What to Expect at Pelvic Floor Physical Therapy in 2025: A Guide to Empowered Healing

If you’re considering pelvic floor physical therapy, know this—it’s about more than just exercises or symptom management. Healing is personal, and you have options. Therapy is one path, not the only path. This guide will help you understand what to expect from pelvic floor therapy while also encouraging you to trust your intuition and explore different healing modalities.

1. Initial Consultation: Open & Honest Conversations

Your first session starts with a conversation. A skilled therapist will ask about your symptoms, concerns, and goals while making space for you to share your story. This is your time to be open and honest—whether you're experiencing incontinence, pelvic pain, postpartum changes, or other concerns.

✅ Trust your gut. If you feel unheard or dismissed, you don’t have to stay. A good therapist listens, validates your experience, and guides you without judgment.

2. Physical Assessment: Understanding How Your Body Moves

Pelvic floor dysfunction isn’t just about one set of muscles—it’s connected to your core, hips, lower back, and posture. Your therapist will observe:

• How you sit, stand, and walk
• The movement and coordination of your pelvic floor, core, and diaphragm
• Signs of muscle tightness, weakness, or imbalance

What matters most: If you feel uncomfortable at any point, speak up. Your body, your rules.

3. Internal vs. External Exam: Your Choice, Your Comfort

Your therapist may suggest an internal pelvic exam to assess muscle function. Unlike a gynecological exam, this is a gentle, one-finger assessment to check for:

• Muscle tightness or weakness
• Coordination and ability to contract and relax
• Areas of pain or tension

✅ You can say no. Internal exams are always optional. If it doesn’t feel right for you, a therapist can gather valuable information through external assessments, breathwork, and movement-based testing.

4. Creating a Personalized Healing Plan

After your assessment, your therapist will outline a custom plan based on your needs. This may include:

• Targeted exercises (strengthening or relaxation)
• Hands-on techniques (manual therapy, fascia release)
• Breathwork & posture training
• At-home strategies for daily improvement

✅ You are in control. If the approach doesn’t feel right, you have the right to adjust your plan or seek other healing methods.

Pelvic Floor Exercises: Strengthening or Relaxing

• If your muscles are weak, exercises like engaged breathing and core activation may help.
• If your muscles are overly tight, therapy will focus on relaxation techniques rather than Kegels.

Manual Therapy: Hands-On Release for Pain Relief

Some therapists use external or internal manual therapy to release scar tissue, trigger points, or tight fascia.

Breathwork & Postural Alignment

Your breathing and posture directly impact pelvic function. A therapist may guide you in diaphragmatic breathing and realignment exercises to improve muscle coordination.

Biofeedback & Electrical Stimulation

Some therapists use biofeedback sensors to help you connect with the right muscles. In cases of extreme weakness, gentle electrical stimulation may be used to activate muscles.

✅ These tools can be helpful, but they are not the only way. Many people find healing through breathwork, movement therapy, and fascia release—without medical devices.

Pelvic floor therapy is just one tool in a much larger healing journey. If traditional therapy doesn’t feel right for you, here are other powerful ways to restore pelvic balance:

1. Breathwork & Nervous System Regulation

Dysfunction isn’t always about the muscles—it’s also about the nervous system. Slow, intentional breathing helps downregulate stress and improve pelvic function.

2. Movement-Based Healing

Instead of rigid exercise routines, many people find relief through yoga, dance, Pilates, or intuitive movement.

3. Fascia Release & Scar Tissue Work

Tension in the pelvic floor is often linked to tight fascia and old scar tissue from childbirth, surgery, or injury. Soft tissue release and myofascial work can provide lasting relief.

4. Mindset & Emotional Healing

The pelvic floor holds stored tension, trauma, and subconscious patterns. Working with somatic therapy, meditation, or guided visualization can help reconnect you to this area.

✅ Your body is not broken. Healing is possible, and you have options.

1. Wear Comfortable Clothing – You’ll want to move freely during your session.

2. Be Open With Your Therapist – If something feels uncomfortable, ask questions or request modifications.

3. Stay Consistent With At-Home Practice – Whether it’s therapy exercises, breathwork, or fascia release, progress happens in between sessions.

4. Listen to Your Body – If an exercise or treatment feels wrong, trust that feeling.

5. Know When to Walk Away – If your therapist’s approach doesn’t feel supportive, find another path. Healing is not one-size-fits-all.

Pelvic floor physical therapy can be a powerful tool, but it’s not the only answer. Your body has an incredible ability to heal, and your intuition will guide you toward what’s right for you.

• If therapy feels like a safe and supportive space, use it.
• If something feels off or forced, explore other healing options.
• You are not broken. You have choices. You can heal.

Take the next step with confidence—whether it’s scheduling a consultation, exploring alternative healing programs with MoonRise, or simply tuning into what your body needs today.