The Foundations of Pelvic Floor Therapy — What Everyone Should Know
Dr. Allea Francis, PT, DPT
Pelvic floor physical therapy (PFPT) is one of the most misunderstood areas of rehabilitation. Many people arrive at their first appointment thinking it’s all about Kegels, or that a few sessions will “fix” everything. Others have been told their symptoms are “normal,” or that pain and leakage are simply part of aging, motherhood, or stress.
They’re not.
This week, we’re breaking down the real foundations of pelvic floor therapy—what it is, what it isn’t, and what every person deserves to know before starting their healing journey.
Pelvic Floor PT is Not One-Size-Fits-All
Your story, your body, and your symptoms are uniquely yours.
That means what worked for your friend, sister, partner, or someone on Instagram may not work for you—and that’s not a failure. It simply means you need a plan tailored to you: your specific patterns, history, and goals.
Your Pain is not Someone Else’s Pain
Two people can have the same diagnosis with entirely different drivers beneath it.
One person’s pelvic pain may be rooted in hip mobility issues; another’s in stress-based gripping; another’s in postpartum recovery or old injury patterns. Pelvic Floor PT is highly individual: there is no universal fix.
PFPT is more than Kegels
In fact, most people we treat need the opposite.
Pelvic floor therapy includes:
breath and diaphragm retraining
core coordination
hip and glute strength
postural and movement strategies
bowel and bladder habit retraining
manual therapy
behavioral and lifestyle support
Kegels are one tool. Not the treatment.
Pelvic Floor PT Must Be Trauma-Informed
Your therapist should move at the pace your body and nervous system allow.
You should understand every step of the process, give consent for every part of the evaluation, and feel empowered to say “pause” or “no” at any time.
This is essential—not optional.
Pelvic Floor PT is not Usually a Quick Fix
Most pelvic floor dysfunction develops slowly over time. Because of that, healing also occurs over time. PFPT addresses the root of symptoms, not just the surface-level presentation.
This takes curiosity, consistency, and patience—but the results are lasting.
Symptoms Often Start Outside the Pelvis
We often find contributing factors such as:
core weakness
glute weakness
limited hip mobility
breathing inefficiencies
postural habits
stress-induced muscle guarding
old injuries or surgeries
unresolved pain in other regions
The pelvis is rarely the whole story—and that’s exactly why a holistic assessment matters.
The Sooner You Get In, the Better
Early intervention prevents symptoms from becoming chronic or worsening over time. But even if you’ve struggled for years—it’s never “too late.” The body is adaptable.
You Deserve a Therapist Who Listens
Your pelvic floor therapist should:
listen without dismissing
collaborate with you
support your goals
adapt your plan as your body changes
A good therapist is a guide, not a dictator.
Your Therapist Is a Tool—Not the Solution
This is empowering: Ultimately, you are the one who creates change.
Your therapist provides expertise, insight, strategy, and support—your healing comes from the work you and your body do together.
Your Therapist Should Help You Feel Motivated, Not Pressured
Your therapist should challenge you in a way that builds confidence, and creates an environment free of fear or shame.
We push for growth, not perfection.
PFPT Should Feel Empowering
Understanding your body, your patterns, and your power to change them is foundational in this process.
Soreness After PT Is Normal
We’re asking tissues, muscles, and movement patterns to change.
Some soreness is expected and appropriate—but sharp or alarming pain should always be communicated.
Healing Is Not Linear
Some sessions feel like breakthroughs. Others feel like setbacks. Both are part of the process.
A major part of PFPT is safely identifying triggers—then working through them to resolve the underlying dysfunction.
Read: Is your Pelvic Floor the Missing Link in your Pain?
What You’ve Been Told Is “Normal” Often Isn’t
Sex shouldn’t hurt.
Leaking urine—at any age—is not normal.
Pooping once a week is constipation, not a quirk.
If you clench your jaw, you’re probably clenching your pelvic floor.
These symptoms are common, but not normal, and they deserve proper evaluation.
The Bottom Line
Pelvic floor therapy works—but it works because it treats the whole person, not just the pelvis. When you understand the foundations of PFPT, you’re better equipped to advocate for yourself, participate in the process, and create long-term change.
See Also: What is Pelvic Floor Physical Therapy?
Dr. Allea Francis, PT, DPT
Dr. Allea Francis, is a Doctor of Physical Therapy who began her journey into pelvic health after being diagnosed with interstitial cystitis, an experience that fueled her passion for understanding and treating chronic pelvic pain. She has extensive expertise in managing complex conditions such as pudendal neuralgia, PGAD (persistent genital arousal disorder), rectal spasms, endometriosis, and interstitial cystitis.
In addition to her work with chronic pelvic pain, Dr. Allea has a special interest in the rehabilitation of pelvic organ prolapse and preventive care to prepare the body for labor and delivery. Her holistic, patient-centered approach integrates physical therapy with nutrition, mindfulness, and other complementary therapies to provide comprehensive and compassionate care.
