Pelvic Floor Dysfunction

Pelvic Floor Dysfunction Treatment at North Carolina Physical Therapy
Pelvic Floor Dysfunction (PFD)

is a complex and often misunderstood condition that affects individuals across the gender spectrum and throughout various life stages. At North Carolina Physical Therapy, we take an inclusive, trauma-informed, and medically grounded approach to the evaluation and treatment of pelvic floor disorders—far beyond the typical postpartum or stress incontinence narrative.

Oncology-Related Pelvic Floor Dysfunction

We specialize in treating patients with pelvic floor dysfunction related to cancer treatment, including post-radiation fibrosis, surgical scarring, pelvic organ damage, and nerve trauma. Many of our patients are survivors of gynecologic, colorectal, or prostate cancers and experience pelvic pain, dysfunction, or sexual health challenges as a result of their treatment. Our goal is to restore function, reduce pain, and improve quality of life through compassionate, skilled care.

GI-Related Pelvic Floor Dysfunction

Pelvic floor dysfunction often plays a significant role in gastrointestinal disorders, including chronic constipation, fecal urgency, incomplete evacuation, bloating, or rectal pain. These symptoms may result from pelvic floor dyssynergia, incoordination of abdominal pressure, or functional outlet obstruction. Our evaluation includes assessment of defecatory mechanics, abdominal-pelvic coordination, and core engagement, and treatment is designed to improve muscle recruitment, eliminate straining, and normalize bowel patterns through biofeedback, behavioral retraining, and manual techniques.

Chronic Pain & Hypermobility-Linked PFD

Individuals with chronic pelvic pain syndromes or connective tissue disorders like Ehlers-Danlos Syndrome (EDS) often experience pelvic floor dysfunction as part of a broader musculoskeletal or systemic presentation. Symptoms may include pelvic pressure, prolapse, dyspareunia, abdominal pain, and instability due to ligamentous laxity and impaired neuromotor control. Our approach prioritizes gentle stabilization, sensory retraining, and graded exposure to movement, with special attention to joint protection, tissue loading, and nervous system regulation.

Gender-Affirming & LGBTQ+ Pelvic Health

Our care is inclusive of transgender, nonbinary, and gender-diverse individuals, including those undergoing or recovering from gender-affirming surgeries. We provide affirming, trauma-aware care for patients receiving procedures such as vaginoplasty, phalloplasty, and hysterectomy, with a focus on functional restoration, scar management, core integration, and sexual health support. We honor each individual’s identity, autonomy, and experience at every stage of care.

Male Pelvic Health

We provide specialized pelvic floor care for men experiencing dysfunction related to chronic pain, urinary or bowel issues, and post-surgical recovery. This includes treatment for chronic prostatitis/chronic pelvic pain syndrome (CPPS), erectile dysfunction (ED), urinary urgency or frequency, fecal incontinence, and post-prostatectomy complications. We conduct comprehensive musculoskeletal evaluations that address

pelvic floor muscle tone, scar mobility, neuromuscular control, and movement patterns —offering a plan built on both clinical evidence and empathy.

What to Expect

Your evaluation includes a detailed review of your medical and surgical history, assessment of pelvic floor muscle function, and analysis of posture, core engagement, and mobility patterns. Internal pelvic floor examination is offered when clinically appropriate and always performed with consent and comfort in mind.

Treatment plans are tailored and may include:

• Manual therapy for pelvic and abdominal myofascial restrictions

• Neuromuscular re-education for core and pelvic coordination

  Breathing retraining and optimization of intra-abdominal pressure (IAP) regulation

  Defecation mechanics and bowel retraining to normalize pelvic coordination and reduce straining

  Bladder retraining for urgency, frequency, or retention

• Post-surgical rehabilitation and scar mobilization

• Education on pacing, pelvic awareness, functional movement strategies, and self-regulation techniques

Whole-Person, Inclusive Pelvic Care

At North Carolina Physical Therapy, we believe pelvic health is foundational to overall well-being. No matter your identity, anatomy, or medical history, you deserve expert care that acknowledges your lived experience. If you're experiencing chronic pelvic pain, bowel or bladder dysfunction, sexual health concerns, or post-operative complications, we’re here to help.