist
Dr. Anietie Ukpe-Wallace, PT, DPT and pelvic floor physical therapist
Dr. Shaunic Stanford, PT, DPT, pelvic floor physical therapist and certified Reiki practitioner
The MaMA Space - Holistic perinatal and mental health support
Dr. Anna Frick, urogynecology
Hana Holistic Medical and Wellness Center
Do you have pelvic floor dysfunction?
After reading this blog, are you wondering if you have pelvic floor symptoms?
You can check out the Cozean Screening Tool, developed by Nicole Cozean, PT, DPT, WCS, CSCS, of Pelvic Sanity. You can use the screening tool to decide if pelvic floor PT is right for you.
About Bodyful Physical Therapy and Wellness
Bodyful Physical Therapy and Wellness is a women owned, somatic pelvic health physical therapy clinic in Oakland, CA that gets to the root cause of your pelvic pain symptoms and supports your integrative care for long lasting relief and return to well-being.
As white bodied cis-women, we also work daily to breathe into, deliberately move with, and consciously respond to creating a collective, anti-racist, embodied culture for future generations (Black Octopus Society). We also pay an annual land tax to the Sogorea Te’ Land Trust and help to return land in the East Bay to Indigenous stewardship.
About the Author
Dr. Maryssa Steffen, PT, DPT, and board-certified clinical specialist in Women’s Health, is a pelvic floor physical therapist, a dancer, a healing artist and a movement artist. She is trauma sensitive and values healing at a pace that the nervous system can understand and digest. She is a fierce believer in the power of the body to transform our relationship to ourselves and to our collective consciousness. She is currently studying and practicing for the somatic movement educator training with Body-Mind Centering®, an approved training program of the International Somatic Movement Education and Therapy Association (ISMETA), to become a registered Somatic Movement Educator and Therapist. The program is facilitated by Mary Lou Seereiter at Moving Within.
