Somatic Therapy For Pelvic Pain

Apr 28

Written By Bodyful Physical Therapy Wellness

Authored by Dr. Maryssa Steffen, PT, DPT, Board-Certified Pelvic Health Clinical Specialist

What Is Somatic Therapy in Pelvic Floor Physical Therapy?

Somatic movement therapy is a container co-created and held between you and your therapist so you may be with your personal, body-based material.

In a pelvic PT context, this approach offers creative ways to engage with your exercises, receive and integrate skilled hands-on work, and learn how to listen to your body’s information to guide your actions.

This is a core element of trauma informed pelvic therapy—supporting your agency, pacing, and choice throughout care.

If you’ve ever wondered why you experience recurring or unexplained pain, this body-based inquiry can be a meaningful place to begin.

If you’ve ever asked:

How many exercise repetitions should I do?
How often should I practice my exercises?
When is the best time to do this?

Somatic work helps you begin to answer these questions from within your own body.

This approach supports pacing, choice, and awareness—key principles in trauma PT. It creates space to listen, respond, and build trust with your body over time.

Somatic practices explore interoception, exteroception, and proprioception. Research shows these approaches support discernment, agency, trust, and self-authority.

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How Pelvic Pain Connects to the Nervous System

Folks living with pelvic pain are often navigating more than just physical symptoms. Pain can affect emotional, psychological, sexual, and social well-being. It can impact daily function, relationships, and your sense of safety in your body.

Nociplastic pain describes pain that comes from an upregulated or sensitive nervous system—not from clear tissue damage or structural injury. The pain is real, but the system processing it has shifted.

We see this in conditions like:

fibromyalgia
irritable bowel syndrome
chronic pelvic pain

These often overlap with nervous system symptoms like fatigue, poor sleep, and feeling overwhelmed.

Understanding this changes everything. It moves us away from outdated models that left people feeling dismissed—and toward care that recognizes the full picture.

There is also strong evidence that lived experiences, including trauma, shape how the nervous system responds. Many people with chronic pelvic pain report histories of physical, emotional, or sexual trauma. Rates of anxiety and depression are also higher—not because the pain is “in your head,” but because pain and the nervous system are deeply interconnected.

This is why trauma informed pelvic therapy is essential—and should be part of every aspect of your medical care.

The current standard of care is a biopsychosocial model:
a whole-person approach that includes your body, nervous system, emotional health, and environment.

Common Causes of Pelvic Pain

Pelvic pain is common and often multifactorial.

It may be related to:

endometriosis, fibroids, infections, or ovarian cysts
gut conditions like IBS
bladder conditions
constipation
pelvic floor muscle dysfunction
hypermobility and scoliosis
birth history

Myofascial pelvic pain—pain from muscles and fascia—is one of the most common and often overlooked contributors.

This can be influenced by:

movement patterns
tension habits
how your body processes sensation
past medical history or conditions treated

Other contributors may include prolapse, hormonal shifts, or inflammatory conditions.

Pelvic pain is complex and personal. A pelvic PT approach that includes the nervous system, movement patterns, and lived experience allows for a deeper understanding of what your body is communicating.

How Somatic Therapy Supports Pelvic Pain

Somatic therapy invites questions like:

What do I need to gently bring my attention inward?
Does my environment support or interrupt that process?
What options increase my capacity to listen and respond?

As your attention turns inward, you may notice shifts—more awareness, more options, and sometimes more ease in movement.

This is where trauma PT and somatic work overlap:
not forcing change, but creating conditions where change and new options can emerge.

Over time, this approach can:

improve body awareness
expand options and confidence for pain-free movement
shift how you experience both fear and pleasure in your body

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What a Somatic Pelvic PT Session Looks Like

Your session is guided by your pace.

You may experience:

visual and verbal education about your body
movement exploration based on your learning style
space to pause, integrate, and ask questions

Hands-on work is always optional. Consent is ongoing.

If emotions arise, your therapist supports you in staying present and grounded—this is a key part of trauma informed pelvic therapy.

As you continue, you’ll begin to source movement from your own awareness. Over time, this helps you:

understand your pain signals
respond with more clarity
feel more confident in your body

Techniques Used in Trauma-Informed Pelvic PT

Treatment may include:

myofascial mobilization
visceral fascial mobilization
hands-on guidance during movement
intra-vaginal or intra-rectal pelvic therapy (when appropriate and consented)
instrument-assisted soft tissue work
imagery and nervous system–informed cueing

These are always adapted through a trauma informed pelvic therapy lens—centered on safety, choice, and collaboration.

Who This Is For

This work is for anyone who is curious about their body and willing to explore it with patience and compassion.

It can be especially supportive for those seeking:

pelvic PT for chronic pain
a trauma-informed approach to physical therapy
a more collaborative and body-led healing process

How This Differs from Traditional Pelvic PT

Traditional pelvic PT often solely focuses on muscles, joints, and biomechanics.

Somatic, trauma informed pelvic therapy expands this to include:

the nervous system
internal organ systems
perception and sensory awareness
emotional and environmental context

It’s an integrative and whole person approach to medicine.

What to Expect Over Time

This is the beginning of an ongoing relationship with your body. It is not a destination, but may be the beginning of a process and a practice. You may find it particularly meaningful while in relationship with another body.

Rather than fixing something “wrong,” this work supports you in building a deeper connection to yourself—so you can respond to your body with more clarity, trust, and choice.

Work With a Trauma-Informed Pelvic PT

If you’re looking for pelvic PT in Oakland or virtual pelvic floor therapy in California, our work is grounded in a somatic, trauma-informed approach.

We co-create care that centers your comfort, your pace, and your goals—so you can move toward lasting change, not just temporary relief.