How Pelvic Floor Physical Therapy Can Help with Pelvic Pain

As a pelvic health physical therapist, one of the most common concerns I hear from patients is the experience of pelvic pain. Whether it’s discomfort during intimate activities, chronic lower back or pelvic aching, or pain with bowel or bladder movements, pelvic pain can be both physically and emotionally distressing.

What many people don’t know is that pelvic floor physical therapy (PFPT) can be an effective and life-changing treatment for pelvic pain. In this post, I’ll explain how PFPT works, how it helps manage pelvic pain, and why seeking help from a trained specialist could make a huge difference in your quality of life.

Understanding Pelvic Pain

Pelvic pain is any type of discomfort or aching in the pelvic region, which is the area between the belly button and the thighs. This includes the lower abdomen, hips, groin, lower back, and perineum (the area between the genitals and anus). It can affect men and women of all ages, and the causes of pelvic pain are as diverse as the people who experience it. Some common reasons people experience pelvic pain include:

Pelvic floor muscle dysfunction: When the pelvic floor muscles (the muscles that support your bladder, bowel, and reproductive organs) become too tight, weak, or uncoordinated, they can contribute to chronic pelvic pain.
Endometriosis: A condition where tissue similar to the lining of the uterus grows outside the uterus, causing painful periods and pelvic discomfort.
Interstitial cystitis: A bladder condition that causes urinary urgency and pain in the pelvic area.
Chronic prostatitis: For men, pelvic pain could be related to inflammation of the prostate gland.
Pelvic organ prolapse: When pelvic organs drop and put pressure on surrounding structures, causing discomfort.

Despite these causes, many individuals with pelvic pain don’t immediately think of their pelvic floor as a potential culprit. That's where pelvic floor physical therapy can come into play.

What is Pelvic Floor Physical Therapy?

Pelvic floor physical therapy focuses on evaluating and treating the muscles, ligaments, and tissues of the pelvic floor. Your pelvic floor is a group of muscles that form a "hammock" at the base of your pelvis, supporting the organs within your abdomen. These muscles are responsible for functions like bladder and bowel control, sexual function, and supporting the organs of the pelvic cavity.

When the pelvic floor is tight, weak, or misaligned, it can cause or contribute to a variety of pelvic pain symptoms. A pelvic floor physical therapist is a healthcare professional specially trained to address these issues and can provide hands-on therapy, education, and exercises that help restore pelvic floor function and alleviate pain.

How Pelvic Floor Physical Therapy Helps With Pelvic Pain

Pelvic floor physical therapy can address pelvic pain in several ways:

Identifying Pelvic Floor Muscle DysfunctionOne of the first things a pelvic health physical therapist will do is assess the strength, coordination, and flexibility of your pelvic floor muscles. Pelvic pain can often result from a dysfunction in these muscles, whether it’s muscle tightness, weakness, or even poor coordination. Through an individualized assessment, your therapist can pinpoint the specific areas that need attention and design a plan to address them.
Pelvic Floor Relaxation and ReleaseMany people experiencing pelvic pain have overly tight pelvic floor muscles, sometimes due to stress, trauma, or injury. Pelvic floor physical therapy helps by teaching techniques for releasing these tight muscles. This can involve manual therapy, gentle stretches, and relaxation exercises aimed at improving flexibility and reducing tension in the pelvic area.
Strengthening Weakened Pelvic MusclesOn the other hand, some people experience pelvic pain because their pelvic floor muscles are weak or not functioning properly. A physical therapist will guide you through pelvic floor strengthening exercises, such as Kegel exercises or other targeted techniques. Strengthening the pelvic muscles can provide better support for the organs and improve function, ultimately reducing pain.
Correcting Posture and AlignmentPostural issues, such as poor alignment of the spine or pelvis, can contribute to pelvic pain. A pelvic floor physical therapist can assess your posture and provide strategies to improve alignment, which can reduce strain on your pelvic muscles and improve overall function.
Addressing Dysfunction in Surrounding MusclesThe pelvic floor doesn’t work in isolation—other muscles in the abdomen, back, hips, and legs play a role in pelvic function. Your therapist may incorporate exercises for these surrounding areas to improve the overall balance and coordination of your musculoskeletal system. Strengthening and releasing the muscles around the pelvis can help reduce pressure and alleviate pain in the pelvic floor.
Working with the Nervous SystemChronic pelvic pain is not always just a physical issue—it often involves the nervous system. When pain persists for a long period, the nervous system can become hypersensitive, amplifying the sensation of pain. This is known as central sensitization, where the body’s pain signals become more easily triggered. Pelvic floor physical therapy works not only on the pelvic muscles but also on calming and retraining the nervous system. Techniques like neural mobilization, relaxation exercises, and mindfulness can help decrease this sensitivity, reduce pain perception, and promote better nerve function, allowing the body to return to a more balanced state.
Education and Behavioral ModificationsOften, pelvic pain can be aggravated by certain habits or behaviors. Your physical therapist will help you identify any habits that may be contributing to your pain (like poor bathroom habits, heavy lifting, or prolonged sitting) and teach strategies to improve them. This might include pelvic floor-friendly toileting techniques, posture tips, or lifestyle modifications that help you feel better.

A Personalized Approach

No two cases of pelvic pain are exactly alike, and neither is the treatment. A skilled pelvic health physical therapist will take a personalized approach to your care. This might involve a combination of manual therapy, therapeutic exercises, posture education, and other modalities tailored specifically to your needs.

Why Seek Professional Help?

While pelvic pain can sometimes improve with self-care or over time, chronic pain that doesn’t resolve on its own warrants professional attention. A pelvic floor physical therapist is trained to evaluate your unique situation, uncover the root causes of your pain, and guide you through a structured plan to find relief. Ignoring pelvic pain or hoping it will go away can lead to long-term discomfort and complications. With the right intervention, most individuals can experience significant improvements in their symptoms.

Conclusion

Pelvic floor physical therapy is an invaluable tool for anyone experiencing pelvic pain. Whether it’s pain with sex, bladder dysfunction, or chronic pelvic discomfort, a pelvic floor physical therapist can help identify the underlying causes and develop a tailored plan to relieve your pain and restore function. If you're living with pelvic pain, don’t suffer in silence—consider seeking the care of a pelvic health physical therapist to help you live your best, pain-free life.

Have questions about pelvic pain or pelvic floor physical therapy? Feel free to reach out!