Pelvic Floor Physical Therapy: Your Questions Answered

When people hear “pelvic floor physical therapy,” many immediately think of pregnancy or postpartum recovery. While pelvic health PT is incredibly important during and after pregnancy, that’s only part of the story.

The pelvic floor plays a role in bladder and bowel function, sexual health, core stability, breathing, posture, and pain management—for both women and men, across all stages of life.

If you’ve ever wondered whether pelvic floor PT could help you (or assumed it wasn’t “for you”), this FAQ is a good place to start.

Pelvic Floor Physical Therapy: Your Questions Answered:

What Is the Pelvic Floor?

The pelvic floor is a group of muscles, connective tissue, and nerves that form a supportive sling at the base of the pelvis. These muscles work with your diaphragm, deep abdominals, and back muscles to:

• Support the bladder, bowel, and reproductive organs

• Control continence (urine and stool)

• Contribute to sexual function

• Help manage pressure during lifting, exercise, coughing, and daily movement
  

When the pelvic floor isn’t coordinating well—whether it’s too tight, too weak, or poorly timed—symptoms can show up far beyond the pelvis.

Is Pelvic Floor Physical Therapy Only for Pregnancy and Postpartum?

No. Pregnancy and postpartum care are important, but pelvic floor dysfunction affects people of all genders and ages, including:

• Active adults

• Desk workers

• Athletes

• Post-surgical patients

• Men with pelvic pain or urinary symptoms

• Women who have never been pregnant
  

Pelvic floor PT is about function, not just life stage.

What Symptoms Can Pelvic Floor PT Help With?

Pelvic floor physical therapists commonly treat:

Bladder & Bowel Symptoms

• Urinary urgency or frequency

• Leakage with coughing, laughing, or exercise

• Difficulty starting or fully emptying the bladder

• Constipation or bowel control issues
  

Pain Conditions

• Pelvic pain or pressure

• Pain with sitting

• Tailbone pain

• Hip or low back pain that doesn’t fully resolve

• Pain with intercourse or penetration
  

Core & Movement Issues

• Abdominal separation (diastasis recti)

• Core weakness despite exercise

• Difficulty returning to running or lifting

• Feeling unstable during movement
  

Male-Specific Concerns

• Chronic pelvic pain syndrome

• Prostatitis-type symptoms without infection

• Erectile dysfunction related to muscle tension or coordination

• Post-prostate surgery recovery
  

Can Pelvic Floor Muscles Be Too Tight?

Yes—and this is one of the most misunderstood parts of pelvic health.

Not all pelvic floor problems are caused by weakness. In fact, many people have overactive or tense pelvic floor muscles, which can contribute to:

• Pain

• Difficulty relaxing to urinate or have bowel movements

• Sexual dysfunction

• Persistent “tightness” despite stretching
  

In these cases, doing more Kegels can actually make symptoms worse. Pelvic floor PT focuses on restoring balance and coordination, not just strengthening.

What Happens During a Pelvic Floor PT Evaluation?

A pelvic floor evaluation is thorough, respectful, and tailored to your comfort level. It may include:

• Discussion of symptoms, history, and goals

• Assessment of posture, breathing, and movement patterns

• Evaluation of hip, core, and pelvic floor coordination
  

• Education about how your symptoms connect to movement and muscle function

Internal assessment may be appropriate in some cases, but it is never required and is only performed with clear consent and explanation.

Do I Need to See a Physician or Get Imaging First?

In many cases, no. Tennessee allows direct access to physical therapy, meaning you can start pelvic floor PT without a physician referral.

For many pelvic health conditions, research supports conservative care like physical therapy before medications, injections, or invasive procedures. If red flags are present, your PT will refer you appropriately.

Why Is Cash-Based Pelvic Floor PT Often a Better Fit?

Pelvic health care benefits from time, privacy, and consistency—things that are often limited in insurance-based models.

A cash-based, one-on-one approach allows for:

• Full 60-minute sessions

• Private treatment rooms

• Care with the same therapist each visit

• Individualized progression without visit caps

• Space for education, questions, and real problem-solving
  

For many patients, this model leads to better outcomes and a more comfortable experience.

Is Pelvic Floor PT Only About Fixing Problems?

Not at all. Pelvic floor PT can also be:

• Preventive care

• Support during training or return to sport

• Part of a broader approach to core and movement health

• A way to understand your body better as it changes
  

Many patients come in not because something is “broken,” but because they want to move, exercise, and live with more confidence.

Pelvic Floor Physical Therapy: Your Questions Answered- The Big Takeaway

Pelvic floor physical therapy is not just about pregnancy, postpartum, or aging. It’s about how your body manages pressure, movement, and function—every day, in real life.

If you’re dealing with symptoms you’ve been ignoring, working around, or unsure how to describe, pelvic floor PT may be the missing piece.

At Nashville Physical Therapy & Performance, we provide evidence-based, one-on-one pelvic health care for women and men, designed to support long-term function—not quick fixes.

References

• Fitzgerald, M. P., et al. (2009). Randomized trial of pelvic floor physical therapy for pelvic pain. American Journal of Obstetrics & Gynecology, 201(5), 485.e1–485.e9.

• Anderson, R. U., et al. (2005). Biofeedback-assisted pelvic floor muscle training for men with chronic pelvic pain syndrome. The Journal of Urology, 174(1), 155–160.

• Bo, K., et al. (2017). Pelvic floor muscle function and dysfunction. Neurourology and Urodynamics, 36(3), 755–760.