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Signs that Pelvic Floor Physical Therapy is Right for Me

Updated: Aug 12, 2023

Pelvic floor physical therapy has come a long way in the past couple decades. The origins of this profession are somewhat muddy. However, we have records of pelvic floor muscle exercises described during the days of Hippocrates in ancient Greece. Modern roots seem to trace back to Margaret Morris in the 1930s, a PT who advocated rehabilitative pelvic floor exercises to prevent leaking. However, Arnold Kegel (pronounced KEG-el), a German doctor of the 1940s is the eponym of the pelvic floor exercises we know (and possibly love/hate) today.


So what is pelvic floor physical therapy?

pelvic floor physical therapist demonstrating pelvic floor anatomy on 3D model
Pelvic floor physical therapist, Dr. Brittany Schroeder educates on pelvic floor anatomy

Pelvic floor physical therapy is the restoration of proper pelvic floor muscle function to resolve symptoms that are directly or indirectly related to their dysfunction. It is NOT just “Kegels.” It may involve isolated treatment of the pelvic floor, but the entire movement system should be functionally incorporated into a comprehensive pelvic floor physical therapy plan of care. This means that a patient should be performing the actions of his or her daily life, integrating the pelvic floor with the rest of the body before completing PT.


How do I know if I need it?



The pelvic floor muscles can be considered the guardians of the pelvis:



  • They prevent or allow the passage of urine and stool… also babies, penises, tampons, menstrual cups, suppositories, pessaries, etc.

  • They assist with sexual function, arousal and orgasm

  • They support the pelvic organs like the bladder, bowel, and reproductive organs

  • They manage pressure within the system or “cabin” so everyone on board stays happy and nothing gets ejected unexpectedly (stated another way, they work so you don’t pee when you sneeze)

  • They circulate blood and lymphatic fluid to prevent pooling and congestion

  • They stabilize the pelvis, hips and low back from below



Considering all the roles of these muscles, it is no surprise that when they start to act up it can feel a bit like the sky is falling. Any of the following symptoms may indicate pelvic floor dysfunction and warrants a consultation with a qualified pelvic floor physical therapist:


  • Leaking pee or poop. Period. No caveats. This should not happen. It is not normal. And you do not have to put up with it. Pelvic floor PT is really good at treating this!

  • Urgency or feeling like you will not make it to the bathroom on time

  • Frequency or feeling like to pee too often

  • Pain with sexual activity or penetration

  • Difficulty achieving or sustaining arousal or erection

  • Dulled or painful orgasm

  • Difficulty or pain emptying bowel or bladder

  • Feeling of heaviness, dullness, or something falling out of the vagina or anus

  • Pain in or around the low abdomen, pelvis, genitals, or rectum

  • Pain in the low back, hips, groin that is not responding to traditional PT


If you have pelvic floor dysfunction, you might experience anywhere from one to all of these symptoms. Do not panic. Find a pelvic floor physical therapist. The good news is that pelvic floor PT should be a one-stop-shop to improve all these alarming and frustrating symptoms at once and put the sky back where it belongs.


There are some common medical conditions that often overlap with pelvic floor dysfunction:

woman clutching low belly
Endometriosis is linked to overactive pelvic floor muscles, which can cause low abdomen pain

  • Low back pain

  • Sacroiliac dysfunction

  • Interstitial cystitis or Painful Bladder Syndrome

  • Overactive Bladder Syndrome

  • Polycystic Ovarian Syndrome

  • History of abdominal/inguinal hernias

  • History of chronic constipation

  • History of multiple pregnancies

  • History of vaginal delivery with instrument assist (vacuum, forceps)

  • History of 3rd and 4th degree perineal tearing

  • Menopause

  • Endometriosis

  • Varicocele

  • History of urogenital cancers

  • History of prostate cancer

  • History of hysterectomy

  • Chronic bronchitis, asthma or allergies

  • History of bulemia

  • Temporomandibular joint dysfunction

  • Fibromyalgia

  • Ehlers Danlos Syndrome

  • Pudendal Neuralgia

  • Tailbone injury

  • Migraines


This is not a comprehensive list, nor does it imply any causation. For example, we do not know that endometriosis causes pelvic floor dysfunction or vice versa; however, the two conditions are correlated.


If some of the items on these lists resonated with your current situation, seek out professional help. Physical therapy services are direct access in all 50 states, meaning you do not need a referral from a physical to see an expert. It may be one of the more unique physical therapy experiences of your life, but it may also be the best. Because when pee and poop isn’t where it should be, it’s hard to have a good day.

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