With the growing buzz around pelvic floor therapy, it is essential to do your homework when looking for your pelvic floor physical therapist. Here are some key questions to ask when selecting a clinic:

• Have your Doctors of Physical Therapy been trained in internal examination and treatment of the pelvic floor?
• Will my Doctor of Physical Therapy utilize internal treatment techniques if necessary for my condition? 
• If I have bowel symptoms, do your Doctors of Physical Therapy have training in rectal examination?
• How much one-on-one time will I get with my Doctor of Physical Therapy?
• Will I see the same Doctor of Physical Therapy on every visit?
• Will I ever have to work with a technician during my sessions instead of with the Doctor of Physical Therapy?
• What does a typical treatment plan for my condition look like?
• Can your Doctors of Physical Therapy help me return to _______?

These questions will help you find a clinic that can provide the level of care and expertise you need for your recovery.

The specific diagnosis and treatment codes are given to you during your evaluation with your Doctor of Physical Therapy. We are unable to provide these codes before your visit because your therapist needs to assess you first to determine which codes apply to your situation. Once you’ve had your evaluation, we’ll provide you with the codes you need to check with your insurance for possible reimbursement.

Our Electronic Medical Record and Payment Processing System require a credit card on file. Due to this, we are PCI Certified meaning we are compliant with The Payment Card Industry Data Security Standard which is a set of requirements intended to ensure that all companies that process, store, or process credit card information maintain a secure environment. 

We choose to be out-of-network so we can give you the best, most personalized care possible. Insurance often limits how many visits you can have, how often you can come, and even what kind of treatment you can receive. By staying out-of-network, we can focus entirely on you—your specific needs, goals, and preferences—without any restrictions from insurance companies. When you go in-network, your insurance is ultimately dictating your treatment plan, not your therapist.

Our team of Doctors of Physical Therapy builds your treatment plan based on what we find in your exam, the latest research, and what you want to achieve. This means we can help you with goals that insurance does not cover, like getting back to running, CrossFit, or other activities that are important to you. Our priority is your recovery, on your terms.

Yes! We do accept Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) cards as forms of payment. We also take all major credit cards, checks, and/or cash payments. 

We are an out-of-network/self-pay provider. This means that payment is made at each visit. We offer individualized packages for a discount and payment plans. Additionally, we provide “superbills” that you may send to your insurance for possible reimbursement through your plan’s out-of-network benefits.

By choosing an out-of-network provider like us, you get the advantage of one-on-one, personalized care for a full hour with the same Doctor of Physical Therapy every time. Unlike insurance-based clinics, where you might be rushed with only 30-45 minutes of care with different therapists or be passed off to technicians, our focused approach often leads to faster recovery. 

In the long run, this may save you money compared to high deductibles, copays, and surprise bills you might face in an insurance-based clinic. We’re here to raise the standard of pelvic health care and make sure you get the best, most effective care possible– where your insurance company is NOT the one making the medical decisions for you and your provider! 

Think about it this way: most people with incontinence spend between $50-$200 every month on pads. That adds up to around $2,400 a year! On average, people wait seven years before seeking help from a pelvic floor therapist. That means spending up to $16,800 on pads alone.

Now, let’s compare that to pelvic floor therapy. An average treatment plan costs between $2,000-$3,000. This investment addresses the root cause of incontinence, rather than just covering up the problem with pads. By choosing therapy, you could actually save $13,800 over time! 

Not only is spending on pads costly, but untreated incontinence is also a leading reason for nursing home admissions due to the burden incontinence can have on families. 

When you break it down, the cost of pelvic floor therapy is similar to other long-term investments, like your monthly gym membership, daily coffee, or occasional massages. It’s even less than a few of those spontaneous Target runs! But unlike those, therapy could change your life!

So, ask yourself: what is it really costing you not to address this issue? Investing in pelvic floor therapy could be one of the best choices you make for your health, well-being, and future.

Read these reviews about our patients’ life changing results: 

Yes, stress can definitely impact your pelvic floor! Studies show that the pelvic floor is one of the first muscle groups to respond to stress, along with the upper traps. When stress causes your pelvic floor to tense up, you might experience symptoms like leakage, pressure, pelvic pain, pain during sex, back or hip pain, or constipation.

That’s why we take a holistic approach in therapy, looking at the stressors in your life. Addressing stress is a key part of your progress and helps ensure the best outcomes for your pelvic health.

Stretching your pelvic floor is similar to stretching any other muscle in your body! Just like you have specific stretches for your hip flexors, there are specific ones for your pelvic floor. 

In addition to stretches, internal manual therapy can help release tight pelvic floor muscles. Just like hands-on therapy for other muscle injuries, pelvic floor therapy can involve internal techniques to lengthen tight muscles and external techniques to address tight hip flexors, glutes, and abdominals. These techniques are gentle and are not like a typical pelvic exam with your gynecologist. 

Your pelvic PT may also recommend therapeutic devices, such as pelvic wands or dilators, to use at home. Learning how to use these tools gives you more control over your progress and helps you feel more independent in your recovery.

Signs of a tight or overactive pelvic floor can include:

• Pain during sex, pelvic exams, or tampon use
• Frequent UTIs
• Pelvic, tailbone, hip, or back pain
• Constipation or pain when emptying bowels
• Urinary leakage
• Bladder pain

A tight pelvic floor can result from various factors, such as pregnancy, childbirth, medical procedures, a stressful job, falls on the tailbone, or other traumatic events that put stress on the pelvis.

There are many ways to strengthen a weak pelvic floor, but it’s important to make sure you don’t have pelvic floor tension first. Contrary to popular belief, Kegels aren’t the only way to build strength. In most cases, targeted deep core exercises are highly effective because your pelvic floor is part of your deep core muscles. Strengthening your core and improving balance can help support your pelvic floor.

Everyone’s body is different, so what works for one person may not work as well for another. That’s why, even with all the exercise guides and videos available online, many people benefit from 1:1 pelvic floor therapy. In fact, about 50% of individuals have trouble activating their pelvic floor muscles correctly and need expert guidance to do it right.

Signs of a weak pelvic floor may include:

• Urinary leakage
• A feeling of pressure in the pelvis
• Prolapse (a feeling of organs shifting or dropping)
• Diastasis (separation of abdominal muscles)
• Fecal leakage
• Pain in the pelvic area

A weak pelvic floor can result from several factors, such as repeated pregnancies and births, long labors, straining on the toilet, lifting heavy objects improperly, “push peeing,” and lack of physical activity.

A common misconception: Not all weak pelvic floors need Kegels. Many people with weak pelvic floor muscles also have tight pelvic floor muscles. In these cases, doing Kegels can actually make symptoms worse. This is why a proper evaluation is key to finding the right treatment.

Yes, we use various forms of biofeedback tailored to your needs. We offer manual biofeedback to help relax (downtrain) the pelvic floor muscles and assess their function. For bowel conditions, we may use balloon training biofeedback for certain conditions. However, we do not use sEMG, as current research no longer supports this method as effective. Our goal is to use the most effective, evidence-based techniques for your care.

No, we do not treat pediatric patients. We work with individuals 16 years old and older. However, we’re happy to refer you to a clinic that specializes in pediatric care for those under 16!

Yes, we treat people with Ehlers-Danlos Syndrome (EDS). All of our therapists have advanced training in pelvic floor conditions related to EDS. Common issues we address include pelvic pain, urinary leakage, constipation, and prolapse.

Since EDS is a connective tissue disorder, it can cause the pelvic floor muscles to compensate for hypermobility by becoming tense and overactive in an attempt to create stability. This can lead to pelvic floor dysfunction, showing up as leakage, pressure, or pain. Our therapists understand the specific precautions needed when exercising with EDS and will tailor your treatment to support your unique needs.

Yes, we absolutely treat men! All of our therapists have advanced training in male pelvic floor dysfunction. Common symptoms we help with include urinary leakage, pelvic pain, testicular pain, back or hip pain, constipation, tailbone pain, abdominal pain, pain with sexual activity, and erectile dysfunction- just to name a few! We’re here to support you on your journey to better health.

Not at all! You don’t need to shower or shave before your visits. We’re here to help with your health, and we’re not concerned about the appearance of your vulva, so no worries there!

An internal exam is never required. Your comfort is our top priority. However, if you choose to have one, know that our physical therapists are highly trained, trauma-sensitive, and have between 4 to 7 years of experience in pelvic floor therapy, thus having done thousands of exams. The internal exam provides valuable information, helping us accurately diagnose and treat your condition.

During the exam, your therapist may assess things like range of motion, strength, coordination, muscle tension, and pain. We’ll explain each step before and during the process, so you always know what to expect. Your comfort and trust are at the heart of everything we do.

Read these reviews about how our team made our clients more comfortable:

Your Doctor of Physical Therapy might suggest a few lifestyle changes to support your progress. These can include things like improving your hydration, adjusting your bathroom habits, learning proper pooping mechanics, and incorporating more fiber into your diet. We may also look at your exercise routine, stress management, sleep habits, posture at home and in the gym, and even address any mental health blocks. These changes are all about helping you feel your best!

If there are any exercises or movements that flare your symptoms, we may modify your activity temporarily in order to return you back to that activity symptom-free again! 

Your treatment will depend on your specific diagnosis and how severe your symptoms are. At the start, you’ll likely spend more time one-on-one with your Doctor of Physical Therapy in a private room. During this time, we’ll focus on hands-on techniques, like working on your abdominals, hip flexors, glutes, hip rotators, adductors, and pelvic floor muscles. This might include soft tissue work, cupping, dry needling, or gentle mobilizations.

As you progress, we’ll shift to more exercises in a quiet gym space. These exercises help retrain your muscles to function correctly, keeping your symptoms from coming back. Everything we do is tailored to your needs and goals!

Your Doctor of Physical Therapy will give you specific instructions based on your needs, but it usually involves doing exercises 2-3 times per week. We know everyone’s schedule is different, so our therapists work with you to find simple ways to fit your homework into your routine without taking up too much extra time.

We offer a VIP membership for clients who want to stay proactive and prevent future problems. This allows you to continue coming in for recovery sessions, pelvic floor tune-ups, and progressive exercise programming. Most of our patients in this membership find this ongoing support helpful for maintaining their progress and working toward new goals!

Most of our patients start to feel better between their 2nd and 6th treatment. However, to achieve lasting results and address the root cause of the problem, it usually takes about 12-16 visits. We’ve found that when clients stop coming as soon as they feel some relief, they often end up back with the same issue later. Consistent therapy over time helps create long-term change, so you can stay symptom-free.

With us, a typical plan involves one visit per week for the first 8-12 weeks, depending on your unique case and exam findings. After your full evaluation, your Doctor of Physical Therapy will recommend a schedule tailored to you. As you show progress, your therapist may suggest moving to every other week or twice per month. After that, most of our patients benefit from a maintenance program at once a month or once every two to three months depending on your personal goals and preferences for tune ups. 

In-network clinics often ask you to come in 2-3 times a week for 2-3 months, which can add up to 36 visits—almost double the time! Our approach is designed to provide focused, one-on-one care, so you get the most out of each visit.

It depends on a few factors, like how long you’ve had the issue, how many symptoms you’re dealing with, and how severe your condition is. For mild to moderate cases, a typical plan might involve around 12-16 sessions. For more severe cases, it could take 16-20 visits. After that, most of our patients benefit from a maintenance program at once a month or once every two to three months depending on your personal goals and preferences for tune ups. 

Research shows that pelvic floor muscle training is a key part of treating issues like urinary urgency and incontinence. Consistent therapy over 12-16 weeks allows the muscles to make lasting changes, which is why sticking with your treatment plan is so important. Your Doctor of Physical Therapy will work with you to create the best plan based on your unique situation!

Due to the intimate size of our practice, we do require 48 business hours of notice for any appointment changes. This ensures that we can offer your spot to someone on our waitlist. While we dislike implementing our late cancellation policy, if you do not cancel before 48 business hours, you will be charged 50% of your session rate. For same day cancellations, the late cancellation fee is 100% of your session rate. You will receive multiple appointment reminders via email and text to ensure you do not forget your appointment.

Yes! You may bring your baby or child to your appointment with you. We love to keep pelvic floor therapy accessible even if you don’t have childcare, however you know your child and yourself best, so if you feel that having your child with you may take away from your evaluation or treatment, you may consider bringing a partner or friend with you to your appointment to watch your baby or finding childcare so you can step away for 1 hour to fill your cup back up!

We do have a nursery in the clinic where some of our patients may come early or stay late to nurse their baby, which is available to you to use! 

Yes! You are welcome to bring a spouse or friend with you to your appointments– that is completely your decision! Some of our new patients may choose to bring someone with them for their first appointment. Most of our prenatal patients will bring a partner to 1-2 sessions for birth preparation sometime in their third trimester. 

Yes! We see most of our patients for a video session at least once or twice during the course of their care. This allows your Doctor of Physical Therapy to do a home or workspace assessment to improve your success at home with lifestyle or behavior changes that will speed up your progress. Furthermore, when things outside of our patients’ control arise, we are able to transition to a video appointment to ensure progress of their treatment plan without backsliding. Our Doctors of Physical Therapy have treated some of our patients 100% via video sessions! 

No, we do not have online scheduling. 

Our Doctors of Physical Therapy have appointments as early as 7:00am and as late as 5:00pm. However, we do require that new patients schedule their first appointment or evaluation between the hours of 8:00am and 4:00pm. Occasionally we will have a 4:00pm evaluation slot, so just make sure to inquire about that during your phone consultation.

No, you do not need a referral to see a pelvic floor physical therapist in North Carolina, as it is a direct access state, meaning that you do not need a referral. However, some insurance plans might require a referral for coverage or reimbursement from a superbill, so it’s a good idea to check with your healthcare plan if you plan on submitting to your insurance on your own.

You can ask your doctor, but keep in mind that many doctors aren’t specialized in pelvic floor conditions. To get the most accurate information, it’s often more helpful to speak directly with a Doctor of Physical Therapy who specializes in pelvic health. We can provide a thorough evaluation and discuss the best options for your specific situation.

Each visit is a full hour with your Doctor of Physical Therapy. You’ll always have one-on-one time with your therapist and will never be passed off to a tech, unlike at some insurance-based clinics.

We recommend wearing athletic or comfortable clothes that allow you to move easily. Think of something you might wear to a yoga class or for a light workout!

Your first visit will be with one of our Doctors of Physical Therapy. We’ll start by spending 10-15 minutes talking about your medical history, your current condition, and what goals you want to achieve. After that, your therapist will watch how you move and take a closer look at the area that’s bothering you to figure out what might be causing your symptoms at its root cause.

Based on what we find, we’ll put together a personalized plan and recommend the best course of treatment to help you get back to enjoying your life!

The first step is setting up a phone consultation with our Patient Care Coordinator. Set aside 15-20 minutes for your phone consultation. You may select a time here: https://link.srvcsndr.com/widget/bookings/pelvicprescriptionconsult 

During your phone consultation, please have your schedule handy so that you can reserve your evaluation appointment. We hold a couple of evaluation slots each week for new patients. Due to limited evaluation spots each week, we require a $75 non-refundable deposit to hold your spot. Don’t worry if you need to reschedule your appointment, you may do so and still apply your deposit to your rescheduled appointment time without losing it!

Pelvic floor therapy can be very effective, but it works best for those who are committed to the process. The people who see the most success are the ones who show up for their appointments, follow the treatment plan their Doctor of Physical Therapy creates, and practice their exercises at home. It’s about taking small, consistent steps toward your goals.

If you’re ready to take charge of your health and stay active—even after therapy ends—pelvic floor therapy can absolutely work for you! We’re here to support you every step of the way.

Pelvic floor therapy might not be the right fit if you’re unable to commit to regular appointments or don’t have time to make changes at home. It’s also less effective for those who jump between different treatments or expect immediate results. Being inconsistent will slow down your progress. Success takes patience, consistency, and a willingness to follow the plan your Doctor of Physical Therapy creates for you.

If you’re ready to put in the effort, we’re here to help you achieve lasting results!

You might need pelvic floor therapy if you’re dealing with any of these problems:

• Urinary Issues: Like leaking pee, feeling a strong need to go often (more than 7 times a day), or trouble starting to pee.
• Bowel Issues: Constipation, leaking poop, or having a hard time emptying your bowels.
• Pelvic Pain: Pain in the lower belly, genitals, tailbone, or pubic area. This can include pain during sex, inserting tampons, or during gynecological exams.
• Pregnancy and Postpartum: If you have pain, leaking, or pressure during pregnancy, or if you’re recovering after giving birth (especially if there was tearing).
• Pelvic Organ Prolapse: Feeling heaviness or pressure in the vagina, which could mean organs are shifting or dropping.
• Low Back or Hip Pain: Chronic pain in these areas might be linked to the pelvic floor.
• Other Conditions: Endometriosis, interstitial cystitis, or recovering from surgeries like a hysterectomy or hernia repair.

Pelvic physical therapy helps to strengthen and relax the muscles in your pelvic area, which can ease these symptoms and help you get back to feeling like yourself again! If you’re not sure if this therapy is right for you, a consultation can help you decide.

Your therapist will give you options for the exam to ensure your comfort. The assessment may involve an external examination of the pelvic floor muscles at the perineum and observation of the external anal sphincter. However, the most direct and gold-standard examination is through the intra-rectal canal.

Don’t worry! Your therapist will explain every step of the exam before and during the process to make sure you feel comfortable and fully understand the exam procedure.

Men can experience many of the same pelvic floor problems as women. Some of the male pelvic health conditions we treat include:

• Urinary problems

  • Urinary leakage
  • Urinary urgency and frequency
  • Incomplete bladder emptying

• Post-Surgical

  • Pre- and post-prostatectomy
  • Pre- and post-hernia repair

• Bowel Issues

  • Constipation
  • Fecal leakage

• Pain or discomfort

  • Hip pain
  • Back pain
  • Sciatica
  • Lower abdominal pain
  • Perineum pain
  • Testicular pain

• Sexual dysfunction

  • Erectile dysfunction
  • Premature ejaculation
  • Painful erection and/or ejaculation

Pelvic floor therapy can help address these issues by targeting the root causes to improve function and quality of life.

Yes! If you have a pelvis, you have a pelvic floor. In men, the pelvic floor muscles support bladder and bowel function, help with sexual health, and provide stability for the core. Just like women, men can experience pelvic floor dysfunction, which is why pelvic floor therapy can be beneficial for them too. We regularly treat men for urinary leakage, constipation, pain in the lower abdomen, groin, low back, perineum, testicles, and for sexual dysfunction (erectile dysfunction, premature ejaculation, painful ejaculation or erection). 

Pelvic floor physical therapy can teach you how to retrain your muscles and adopt healthier bathroom habits. We’ll show you techniques to reduce straining and improve bowel movements, helping prevent complications like pelvic organ prolapse, chronic constipation, hemorrhoids, anal fissures, urinary leakage, and pelvic pain. By learning how to relax and properly use your muscles, you can protect your pelvic health and maintain regular bowel function.

Yes! Straining or spending too much time on the toilet can weaken your pelvic floor and lead to problems like prolapse, hemorrhoids, constipation, leakage, and pain. This can make pooping even more difficult in the long run.

Yes! Constipation is often caused by multiple factors, including hydration, fiber intake, lifestyle habits, gut health, stress, and the physical mechanics of bowel movements. In pelvic PT, we’ll assess each of these factors to identify what might be affecting your regularity.

Often, pelvic floor tightness can make it difficult to have a bowel movement. In some cases, patients think they are pushing to poop, but they’re actually squeezing their muscles closed, making it even harder—this is known as dyssynergia. Pelvic floor therapy can help address these issues to improve bowel function. We also work very closely with gut health specialists and Registered Dietitians to ensure you get the best results.

Yes! Pelvic floor therapy is the most direct intervention to treat tailbone pain. Your pelvic floor muscles attach to your tailbone, therefore when you have a tailbone injury from either a traumatic event or chronic muscle overuse injury, your pelvic floor muscles usually are one of the culprits due to this relationship between your tailbone and your pelvic floor muscles. Without assessment of your pelvic floor muscles, tailbone pain may not be properly assessed and treated. 

The main difference is that a pelvic floor physical therapist can examine and treat your pelvic floor muscles, while other providers typically cannot. This is crucial because your pelvic floor muscles might be the missing piece to your pain!

Your pelvic floor is at the center of your body, and tension or dysfunction in these muscles can cause pain in your hips and back, mimicking other conditions. If you’ve been dealing with hip or back pain for years without full relief, or only partial relief (like 80-90%), it may be a sign that your pelvic floor needs to be checked. Pelvic floor therapy takes a more comprehensive, whole-body approach to identify and address the root causes of your symptoms.

Yes, it’s possible! Your pelvic floor muscles work closely with your core, hips, and lower back to provide support and stability for your body. If your pelvic floor muscles are tight, weak, or not functioning properly, they can cause or contribute to lower back pain, SI joint pain, and tailbone pain.

In some cases, back pain may actually be a sign that your pelvic floor is compensating for muscle imbalances or weakness in your core and hips. Pelvic floor physical therapy can help identify these connections and address the root cause of your back pain, providing a more holistic approach to treatment.Check out these reviews from patients who had chronic back pain until they came to see us:

Yes, it’s possible! Your hip muscles are closely linked to your pelvic floor muscles. Sometimes, tight or overactive pelvic floor muscles can refer pain to your hips, making it seem like a hip issue when it’s actually your pelvic floor. This is why our focus is treating the root cause of your hip pain for long-lasting relief. 

We also commonly see hip pain caused by weak or tight muscles around the hips. When this happens, your pelvic floor may compensate, which can worsen the hip pain. Understanding how these muscles work together is key, and pelvic floor physical therapy can help identify and treat the root cause of your pain.Check out these reviews to see how we helped our patients overcome years of hip pain:

Yes! Pelvic floor therapy has grade A evidence for effectiveness according to the IUA guidelines, even more so than some medications like Elmiron. While managing Interstitial Cystitis (IC) often requires a multidisciplinary approach, pelvic PT plays a key role by addressing the musculoskeletal dysfunctions that can worsen your pain.

Yes! While endometriosis is a complex condition that requires a full healthcare team, pelvic floor therapy can significantly help reduce the pain you’re experiencing. Endometriosis pain often stems from both the condition itself and the tension in the pelvic floor muscles. By addressing these muscles, pelvic PT can help alleviate some of your discomfort.

Pelvic PT can also improve post-op outcomes by providing both pre-op and post-op care. It’s all about creating a comprehensive approach to manage your pain.

It depends, as every person is different. For some, attempting sex when it’s painful can cause the pelvic floor muscles to become even more tense, potentially worsening symptoms. If this sounds like you, it’s important to work with your pelvic PT to create a plan for changing your pelvic floor’s response before resuming sexual activity.

For others, sexual activity may actually help ease their symptoms. The key is to listen to your body and work closely with your pelvic PT to find the right approach for you.

Pain with sex is usually caused by overactive or tense pelvic floor muscles. When these muscles become too tight, they can create a “wall-like” sensation at the entrance of the vaginal canal, making penetration difficult or even impossible. This tension can also make pelvic exams or using tampons uncomfortable.

But this doesn’t mean something is wrong with you! It simply means there are underlying factors causing your pelvic floor muscles to be overactive. Working with a pelvic floor PT can help uncover the root causes of your pain and provide the right treatment to help you feel better.

No problem! You are in control of your treatment. We will do everything we can to teach you how to help yourself at home with tools and techniques and answer questions as they come up on your journey.

We see patients with pelvic pain everyday. We can perform internal and external pelvic floor, nerve and tissue assessments to see what the root cause of your pain is. Our internal exams and treatments are with one goved single digit inserted internally– no uncomfy speculums ever! We never want your pain to go above 3-4/10 during any point in the session. You probably have had some painful exams in the past, but we are here to help and will constantly check-in with you throughout the exam and treatment. You may choose to defer the internal at any appointment or at any point during your appointment– that is 100% okay with us! Our treatments are educational and performed with your consent. We also teach our patients how to treat themselves with tools at home between appointments if you are comfortable with that! All treatment rooms are private and comfortable rooms.

Yes! Regardless of how many fingers wide your diastasis is, pelvic floor therapy can help. The wider the separation, the more time it might take, but with the right approach, you’ll gain the tools to support healing and prevent it from getting worse. We’re here to guide you every step of the way!

That’s entirely up to you! In most cases, surgery isn’t necessary. Many women find that physical therapy is enough to effectively heal their diastasis. In more severe cases, some women choose to have surgery, but they often benefit from doing physical therapy both before and after the procedure to support the best outcomes.

Yes! Diastasis can heal with physical therapy. A normal separation is about 1 finger width. We take a whole-body approach to treat diastasis, which includes assessing pelvic floor function, addressing abdominal restrictions and weakness, checking for gut health issues related to bloating, and treating scar tissue, among other factors. By optimizing all these areas, we can strengthen the abdominal muscles and stabilize the core to support healing.

Read this review from one of our patients with DRA:

A common misconception is that you have to stop all ab and core exercises if you have diastasis and stick only to “safe” ones. This belief isn’t based on any evidence. The truth is, every person with diastasis requires an individualized assessment to determine which exercises are appropriate. With proper rehab and retraining of the abdominals, many people can safely perform a wide range of core exercises.

When assessing what exercises are right for you, we examine how your abdominals respond during the exercise. We look at the separation distance between the rectus abdominis muscles, the tension created by the muscles underneath, and the “end-feel” of the tissue. We want to avoid exercises if the tissue feels hard, indicating organs, but soft tissue indicates it’s safe to proceed.

Diastasis is the separation of the rectus abdominis muscles (the “six-pack” muscles). This often happens during pregnancy to create more space for the baby to grow. Diastasis can be more pronounced in women with multiple pregnancies or those carrying multiples.

While some women’s diastasis heals on its own after giving birth, others may need pelvic floor therapy to help with recovery. Diastasis can also occur in men and children, not just during pregnancy.

That’s entirely up to you! However, keep in mind that prolapse repair surgery isn’t always a permanent fix. Studies show that many people who undergo surgery may still experience symptoms, like leakage and pelvic pressure, within two years. 

Why? Because without pelvic PT, you don’t learn how to move and use your pelvic floor muscles properly, which increases the risk of re-injury. Surgery does not fix the root cause of your prolapse. It only addresses the symptoms that resulted from the cause. This means most individuals experience a prolapse again after surgery because they did not make the necessary changes to prevent re-injury. 

Prolapse often happens due to poor movement patterns and incorrect use of pelvic floor muscles. With pelvic floor therapy, you can learn how to use your muscles correctly, which may help you avoid surgery altogether. 

Read this review to see how we helped a patient cancel her surgery and regain control of her pelvic health!

No! Lifting heavy does not increase the risk of prolapse. In fact, research shows that women who lift heavier weights tend to have a lower instance of prolapse compared to those who only lift lighter weights. 

Why? Because women who lift heavier are generally stronger overall, which includes having a stronger pelvic floor. The key is learning how to properly use your core and pelvic floor during lifting, which is something pelvic floor PT will help you with! The myth that lifting weights is bad for your prolapse comes from individuals who have prolapse and haven’t learned how to properly use their core and pelvic floor during lifting, which can worsen prolapse. 

Read this review from one of our patients with prolapse who has to lift for her job:

It depends on you! The safety of specific exercises varies based on how well you use your pelvic floor and core during each movement. A pelvic floor PT can assess what your pelvic floor is doing to support your prolapse during different exercises to help you find the ones that are safe and beneficial for your body. With the right guidance, you’ll learn how to modify if necessary and strengthen safely. 

It depends! Prolapse happens when the demands on the pelvic floor are greater than what the muscles can handle, or when there’s too much pressure on them. Pelvic floor therapy focuses on strengthening the pelvic floor and core muscles to provide better support for your organs, which can help reduce or even prevent the downward shift.

While results of a prolapse “going back in” vary depending on the grade of your prolapse, a 16-week pelvic floor therapy program will significantly improve your symptoms such as discomfort or pressure AND provide you with the tools to manage and support your body effectively in the future to prevent worsening symptoms in the future.

Pelvic organ prolapse (POP) is a condition where one or more of the pelvic organs shift downward and may bulge into the vaginal canal or rectum. It’s common, especially after childbirth, because of the extra demands placed on the pelvic floor muscles during pregnancy. Prolapse can become more severe with prolonged labor and pushing during delivery. It can also happen from straining on the toilet or lifting heavy items over time.

That’s why we advocate for early intervention and preventative pelvic health care to avoid years of frustration and embarrassment. It’s like having a knee injury and ignoring it for seven years while continuing to walk on it—it rarely just goes away on its own! Seeking help sooner can make a big difference in your recovery.

Your therapy may include hands-on techniques to address any muscle imbalances in your pelvic floor or other areas. We’ll work on retraining your muscles using hands-on cueing to ensure they are learning to function correctly. Strengthening exercises for your pelvic floor and surrounding muscles are also key to providing support and preventing future leakage. Your treatment is tailored to your specific needs for the best possible outcome.

Treatment for leakage can vary depending on the type of leakage you’re experiencing and its root cause. There are two main types:

• Urge incontinence: Leakage happens when you feel the urge to urinate and experience leakage while trying to get to the bathroom.
• Stress incontinence: Leakage occurs during activities like sneezing, coughing, laughing, jumping, running, or lifting.

Some people experience both types of leakage. Common causes can include a heightened fight-or-flight response, sensitive bladder-filling sensors, tension or weakness in pelvic floor muscles, poor pressure management, or even abnormal posture.

No, it’s not normal to accidentally pee yourself. While it’s often joked about and sometimes even normalized (how many times have you seen a movie where a mom laughs about peeing herself?), the truth is that your muscles are supposed to prevent leakage. If you’re experiencing leakage, it means those muscles aren’t doing their job effectively.

That’s where pelvic PT comes in. Pelvic physical therapists can examine and treat these muscles, helping to retrain them so they function properly and stop the leaks. You don’t have to just live with it—there’s help available!

If you had a c-section, you might actually need pelvic floor therapy even more than someone who had a vaginal birth!

Here’s why: Many postpartum problems stem from the physical demands of pregnancy itself. During pregnancy, your joints and pelvic floor muscles are under constant strain from carrying your baby. This can weaken or overly tense the pelvic floor, potentially leading to issues like urinary or fecal leakage, pelvic organ prolapse, diastasis recti, pelvic pain, pain with intercourse, pelvic girdle pain, tailbone pain, and hip or back pain. If you had an unplanned C-section and labored before the surgery, your pelvic floor muscles were likely impacted by the labor itself as well.

Additionally, c-sections often leave behind significant scar tissue, which can create a “shelf-like” appearance and may pull on joints and fascia, causing tailbone, hip, back, or abdominal pain. Pelvic PT can help address and treat this scar tissue to alleviate these symptoms.

Lastly, remember that a c-section is major abdominal surgery. After any major surgery, physical therapy is key for full recovery and a return to normal activity. During a c-section, seven layers of tissue are cut or pulled apart. Without proper pelvic PT, these muscles may not heal to their fullest capacity, leading to pain and limited activity for years to come. Pelvic PT will guide you in retraining your abdominals from the inside out for complete healing.

Pelvic floor PT awareness has only started to grow in the last 5-10 years, thanks to more women advocating for themselves. The lack of awareness or skepticism around pelvic floor therapy might be why it wasn’t mentioned to you. Many of our postpartum patients ask the same question!

This is why we’re committed to spreading awareness and letting people know that help is available. You’re not alone, and we’re here to support you on your journey.

It’s unlikely that postpartum pelvic floor dysfunction will heal on its own. Many women dismiss pelvic floor issues until they become major problems, but waiting often means more time and visits are needed to resolve them. If you’re planning on future pregnancies, these conditions can worsen over time. Early intervention with pelvic floor therapy can help you address the problem before it becomes more severe.

Once your OBGYN clears you to resume intercourse, it’s normal to experience some initial discomfort, but this should quickly resolve. If pain persists, it may be a sign of either scar tissue from a healing perineal tear or stitches or overuse of the pelvic floor muscles due to pregnancy, labor, or delivery.

This can happen even for women who had a C-section. Pain with sex is one of the top complaints we treat for C-section mamas! If the pain continues, it’s a good idea to consult with a pelvic floor physical therapist to address the root cause and help you feel more comfortable.

No, you don’t need an abdominal binder. In fact, for some people, an abdominal binder can increase pressure on the pelvic floor and delay healing, potentially raising the risk of leakage and prolapse.

Instead, we recommend wearing comfy clothing and compression leggings or shorts to support blood flow and lymphatic drainage after birth. If you’ve had a c-section, try to avoid clothing with a waistband at the incision level—high-waisted options are usually more comfortable. One of our favorite brands is Bao Bei!

Yes, you can do sit-ups again, but timing and technique are key. Before returning to sit-ups, it’s important to first rebuild your foundational core strength. Once you’ve built up to the point where sit-ups are safe, you need to make sure you’re not putting extra pressure on your pelvic floor and core while performing them.

Poor form and technique during sit-ups can potentially worsen pelvic floor symptoms. Consulting with a pelvic floor physical therapist will help ensure your form is correct and safe.

Some signs that your body might not be tolerating exercise include an increase in vaginal bleeding, leakage, pressure, or pain. These symptoms suggest you may have over-exerted yourself and need to scale back.

For example, if you’re two weeks postpartum and go for a 1-mile walk, but then notice heavier bleeding afterward, it’s a sign that 1 mile might be too much for now. In this case, reducing the distance is more appropriate at this time.

Remember, every individual is different, so it’s important to listen to your body and adjust as needed.

It’s best to wait until 12 weeks postpartum before returning to high-impact activities. 

Why? Jumping back into intense exercise too early without building back your foundation can lead to postpartum issues like leakage, prolapse, diastasis, and pain in the future– especially after multiple pregnancies. 

But don’t worry, this doesn’t mean you have to be sedentary for 12 weeks. During this time, you’ll focus on rebuilding your foundation and gradually strengthening your body with progressive exercises to challenge your body. This way, when you do return to high-level exercise, you can do so confidently, without fear of setbacks.However, patients who come in for prenatal PT often recover smoother and can safely return to higher-impact and intensity exercises even sooner under supervised postpartum rehab. By preparing their bodies during pregnancy, they set themselves up for a faster, more confident postpartum recovery.

At your 6-week follow-up, your OBGYN checks for signs of infection and ensures you aren’t at risk for any serious medical complications. However, they do not assess your abdominal or pelvic floor muscles or screen for pelvic floor dysfunction.

Only a pelvic floor PT can thoroughly examine your pelvic floor and provide a personalized treatment plan for common postpartum issues like urinary or fecal incontinence, pressure or prolapse, diastasis, pelvic pain, pain with sex, hip or back pain, and tailbone pain. While your OBGYN is there to ensure your overall medical health, your pelvic PT focuses on helping you regain strength, comfort, and confidence so you can live your life and spend time with your family without worry.

Many women continue to hold onto patterns from pregnancy into postpartum, which can lead to long-term issues like chronic pain, leakage, pressure, and discomfort. A thorough evaluation with a pelvic floor PT will help you safely rebuild strength and prevent these problems as you continue your recovery. 

After 6 weeks, you can start gradually progressing your exercises, but it’s important to avoid high-impact activities that might set back your healing. This is the perfect time to see a pelvic floor PT for a full postpartum assessment if you haven’t already. We’ll check your posture, movement patterns, abdominals, spine, pelvis, and pelvic floor muscles.

It depends on the type of exercise! We actually recommend starting gentle mobility and stabilization exercises in the first couple of weeks postpartum. Why? Research shows that after just 1-2 days of immobility, muscle mass begins to atrophy. This can be especially challenging for a new mom who needs strength to care for her baby. That’s why, during prenatal sessions, we prepare moms with a plan for their first three weeks postpartum. We then meet virtually at the 3-week mark for a home assessment via video to safely progress from there and so a home assessment if necessary. 

However, we do not recommend high-impact activities, like running or sports, until at least 12 weeks postpartum. Even if your OB has “cleared” you at 6 weeks, jumping back into everything you were doing before can lead to postpartum issues like increased vaginal bleeding, leakage, pressure, prolapse symptoms, and diastasis. It’s important to give your body the time it needs to heal before returning to more intense exercises.

A 1:1 birth prep session with a pelvic PT offers a unique experience that goes beyond what you learn in a general birth education class. In these personalized sessions, you receive an individualized assessment of how your body and pelvic floor function in different birthing positions and how your pelvic floor muscles respond when you practice pushing.

Pelvic PTs are the only providers trained to fully examine and treat pelvic floor muscle dysfunction, which can arise during pregnancy. In fact, research shows that only 50% of women do not know how to properly engage and relax their pelvic floor muscles. This one-on-one assessment can address that gap, teaching you how to effectively use your pelvic floor during birth. This knowledge not only helps reduce the risk of prolonged labor, complications, and severe perineal tearing but also gives you more confidence going into delivery.

Pelvic PTs bring a unique skill set that complements your other birth team members. We are the only providers trained in internal pelvic floor muscle examination and treatment. The tools and techniques you’ll learn during your pelvic PT sessions are not covered by any other birth provider.

This is crucial because if your pelvic floor muscles aren’t functioning properly, it can slow down labor and increase the risk of complications. Working with a pelvic PT ensures your body is well-prepared for labor and delivery, helping you have a smoother experience.

No, it is not normal to experience pain during pregnancy. While you may feel some discomfort from your baby pushing on your ribs or bladder, you should never be in pain. Many providers might tell you that pain is “normal,” but if that were true, why do only about 50% of pregnant women experience it?

If you’re feeling pain, it’s important to seek help sooner rather than later. The longer you wait, the worse it can get, making it harder and more time-consuming to manage.

Common causes of pain during pregnancy include muscle imbalances, weakness, hormonal changes that affect your joints, and shifts in posture or walking patterns. These issues are often more noticeable in women experiencing their second (or more) pregnancies or carrying multiples.

What can you do about it? Get a pelvic floor physical therapist on your team! A pelvic floor PT will assess your whole body to find the root cause of your pain and treat it. They’ll also prescribe corrective exercises to help stabilize your body, preventing pain from returning or even occurring in the first place.

If you are experiencing any symptoms, then ASAP! Symptoms include but are not limited to: Pubic Bone Pain, Lightning Crotch, Round Ligament Pain, Hip Pain, Back Pain, SI Joint Pain, Sciatica, Pelvic Heaviness, Prolapse, and Leakage. 

Some patients start their prenatal PT journey in the first trimester, especially if they’re experiencing aches and pains. This is more common in women who are on their second pregnancy or beyond, as symptoms often appear earlier.

Most patients start in the second trimester when they’re feeling less nauseated and might start to notice some discomfort. If you’re not experiencing pain, the second trimester is also a great time to work on preventing pregnancy-related pain and postpartum issues.

Starting pelvic PT in the third trimester can still be beneficial, especially for birth prep and pain management. However, the earlier you start, the more likely you are to see the full range of benefits during pregnancy and postpartum recovery.

Absolutely! Many pregnant women come to us not because of a problem, but to ensure they’re doing safe and effective exercises throughout their pregnancy. We work with women to prevent pregnancy or postpartum conditions, such as urinary leakage, fecal leakage, pelvic organ prolapse, pelvic pressure, pain during intercourse, diastasis recti, and general pain.

Consistent prenatal PT has a big impact. Our patients who regularly attend prenatal sessions recover faster and more smoothly than those who either didn’t attend or only came sporadically.

We also offer 1:1 birth prep sessions that focus on preparing you for labor and delivery. In these sessions, you’ll learn to control your pelvic floor muscles (both engaging and relaxing), practice pushing techniques, and assess various birthing positions to find what feels best for your body. We’ll also discuss early, middle, and active laboring positions. Your partner or birth support person is welcome to attend to better support you during delivery.

Research supports that consistent pelvic floor PT can help reduce labor times, decrease the risk of severe perineal tearing, lower the chance of instrument-assisted delivery, and improve postpartum recovery.

No, it’s not bad to do core exercises while pregnant! This is a common myth that isn’t backed by evidence.

In fact, avoiding all core exercises during pregnancy can lead to less favorable healing outcomes. When you skip core exercises, your muscles weaken, making it harder for them to support your body as it changes. This can increase the risk of pregnancy-related aches and pains and result in a more challenging postpartum recovery due to muscle deconditioning.

That said, some core exercises are more beneficial during pregnancy than others. Always listen to your body, and consider working with pregnancy specialists or a pelvic PT to ensure you’re doing exercises that support your unique needs.

A common misconception about pregnancy is that you need to stop exercising or only do “pregnancy-safe” exercises. This belief isn’t backed by evidence. In fact, most exercises you did before pregnancy are safe to continue!

A few exceptions:

• Lying on your back: After the first trimester, about 25% of women may feel lightheaded when lying on their back due to pressure on the blood vessels to your heart. If you’re in this group, avoid exercises in this position after 13 weeks. However, if you don’t feel lightheaded, you may tolerate short periods on your back.
• Lying on your stomach: Once you have a noticeable bump, exercises that involve lying on your tummy should be avoided.
• High-risk sports: Avoid activities with a risk of physical contact or falling to prevent impact injuries.
• Barbell movements: Avoid movements like cleans, clean and jerks, and snatches once the bar path crosses your growing belly.

Always listen to your body and modify as needed to stay comfortable and safe during your pregnancy!

The only reason you would need to avoid pelvic PT during pregnancy is if your OBGYN has placed you on bed rest. Otherwise, pelvic PT is a very safe and conservative way to support your pregnancy, so you don’t need specific approval from your OBGYN.

We do ask for your OB to provide a “clearance” form for internal examination and treatment. This is simply to keep everyone on the same page and ensure we work together as part of your birth team. If your OBGYN has cleared you for intercourse during pregnancy, rest assured that our internal exam or treatment is much less invasive.

Yes! Nearly one-third of our patients are pregnant, ranging from the first to the third trimester. Our Doctors have advanced training in assessing and treating pregnant women. For those seeking pregnancy support, we focus on managing pain related to pregnancy, such as back or hip pain, pubic bone pain, “lightning crotch,” round ligament pain, SI joint pain, neck pain, pelvic girdle pain, tailbone pain, pelvic pain, and pain during intercourse. (For more on why pain happens during pregnancy, see our section on “Is it normal to have pain during pregnancy?”)

We also work with pregnant women from a preventive approach to help prevent conditions like urinary or fecal leakage, pelvic organ prolapse, pelvic pressure, pain during intercourse, diastasis recti, and more. Additionally, we offer one-on-one birth prep sessions to help you feel confident in your pelvic floor and body as you prepare for labor and delivery.

While you might find plenty of pelvic floor exercises online, we don’t recommend following a program without professional guidance. The reason is simple: not all exercises are safe or appropriate for every condition. For example, contrary to popular belief, doing Kegel exercises can actually worsen symptoms if you have an overactive or tense pelvic floor.

A study showed that supervised pelvic floor therapy is far more effective than doing exercises on your own. In fact, patients who received guided therapy were twice as likely to see improvement in their symptoms compared to those who tried it alone! The only way to determine the right approach for your pelvic floor is through an evaluation with a licensed Doctor of Physical Therapy who has advanced training in this area.

No worries! You should still come in for your appointment. Your physical therapist plans each visit to meet you where you are, so you’ll still benefit from the session. Skipping a week can slow down your progress, so it’s best to keep your appointment.

If you’re finding it hard to do your homework, let your therapist know. We’re here to help you problem-solve and adjust your plan so it fits into your life more easily.

There’s no need to cancel your appointment! Having your period won’t impact your treatment plan. We can still do an internal exam if you’re comfortable with it. However, if you prefer not to do internal therapy during your period, that’s perfectly fine. Your therapist will focus on a whole-body approach, addressing areas outside the pelvis that may be affecting your symptoms.

Skipping a week can set you back in your progress, so we encourage you to keep your appointment and let us adjust the session to fit your needs.