Pelvic Floor Physical Therapy: It’s more than just Kegals

Did you know that physical therapy can be an effective treatment for a variety of pelvic floor disorders such as incontinence, urinary frequency and pelvic pain? As experts of the musculoskeletal system, a pelvic floor physical therapist is trained to evaluate pelvic floor muscle function in order to determine an individualized course of treatment to optimize muscle function.

The most common reason for a person to be referred for evaluation by a pelvic floor specialist is urinary incontinence. Both men and women can suffer from incontinence for various reasons such as childbirth or surgery, however some patients suffer from incontinence for no apparent reason. One misconception is that all patients with incontinence should simply do kegals (pelvic floor contractions). This, however, is not always the best advice.

Incontinence can occur due to a weakness of the pelvic floor musculature, however it can also be due to an overactive pelvic floor. A hypertonic pelvic floor can cause the pelvic floor muscles to become less effective when the intra-abdominal pressure increases, such as with laughing, sneezing or coughing. Therefore, symptomatically, stress incontinence due to weakness and overactivity can appear similar, however the treatments can be very different.

The only way to asses whether a patient’s incontinence is due to weakness or over active pelvic floor muscles is to perform an examination to determine the strength and tone of the pelvic floor. Based on that information, a pelvic floor specialist can determine whether strength training, or relaxation training (or a combination of both) will be most effective in treating the patient’s symptoms. 


There is also a large behavioral component to physical therapy for pelvic floor dysfunction. Patients can have triggers causing them to feel the need to urinate more frequently. This can be due to an overactive/irritable bladder, or it can be caused by the fact that the bladder is not fully emptying during urination. Proper pelvic floor training can help determine the best treatment for urinary frequency.


Whether the symptoms are due to weakness or overactive pelvic floor muscles, pelvic floor physical therapy can be an effective treatment for pelvic floor dysfunction. To schedule an appointment or to ask specific questions, please call our office at 415-388-8166 or email Whitney Rogers, our women’s health expert, at