Pelvic floor therapy targets the muscles, ligaments, and connective tissues that support your pelvic organs—think bladder, bowels, and reproductive system. These structures play a starring role in everyday functions like urination, digestion, and even sexual health. Problems here can affect anyone, regardless of gender, and can throw a wrench into your quality of life. In a recent interview, Dr. Rachel Daof, a pelvic floor physical therapist at Pelvic Model Physical Therapy, sat down with Dr. Connor McClenahan to unpack this essential yet often overlooked topic.

What Pelvic Floor Therapy Can Do for You

Pelvic floor therapy tackles a surprising variety of issues that might be disrupting your daily routine. Dr. Daof sums it up with a memorable phrase: “We help with pee, poo, and pleasure.” Here’s a closer look at the common challenges it addresses:

• Urinary Incontinence: Ever leak a little when you cough, sneeze, or hit the gym? That’s more common than you might think.
• Bowel Dysfunction: Struggles like constipation or fecal incontinence can be tough to talk about, but they’re treatable.
• Pelvic Pain: Discomfort in the genital, anal, or lower abdominal areas can stem from muscle tension or injury.
• Sexual Health Challenges: Pain during intimacy, erectile dysfunction, or premature ejaculation can all tie back to pelvic floor issues.

These problems don’t discriminate—they can affect people of all ages and genders, often triggered by things like childbirth, trauma, or even prolonged stress. The good news? They’re not something you have to just live with.

Pelvic Floor Therapy is About Safety

At Pelvic Model Physical Therapy, the treatment process is all about creating safety. It starts with a conversation—a detailed chat about your symptoms and history. Dr. Daof stresses that consent is non-negotiable: “We make sure patients are comfortable with every step.” Depending on what you’re dealing with, the next phase might involve an internal exam to check how those pelvic muscles are functioning. Don’t worry—these are done with care and always with your boundaries in mind.

From there, the team crafts a plan tailored just for you, targeting any weaknesses or tightness in the pelvic floor. “We want them to feel safe in our environment, with our presence, and with the manual therapy,” Dr. Daof explains. That sense of safety isn’t just a bonus—it’s what’s actually required for the muscles and nervous system to elongate and heal.

Pelvic Guarding and Kegel Exercises

Dr. Daof uses a simple yet powerful analogy to illustrate why pelvic floor issues often go beyond a lack of strength: imagine trying to clench your fist tightly for hours on end. Eventually, the muscles tire out, becoming so fatigued that they can no longer contract effectively, even if you want them to. This is similar to what happens with an overly tight or hypertonic pelvic floor. When these muscles are chronically tense—whether from stress, poor posture, or overcompensation—they lose their ability to relax and then contract properly. It’s not a matter of weakness but rather a state of exhaustion or dysfunction.

This is why Kegel exercises, which focus on strengthening through repeated contractions, often fall short or even worsen the problem. For many, the pelvic floor doesn’t need more tension; it needs release, retraining, and balance to restore its natural function. This points to the need to relax, elongate and understand the chronic tension we carry.

Emotional History Impacts Pelvic Floor Muscles

Here’s where it gets interesting: your pelvic health isn’t just about muscles—it’s tied to your emotions, too. Dr. Daof points out that experiences like childhood shame or trauma can show up years later as physical issues. Imagine a kid taught to “hold it in” because of strict rules or embarrassment. Over time, that habit can turn into chronic muscle tension down below.

That’s why pelvic floor therapy often takes a holistic approach, sometimes teaming up with psychotherapists to tackle both the physical and emotional sides of healing. It’s not just about fixing a symptom—it’s about understanding the whole picture to get lasting results.

Create Safety and Healing

If any of this sounds familiar—whether it’s a little leak or a nagging pain—know that you’ve got options. Pelvic floor physical therapy can make a real difference, and there’s no reason to let embarrassment keep you from getting help. Dr. Daof and her team are here to guide you with expertise and compassion.

We believe emotional and physical healing are 2 sides of the same coin. The pain you experience creates an emotional stamp that’s felt by both your internal world of relationships and self, as well as your body’s muscular and nervous system. Whichever side of the tunnel you approach it – whether with a psychotherapist or with a pelvic floor therapist – we know the healing is worth reaching out.