• Dr. Jodi Hierholzer, DPT

What is Pelvic Health Physical Therapy?

Updated: Nov 9

The pelvic floor is increasingly gaining time in the spotlight, most commonly thought of in reference to the infamous ‘Kegel’ strengthening exercises. In all reality, the pelvic floor is SO MUCH MORE!

Pelvic health therapy is targeted at the low back, hips, and pelvic floor muscles, ligaments and connective tissues, all of which work together to support the pelvic organs, sexual function, and assist in bladder and bowel control.

Pelvic health PT is a non-surgical approach aimed at resolving impairments that arise from dysfunctions within the pelvic floor. Example impairments include but are not limited to:

  • low back/hip pain

  • diastasis recti

  • poor core function

  • urinary urgency/incontinence (including overactive and/or painful bladder) - Ever pee when you jump rope???

  • constipation

  • pain with sexual intercourse

  • pelvic organ prolapse

  • pelvic girdle pain

  • pregnancy & postpartum (labor conditioning, exercise progressions throughout pregnancy, etc.)

When patients present with these concerns, our pelvic health Physical Therapist (Dr. Amber Lewis) will perform a comprehensive assessment, which may include an internal assessment if warranted (BUT NOT ALWAYS!). If this sounds strange, think of it this way: you would never have your knee treated by a physical therapist without having them test and palpate the muscles of the knee first. Through internal palpation the PT discerns whether pelvic floor muscles are overactive or underactive, as well as whether they are coordinated with other muscle groups. An internal assessment is not always warranted, and will always be discussed and consent obtained prior to internal examination. You can also look forward to a safe and private setting to make your visit with us as comfortable as possible.

A pelvic health PT also considers the orthopedic components that may be contributing to the individual’s symptoms (examples: core/hip weakness, spinal & pelvic alignment, motor control, history of pregnancy/trauma).

Upon examination, patients receive an integrative treatment approach that emphasizes current sources of dysfunction but also aims to prevent further concerns down the road (after all, prevention is the best medicine!). Treatment options typically include manual therapy and soft tissue work, therapeutic exercise, patient education, neuromuscular re-training, & recommendations on tools that can help patients reach their specific goals (i.e. pelvic floor wands, pelvic weights, dilators etc).

Pelvic Health PT can be particularly important during and after pregnancy. If you had shoulder surgery, your doctor would not hesitate to send you to PT. The same should go for pre & postpartum!

Let's be real...the body undergoes an immense amount of change during pregnancy, labor, and postpartum. The birth process can take a certain physical toll, leaving behind tissue damage, weakness, pain, instability, inhibited or spastic muscles, and the list goes on. While some of these side effects are unavoidable, seeing a pelvic health PT during pregnancy can help to accentuate the natural healing capacity of the body.

Following birth, many of our patients report urinary incontinence when sneezing, jumping, running, exercising, bracing, etc, as well as pelvic organ prolapse issues. Patients also commonly report neck and back pain, sciatica, pelvic pain, and tailbone pain, a lot of which can be the result of the postural changes that come with nursing, carrying your baby/car seat, wearing your baby etc. Many of our patients have problems connecting with their pelvic floor muscles, and they want to get a sense of what they need to be doing to reintegrate that and how to return to an exercise regimen. We can help with that!

Understanding how to safely and effectively take care of yourself and understanding the resources you have available to you can be a game changer when dealing with pelvic health dysfunction!

If you are interested in seeing how pelvic health PT can help you, or if you want to get on Dr. Amber Lewis's schedule for a pelvic health consult & treatment, give us a call at 325-261-0043, or email us at

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