Conditions Pelvic Floor Dysfunction

Your body changed. The 6-week clearance didn't account for most of it.

Leaking when you sneeze, pelvic pressure that won't quit, pain during sex, a core that doesn't feel like yours anymore — these aren't just the cost of having a baby. They're signs that something specific happened to specific structures, and those structures can be treated. Whether you're 6 weeks postpartum or 6 years out, this is addressable. You haven't missed the window.

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What it is

What Postpartum Recovery Actually Involves

Pregnancy puts sustained load on the pelvic floor, stretches the abdominal wall, shifts how the hips and spine move, and — depending on delivery — leaves behind scar tissue, nerve changes, and muscle trauma. Birth is a significant physical event. Recovery from it is more than waiting for a wound to close.

Postpartum physical therapy addresses what the body actually went through: pelvic floor muscle function, core integrity, scar tissue mobility, and how all of that feeds into the way you move, lift, run, and feel day to day. It's not a generic exercise program. It starts with figuring out what's actually happening in your body and building from there.

The goal isn't to get you back to where you were before. It's to get you to where you want to be now — with a body that works, doesn't hurt, and doesn't leak.

Conditions We Address in Postpartum Rehab

These are the specific things we see and treat. Each one connects directly to what pregnancy and delivery do to the body. Urinary leakage — leaking with sneezing, coughing, laughing, or exercise. Common after vaginal delivery, but also present after C-section. Usually a sign of pelvic floor muscle dysfunction, not permanent damage. Learn more about how we treat urinary incontinence. Pelvic organ prolapse — pressure, heaviness, or a bulging sensation in the vaginal area. Happens when pelvic organs descend due to weakened support structures. Treatable with PT in many cases, even without surgery. Diastasis recti — separation of the abdominal muscles along the midline. Affects how the core generates pressure and stability. Not just a cosmetic issue — it connects to back pain, pelvic floor symptoms, and how your body handles load. Learn more about diastasis recti treatment. C-section scar tissue — restricted mobility at or around the scar that can affect bladder function, hip movement, and even pain patterns that seem unrelated to the incision site. Painful intercourse — pain with sex after delivery, whether from perineal tearing, scar tissue, or pelvic floor muscles that are too tight. This is treatable. It is not something you have to live with. Low back and hip pain — often connected to how the pelvis and core are functioning postpartum. Treating the pelvic floor frequently resolves pain that seemed like a separate orthopedic problem. Tailbone pain — can result from pressure or injury during delivery and often persists long after. Responds well to manual therapy and targeted treatment.

• Leaking urine when you sneeze, cough, jump, run, or lift

• Urgency — can't make it to the bathroom in time

• Pain with sex or penetration

• Pelvic pain or pressure that lingers

• Heaviness or “something falling out” (prolapse)

• Tailbone pain that won't quit

• Chronic constipation, urgency, or pain with bowel movements

• Postpartum core that feels weak or “not yours”

• Diastasis recti — abdominal separation that hasn't closed

• Hip or back pain a regular PT couldn't resolve

• Pelvic-area pain without a clear structural cause

• Symptoms that started after pregnancy, surgery, or injury

The 6-Week Clearance Myth

The 6-week OB appointment is a wound-healing check. Your provider is looking at whether the incision or perineal tissue has healed, whether your uterus has returned to its normal size, and whether there are signs of infection or complication. That's important. It is not a full assessment of your pelvic floor, your core, or your readiness to return to exercise.

Hypertonic

What the clearance doesn't cover

It doesn't assess whether your pelvic floor muscles are functioning. It doesn't evaluate diastasis recti or core pressure management. It doesn't look at how your hips and spine are moving, or whether your body is ready to run, lift, or do anything more demanding than walking. "Cleared" means the healing tissue is okay. It doesn't mean the rest of the system is ready.

Most postpartum patients who come in with leaking, prolapse symptoms, or pelvic pain were told at 6 weeks that everything looked fine. It's not that the OB missed something — it's that the appointment wasn't designed to catch those things. Physical therapy is what fills that gap.

Hypotonic

It's not too late, even if it's been years

One of the most common things we hear: "I had my baby two years ago — is it too late?" No. Pelvic floor and core dysfunction doesn't have an expiration date on treatment. The tissue is still responsive. The muscles can still be retrained. Whether you're 6 weeks or 6 years postpartum, what you're dealing with is worth treating.

A lot of people have been quietly managing symptoms for years — wearing a pad, avoiding certain exercises, dreading sneezing — because someone told them it was just normal after having a baby. It's common. It's not something you're stuck with.

A lot of patients arrive with a mix: tight in some areas, weak in others. That's why blanket prescriptions (“do a hundred Kegels a day”) so often don't help. The right approach starts with finding out what's actually going on.

How we treat it

What Postpartum PT Looks Like at Centered

It starts with a full assessment. Your first session is an hour with one clinician. We look at your history, your symptoms, your birth experience, and how your body is actually moving and functioning. If an internal pelvic exam is indicated, we explain exactly what it involves before we do anything. It's your call whether to include it, and it can always happen at a later session when you're more comfortable.

Manual therapy when it's useful. Hands-on work to address muscle tension, scar tissue restrictions, and movement limitations. For C-section patients, that often includes work on the scar itself — which most people have never had addressed. For pelvic floor patients, it may include internal or external soft tissue work depending on what the assessment shows.

Exercises that match what you actually need. Not a generic postpartum protocol. The exercises you get depend on whether your pelvic floor is too tight, too weak, or both — and that changes what treatment looks like. Kegels are not always the answer. Sometimes they make things worse.

The whole picture, not just the pelvic floor. Postpartum symptoms rarely stay in one place. Back pain connects to core function. Hip pain connects to how the pelvis is moving. Leaking connects to how you breathe and manage pressure. One clinician sees all of it — pelvic floor, orthopedics, and movement mechanics together. You don't have to see three different providers and hope they talk to each other.

A clear plan. At the end of your first session, you'll know what's going on, why, and what the plan is. No open-ended commitment. We'll give you a realistic picture of how many sessions to expect and what we're working toward.

What to expect at Centered

Frequently Asked Questions

When can I start physical therapy after giving birth? For most people, somewhere between 4 and 8 weeks postpartum is appropriate for an initial evaluation, depending on how delivery went and how healing is progressing. You don't need to wait for your 6-week clearance to schedule a consultation. We can talk through timing on a free call before you book anything.

What does postpartum physical therapy actually involve? Your first session is a full hour. We go through your history and symptoms, assess how your body is functioning, and — if you're comfortable — include an internal pelvic exam to evaluate the pelvic floor directly. From there, treatment involves a mix of hands-on work, targeted exercises, and education about what's happening and why. Every session is one-on-one. You see the same clinician each time.

Can PT help with postpartum pain even if my baby is older? Yes. There's no point at which postpartum pelvic floor and core dysfunction becomes untreatable. We regularly see patients who are months or years out from delivery and still dealing with leaking, pelvic pain, painful sex, or a core that doesn't feel right. The body responds to treatment regardless of how long the symptoms have been present. If you've been told to just live with it, that's worth getting a second opinion on.

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A few common questions

Frequently asked questions.

Can pelvic floor dysfunction resolve without surgery?

For most presentations, yes. Physical therapy is the first-line treatment recommended in clinical guidelines for incontinence, pelvic pain, sexual dysfunction, and most prolapse. Many patients improve substantially or fully resolve without surgery.

Some cases benefit from a combined approach with a physician or surgeon. We work alongside referring providers when that's the right path.

What does a pelvic floor physical therapist actually do?

Four things, repeatedly: assess, treat with hands and movement, teach, and progress you back to what you want to be doing. Internal exam is one tool in the toolkit, not the whole job. The bigger work is figuring out what's going on, why it's going on, and what's going to fix it.

Is pelvic floor dysfunction only a women's issue?

No. The conversation around pelvic floor health has historically centered on women's health, but pelvic floor dysfunction affects people of all genders. Men experience pelvic pain, post-prostatectomy incontinence, chronic prostatitis-type symptoms, and other pelvic floor conditions. Centered treats all patients.

I've done Kegels for years. Why am I still leaking?

Two possibilities. One: you have a hypertonic pelvic floor, and Kegels are making things worse. Two: your pelvic floor is weak in the way Kegels can help, but you're doing them in a way that isn't translating to function (timing, breathing, posture, force production). An assessment sorts out which one is happening for you.

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