Is Pelvic Floor Physical Therapy Just Kegels?

When I tell people what I do for work, the most common response I get is, “So, do you just tell people to do kegels?”

The short answer? No.

The long answer…

The pelvic floor is a complex part of the body made up of bones, muscles, tendons, ligaments, fascia, nerves, and blood vessels. It also supports major organs, including the bladder, rectum, and—depending on anatomy—the uterus or prostate.

Because of its central position, the pelvic floor is affected by everything from how we move and sit to our stress levels. Even habits like clenching your jaw or the way you walk can impact pelvic floor function. And because this region houses critical organs, issues like digestion, menstrual health, and constipation can also play a role.

As pelvic floor physical therapists, our goal is to assess the whole person to figure out the root cause of their symptoms. This means that while we’ll likely evaluate and treat the pelvic floor directly—including its strength—we also assess the rest of your body.

Beyond Kegels: Our Approach to Pelvic Floor Health

Here are some key areas we examine beyond just kegels:

Breathing

Your diaphragm (the dome-shaped muscle under your ribs) and the pelvic floor work together. How you breathe affects how your pelvic floor moves. If you're mainly breathing with your upper chest and limiting diaphragm movement, your pelvic floor likely isn't functioning as well as it could be.

Posture

Modern life involves a lot of sitting—at desks, in cars, and on our phones. These habits contribute to a forward head posture and rounded shoulders, which can impact the spine, hips, and pelvis. During pregnancy and postpartum, posture changes even more, adapting to a growing baby and then shifting again due to feeding, diaper changes, and carrying the baby.

Bowel and Bladder Habit Re-training

We spend a lot of time discussing bathroom habits—when to hold it, how often to go, and tips for better bladder control. Many solutions have nothing to do with strengthening the pelvic floor!

Strength & Coordination

Yes, strength matters—but it’s not just about squeezing. We check how well the pelvic floor muscles contract, how long they can hold, and whether they fatigue quickly. Coordination is key, too. Are all parts of the pelvic floor working together, or is one side lagging? This can give us valuable insight, especially when treating incontinence.

Flexibility

Your pelvic floor muscles must be able to relax—just like any other muscle. Tightness can contribute to pain, difficulty with bowel movements, and even complications with childbirth.

Pressure Management

Think of your trunk as a canister. The pelvic floor is the bottom, your abs and low back are the sides, and your throat/mouth is the top. How you manage pressure inside this system matters. Too much downward pressure can overload the pelvic floor, contributing to issues like prolapse or incontinence.

Stress Management

When we’re stressed, we clench our muscles—including the pelvic floor. Stress also affects breathing, which (as we mentioned earlier) impacts pelvic function. Plus, a nervous system in high alert mode can increase pain perception and make symptoms worse.

Hormones

Hormone levels shift throughout life—during the menstrual cycle, pregnancy, postpartum, perimenopause, and menopause. These changes directly impact pelvic floor tissues, so we tailor treatment accordingly.

Diet & Hydration

Since many pelvic floor issues involve the bladder or bowels, we evaluate diet and hydration. Some foods and drinks irritate the bladder, and even how you drink water (sipping vs. gulping) can make a difference.

Functional Movements

How do you get out of bed? How do you bend, lift, and carry your child or groceries? What does your current exercise routine look like? Everyday movements can place unexpected pressure on the pelvic floor, sometimes worsening symptoms.

Other Orthopedic Concerns

The pelvic floor doesn’t work in isolation. We often find weakness or mobility issues in nearby areas like the hips and lower back, but we also assess the neck, feet, and ankles if needed—because everything is connected!

TLDR? Pelvic floor physical therapy is not just kegels.

When you come to Pelvic Health and Wellness, you can be confident that you’ll receive a thorough evaluation and a treatment plan that goes far beyond just kegels. Curious about what to expect? Check out our blog about what to expect at your pelvic floor PT evaluation.

About Pelvic Health & Wellness

Pelvic Health & Wellness was built with you in mind. We practice whole-person, individualized pelvic floor physical therapy in a caring and safe environment. Our physical therapists specialize in treating pelvic health concerns such as pelvic floor dysfunction, pain, prolapse, constipation, incontinence, fertility, and various pregnancy and postpartum-related conditions.

We understand that being ready to talk about and address your pelvic floor wellness concerns comes from a place of strength. We are here to support and encourage you on your journey back to health so you can return to doing what you love! If you are ready to take the first step in reclaiming your pelvic health and wellness, don't hesitate to get in touch with us today.