What is Pelvic Floor Therapy?

The pelvic floor is the unsung hero of the lower body. Think of it like an upside down umbrella of muscle and tissue that keeps important organs — including your bladder and bowels — where they should be. If that wasn’t cool enough, pelvic floor muscles also help you achieve orgasm and help control bodily functions like when you pee or poop.

Pelvic floor muscles are like other muscles in your body in the way that they can get weaker over time. Age, childbirth, health conditions and injury can put strain on the pelvic floor which can lead to problems such as bladder leakage and prolapse. But you can strengthen pelvic floor muscles which can help with a range of symptoms and problems. “Just like you would go to an exercise class, you should go to pelvic floor physical therapy,” said Robyn Faye, M.D., an OB-GYN and member of HealthyWomen’s Women’s Health Advisory Council.

Faye noted that pelvic floor physical therapy can also help with pelvic muscles that are too tight (hypertonic) which can cause difficulty peeing and painful sex. “I’m a real proponent for a pelvic physical therapist because they do so much work and help so much with [things like] painful intercourse,” Faye said.

Read: Your Pelvic Floor. What Is It Good for? >>

If you’re having problems with your pelvic floor, here’s what you need to know about pelvic floor physical therapy.

​What is pelvic floor physical therapy?

Pelvic floor physical therapy is a specialized form of physical therapy that helps strengthen, relax, rehabilitate and train your pelvic floor muscles.

Depending on your symptoms, therapy can include:

Manual therapyElectrical stimulation BiofeedbackIn-person exercisesAt-home exercises

Pelvic floor physical therapists are licensed to perform both internal pelvic exams and external physical exams to determine the plan for treatment.

​Who should try pelvic floor physical therapy?

Pelvic floor physical therapists can work to help relieve symptoms for many pelvic floor issues. These can include:

Bladder leakage (called urinary incontinence)Pelvic organ prolapseFecal incontinence (when you poop but don’t mean to)Vaginismus Vulvodynia

Read: Prolapse Changed My Life for the Better >>

Pelvic floor therapy may also be good for people planning to have children before, during and after pregnancy to keep muscles strong.

It’s a good idea to talk to your healthcare provider (HCP) before looking into physical therapy for the pelvic floor. You may need a referral depending on your insurance plan and where you live.

​What to expect at pelvic floor physical therapy

During the first visit, you’ll sit down with the physical therapist to talk about your medical history, symptoms and your goals for treatment. A physical exam will be done to look at your spine, pelvis, hips, abdomen, posture and breathing.

Your physical therapist may want to perform an internal pelvic floor exam to gauge muscle, strength or coordination problems. Note: This usually requires a gloved finger in the rectum or vagina.

If you’re not comfortable with the exam, you don’t have to do it. Talk to your physical therapist about other options or ways you can move forward without the internal exam.

You and your physical therapist will create a plan. The amount of time and how many sessions are needed vary per person and depend on your goals.

The in-office exercises can range from stretching to core and joint exercises to massage. And you may have homework like Kegel exercises to do at home.

​Is pelvic floor therapy covered by insurance?

Pelvic floor physical therapy is becoming more widely known, but not all insurance companies cover it. If you’re interested in pelvic floor physical therapy, check with your insurance company before you make an appointment.