Pelvic Floor Therapy Near Me

Your guide to pelvic floor therapy

Curious how pelvic floor therapy can help you? Read on for answers to basic questions like: What is Pelvic Floor Therapy? What about internal exams? How can I find the right therapist? What can I expect at my first visit?

If you are ready to find a pelvic floor therapist, use the directory below to search for occupational therapists (OTs) with a focus area of pelvic floor therapy near you. Both OTs and physical therapists (PTs) can practice as pelvic floor specialists. Pelvic Rehab is another great resource for finding pelvic floor therapists! 

What is pelvic floor therapy?

Pelvic floor therapy is treatment for problems related to the pelvic floor. In the simplest sense, the pelvic floor is a group of 14 muscles in 3 layers. These muscles support our internal organs. 

Pelvic floor therapy involves much more than just simple strengthening exercises. The nature of the pelvic floor necessitates a holistic approach—as these core muscles support everything from intimacy to posture when sitting in a chair. They are also affected by a variety of factors ranging from your stress level to your breathing. 

Signs you may need pelvic floor therapy: 

• Incontinence/leaking pee, poop, or gas
• Constipation
• Pelvic pain
• Pain and discomfort with sex
• Lower back pain
• Abdominal pain

Common conditions pelvic floor therapists may work with: 

• Prenatal and postpartum care
• Pelvic organ prolapse
• Diastasis recti abdominis
• Endometriosis
• Hysterectomy rehabilitation
• Prostatectomy rehabilitation
• Polycystic ovarian syndrome

Can men and children receive pelvic floor therapy? 

Yes! Every single person has a pelvic floor, so the reality is that everyone can benefit from pelvic floor therapy.

Many people associate pelvic floor therapy with childbirth, but the truth is that people of all genders and all ages may benefit from pelvic floor therapy. 

Bedwetting is a common reason for children to be referred to pelvic floor therapy—as are constipation and fear of going to the bathroom. Pelvic floor therapy can also play an important role in gender-affirming care.

What happens in pelvic floor therapy?

When you begin pelvic floor therapy, your therapist will provide an evaluation and collaborate with you to set goals. (Learn more about this below, in the section on what to expect at your first visit.)

Given the complex nature of the pelvic floor, there are multiple approaches to treatment. You have probably heard of Kegels, an exercise to strengthen your pelvic floor. This is one of the best-known pelvic floor treatments. (But, it is important to note that Kegels are not appropriate for everyone, and there are cases where they can actually make pelvic floor dysfunction worse!)

Other pelvic floor interventions include: 

• Breathwork 
• Posture work
• Manual therapy 
• Biofeedback
• Relaxation and mindfulness techniques 
• Stretching
• Massage
• Corrective exercises and functional movement training (beyond just Kegels)
• Habit retraining (e.g., bladder/bowel habits)
• Ergonomics (e.g., position used to void; a Squatty Potty can be effective in addressing this)
• Patient education and support

What about internal exams? 

Pelvic floor therapy may involve receiving an internal exam, where the therapist uses a gloved hand to check the health of your pelvic floor. 

Internal exams provide valuable information that can be used for treatment. However, they are not the only way to gather information about how your pelvic floor muscles are working. Assessments and treatments can be performed intra-vaginally or intra-rectally.  

If this is not something you are interested in or comfortable with, just let your provider know. 

What happens during pelvic floor internal work?

Internal work begins with a visual assessment of the external tissues to see how well your superficial muscles can contract and relax. 

The therapist will then take a gloved finger and apply gentle pressure to the superficial muscles to identify any areas of tenderness or tightness (i.e., hypertonicity). They may also place their finger on the perineum (i.e., the space between the vagina and anus) to assess the quality of the tissue. At the vaginal opening (or rectal opening), the therapist may assess the quality of the muscle to determine muscle strength, tone, and coordination. 

Internal assessment can occur at each layer of the pelvic floor. This is all done with consent at each step of the process—and you can stop the process at any point. 

Many therapists use a sheet to cover the area throughout the entire process, even while internal work is happening. A pelvic floor therapy session differs from an OB/GYN appointment in that once the therapist completes their visual assessment of the tissues, they can insert a finger while keeping a sheet in place to cover the person receiving treatment—because it’s all about feeling the tone and coordination of the muscles.

Before becoming a pelvic floor provider, I was a patient myself—and I found it very comforting when I realized the therapist wasn’t going to be looking at my crotch for the entire one-hour session. 🙂

Given the intimacy of the pelvic floor and differing levels of priority placed on pelvic floor work, it is important to find the right therapist for you.

How can you find the right therapist? 

Pelvic floor therapists are highly trained professionals—and here in the United States, most pelvic floor therapists are licensed as occupational therapists or physical therapists. 

To find the right fit for you, dig into what type of pelvic floor therapy the provider specializes in and what training they’ve done! We encourage you to call or send a message to ask the therapist your questions before you schedule your first appointment. Here are some ideas to get you started: 

Questions to ask before starting pelvic floor therapy: 

• What is your approach to therapy?
• What can I expect during our first session together?
• Are home exercises required?
• How much internal work will happen?
• What if I have a trauma history? How do you deal with past trauma related to the pelvic floor?
• Do you consider mental health as part of your pelvic health work?
• Are babies welcome? Are support people welcome?

Can pelvic floor therapy be done at home? 

Yes. Pelvic floor therapy can be done via telehealth. There’s a lot that providers can assess virtually about your posture, breathing, body mechanics, and core muscle engagement. Working with a provider in person may help you reach your goals more quickly. However, it is undoubtedly possible to achieve significant change through virtual sessions. 

Does insurance cover pelvic floor therapy?

Maybe. It depends on what kind of OT/PT coverage your specific plan has. Not all pelvic floor therapists take insurance, though. Some are private pay only. If you need to pay out of pocket for your session and the cost is a barrier or concern for you, ask if the therapist is able to provide you with a superbill. That way, you can submit it to your insurance to seek reimbursement after your session.

What can you expect during your first visit?

What should you wear to your pelvic floor therapy session?

Wear comfortable clothes that you can move in—and that allow the therapist to view what is happening with your body. Leggings/yoga pants/bike shorts and a sports bra/fitted tank tend to work best. If you are receiving internal work, you will be asked to undress from the waist down and will be covered with a sheet.

Should you bring your baby?

If you want to! It can be helpful for the therapist to observe how you hold/carry/lift your baby in relation to any pelvic floor symptoms you are experiencing. Most therapy providers are used to accommodating the needs of baby/parent dyads during sessions—we make it work! 

How long will it take to get better?

The short answer is…it depends. You might experience relief after a handful of sessions (i.e., 4–6 visits). However, it may take longer depending on the root cause of your issue. The health of our pelvic floor is closely connected with how we move through our days—so, if your posture or daily habits are impacting your pelvic floor, it can take a while to retrain those habits. 

We encourage you to have a conversation with your provider about any questions or concerns related to your progress in therapy. 

Pelvic floor devices and exercises

• Dilators – These can be helpful for people who are experiencing pain with intimacy, vaginismus (i.e., involuntary spasm of the muscles around the vagina), and other types of pelvic pain. Dilators provide a gentle stretch to the tissues surrounding the vaginal opening. They are typically made of plastic or silicone and come in varying sizes. Users are educated on how to select the dilator size, insert with plenty of lubricant, and engage in relaxation techniques as the tissues gently stretch. When using the dilators, the goal is to help the user learn how to relax using a smaller size first before moving up to a larger size. 
• Wands (including vibrating and thermal) – These can be helpful for the self-management of tender points (i.e., trigger points) deep within the pelvic floor muscles. They can also help with hypertonic (tight) pelvic floor muscles and pelvic pain. 
• Vaginal weights – These provide helpful proprioceptive feedback for people who are having difficulty connecting to their pelvic floor muscles or who need to strengthen their pelvic floor. 
• Biofeedback – This process uses electrodes applied externally or internally to help determine which muscles you’re using. 

How do people become pelvic floor therapists? 

Your pelvic floor therapist is a highly skilled healthcare professional, as they must first become licensed as an occupational or physical therapist. If you are interested in becoming a pelvic floor therapist, here are the basic steps:

1. Earn a master’s or doctorate degree in occupational or physical therapy. 
2. Get licensed by your state. 
3. Complete additional training to specialize in pelvic floor therapy. 

Additional training options for pelvic floor therapists are wide-ranging and include: 

• OT Pioneers: Introduction to Pelvic Floor Therapy 
• Essential Pelvic Health: Pelvic Rehab Manual Assessment and Treatment Techniques (PR-MATT)
• Herman and Wallace Pelvic Rehabilitation Institute
• Biofeedback Training and Incontinence Solutions 
• Institute for Birth Healing
• Core Exercise Solutions: Pregnancy & Postpartum Corrective Exercise Specialist Certification 2.0
• Restore Your Core
• MedBridge Courses with Lindsey Vestal

Bottom line: Is pelvic floor therapy worth it?

Yes! Your pelvic health impacts so much of your daily life. If you have any inkling that you may benefit from pelvic floor therapy, talk to your doctor or get a hold of a local pelvic floor therapist. They can guide you through the steps to get started. 

Overall, the sooner you begin therapy after a problem starts, the better! (In fact, research suggests that the most cost-effective time to begin childbirth-related pelvic floor therapy is actually before you give birth—because this allows you to receive preventative therapy services.)

No matter where you are in the journey, though, I hope this article has helped demystify this critical and holistic type of therapy! 

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Listen to our pelvic health episodes on the OT Potential Podcast