Internal Pelvic Floor Treatment

First, What Are the Pelvic Floor Muscles?

Your pelvic floor is a group of muscles, ligaments, and connective tissue that sits like a hammock at the base of your pelvis. These muscles support your bladder, uterus or prostate, and rectum. They play a key role in:

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• Bladder and bowel control

• Sexual function and pleasure

• Core stability and posture

• Supporting pelvic organs

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When these muscles are tight, weak, painful, or not coordinating properly, they can lead to a wide range of symptoms—like urinary urgency, leakage, pain with sex, constipation, or pelvic pressure.

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What Is Internal Pelvic Floor Muscle Treatment?

Internal pelvic floor muscle treatment is a gentle, hands-on technique used by specially trained physical therapists to assess and treat the deeper layers of the pelvic floor—muscles that can’t be reached externally.

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Depending on your anatomy, this may involve:

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• Intra-vaginal techniques (for people with a vagina)

• Intra-rectal techniques (for people with a rectum, including men)

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Your therapist may use a gloved and lubricated finger to assess the strength, tension, coordination, and mobility of the pelvic floor muscles. If appropriate and with your consent, they may use gentle pressure, stretching, or release techniques to help relax overactive muscles, release trigger points, or retrain coordination.

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Why Is Internal Work Sometimes Needed?

Many pelvic floor issues originate from dysfunction deep inside the pelvis, where muscles may be tight, weak, or holding tension due to past injury, childbirth, stress, trauma, or chronic holding patterns. These internal muscles:

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• Can’t be reached effectively from the outside

• Respond better to gentle, direct, internal release and retraining

• Are often the missing link in chronic pelvic pain, incontinence, or sexual discomfort

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Think of it like seeing a physical therapist for shoulder pain—you’d expect them to palpate and assess your shoulder muscles directly. The same goes for the pelvic floor—it just happens to be more private, and that’s why consent and comfort are essential.

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Common Conditions That May Benefit from Internal Pelvic Floor Treatment:

• Pelvic pain (vaginal, rectal, testicular, tailbone, or deep hip pain)

• Pain with sex, tampon use, or pelvic exams (dyspareunia, vaginismus, vestibulodynia)

• Urinary urgency, frequency, or leakage

• Constipation or difficulty emptying bowels

• Pelvic organ prolapse

• Postpartum recovery and scar tissue healing (e.g., perineal tears, episiotomy, C-section)

• Chronic prostatitis or painful ejaculation

• Endometriosis-related pain

• Post-surgical pelvic floor scarring or tension (e.g., after hysterectomy or prostatectomy)

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What to Expect During a Session:

• You’ll receive full education beforehand, and you always have the right to decline or modify any part of the treatment.

• You’ll be draped with a sheet or gown, and your therapist will use gloves and lubricant.

• Your comfort, consent, and communication are top priority. Nothing is ever rushed, and there are no surprises.

• If internal treatment isn’t appropriate or comfortable for you, external techniques and other evidence-based strategies can still make a big difference.

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Is Internal Pelvic Floor Work Safe?

Yes—when performed by a licensed, specially trained pelvic health physical therapist, internal pelvic floor treatment is safe, well-tolerated, and backed by research. It is non-surgical, low-risk, and often highly effective—especially for stubborn or chronic pelvic symptoms.

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In Short:

Internal pelvic floor muscle treatment is a powerful tool for healing when done with care, consent, and clinical expertise. It allows your therapist to work directly with the muscles that matter most—so you can feel better, move better, and reconnect with your body from the inside out.

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We Honor Your Autonomy and Comfort

Your body is yours. Internal work is never required and is only offered when it’s appropriate, with your full, informed consent. You’re always in control—and we’re here to support your healing journey in whatever way feels safest and most empowering to you.