Pelvic Floor Therapy: What It Is, Signs of Dysfunction, and When to Seek Treatment

By Dr. Jen Holt, PT, DPT — Pelvic Health Therapist, Certified Birth Doula, Holistic Hormone Coach, Genesis PT & Wellness

If you have a pelvis, you have a pelvic floor — and understanding how it works can make a significant difference in your health and quality of life. But what exactly is the pelvic floor? Why is pelvic floor therapy gaining attention? And should you be doing Kegels?

Let’s break it down. 

What Is the Pelvic Floor?

The pelvic floor is a group of muscles, ligaments, and connective tissue located at the base of the pelvis. These muscles form a supportive “bowl” that plays a crucial role in:

  • Stability

  • Core support and connection

  • Continence

  • Organ support

  • Sexual function

  • Blood and lymphatic flow

Although hidden from view, the pelvic floor works continuously with other core muscles to support movement, regulate pressure, and maintain internal function. 

What Is Pelvic Floor Therapy?

Pelvic floor therapy is a specialized form of physical or occupational therapy focused on assessing and treating pelvic floor dysfunction. A comprehensive evaluation may include a head-to-toe assessment to identify underlying contributors to symptoms.

Treatment options can include:

  • Manual therapy and soft tissue techniques

  • Dry needling or cupping

  • Breath training and core coordination

  • Mobility and strength exercises

  • Patient education and behavior modification

Over the past 15–20 years, pelvic floor therapy has gained recognition in the rehabilitation field, although many (especially from older generations) are still unaware of its benefits.

Signs of Pelvic Floor Dysfunction

The pelvic floor affects multiple systems in the body, so symptoms can vary widely. Past injuries such as ankle sprains, tailbone falls, or whiplash can contribute to issues later in life.

Common signs include:

  • Incontinence (urine or stool leakage) — even a small amount

  • Pelvic organ prolapse

  • Pain during intercourse

  • Pelvic pain (pubic bone, tailbone, sacrum, hips)

  • Pelvic pressure or heaviness

  • Chronic constipation

  • Chronic low back or hip pain

  • Urinary urgency or frequency

  • UTI-like symptoms without infection

  • Pain with menstruation

Who Can Be Affected?

Pelvic floor dysfunction can affect anyone — not just women.

  • People with chronic pelvic pain (endometriosis, IBS, constipation)

  • Pregnancy and postpartum — a common time for pelvic floor changes, including leaking, diastasis recti, and birth preparation needs

  • Aging and hormonal changes — worsening incontinence or prolapse

  • Post-operative patients — after prolapse surgery, prostatectomy, or C-section

  • Athletes — high-impact activities leading to leakage or pelvic pain 

What’s the Deal with Kegels?

Kegel exercises (contracting and relaxing the pelvic floor) are often recommended but are not appropriate for everyone.

A strong pelvic floor isn’t just about squeezing. It's also about the ability to relax and coordinate those muscles. In fact, for individuals with a tight or overactive pelvic floor, Kegels can sometimes worsen symptoms.

Because of this, it’s important to be evaluated by a qualified pelvic floor therapist before beginning pelvic floor exercises. Therapy can be tailored to your specific needs rather than relying on a one-size-fits-all approach.

When Should You Seek Pelvic Floor Therapy?

Consider therapy if you have symptoms listed above, are preparing for childbirth, recovering from surgery, or want to proactively protect your pelvic health.

It’s never too late to begin. Many people suffer silently with symptoms they’ve been told are “just normal,” especially after childbirth or with aging. But common doesn’t mean normal, and pelvic floor therapy can help. The first person to talk to when you have any of these issues should be a pelvic floor therapist, they are the specialists to treat any musculoskeletal related to pelvic health and the pelvic floor!

Interested in speaking with a pelvic floor therapist?

Book a FREE 15-minute consultation with a Genesis PT & Wellness therapist here. We offer virtual appointments worldwide and in-person care throughout the Dallas–Fort Worth area.