Confessions of a Pelvic Floor PT: Things I Wish Everyone Knew

Dr. Sasha Speer, PT, DPT
1 day ago
4 min read

Let’s be real: pelvic floor health isn’t exactly dinner table conversation—but maybe it should be.

As a pelvic floor physical therapist, I spend my days helping people navigate the very real (and very common) issues that most of us were never taught about.

From bladder leaks to bowel trouble to that mysterious pelvic heaviness—there’s a lot I wish more people knew. So today, I’m sharing a few confessions from the treatment room in hopes of clearing things up and making pelvic health just a little less taboo.

1. Everyone has a pelvic floor—and it matters more than you think.

It doesn’t matter your age, gender, or whether you’ve had kids—if you have a body, you have a pelvic floor.

These muscles sit at the base of your pelvis and help support your organs, control when you go to the bathroom, contribute to sexual function, and even play a role in posture and core strength. They're working quietly in the background all day long—and they deserve a little more love and attention.

2. Peeing “just in case” can actually make things worse.

We’ve all done it: one last bathroom trip before heading out the door. But if you’re constantly peeing “just in case,” your bladder can start getting the wrong message and signaling urgency way before it’s full.

Over time, this can lead to more frequent urges and a bladder that feels unpredictable. It’s a small habit that can have a big impact—and one that’s easy to shift with the right strategies.

3. Kegels aren’t always the answer.

When people hear “pelvic floor,” they often jump straight to Kegels.

But the truth is, not everyone needs to strengthen—some people need to relax. And doing Kegels the wrong way (or at the wrong time) can actually make symptoms worse. Pelvic floor therapy is about more than squeezing—it’s about balance, coordination, and knowing what your body actually needs.

4. Constipation is common

—but it’s not something you have to live with.

If you’re straining, skipping days, or relying on coffee and crossed fingers to get things moving, your pelvic floor might be involved. Chronic constipation puts extra pressure on those muscles and can lead to issues like prolapse, leakage, or pain.

The good news? With the right combination of movement, muscle coordination, and habits, you can have easier, more regular bathroom trips—and your pelvic floor will thank you.

5. Pain with sex might be common—but it’s not normal.

If sex is painful—whether during, after, or even just with certain positions—it’s a sign your body needs support. So many people assume it’s just “part of getting older” or “what happens after kids,” but that’s simply not true.

Pelvic floor therapy can address tightness, tension, or muscle dysfunction that may be getting in the way of comfort and connection. You deserve to feel good in your body.

6. We hold stress in our pelvic floors—without even realizing it.

Just like we clench our jaws or tense our shoulders when we’re stressed, many of us unknowingly grip through our pelvic floor.

Over time, this can lead to symptoms like urgency, pain, or a general feeling of “something’s off.” Learning how to release tension—especially through breathwork and nervous system regulation—can be a game-changer.

7. You don’t have to live with it.

This might be the most important one. Whether you’re dealing with leaking, heaviness, constipation, pain, or any other symptom that’s keeping you from feeling your best—it’s not just “part of life” you have to accept.

Pelvic floor issues are so common, but they’re also so treatable. With the right support, things can get better—sometimes much faster than you think.

8. Back and hip pain? Your pelvic floor might be the missing link.

If you’ve been struggling with stubborn lower back or hip pain that just won’t quit, your pelvic floor could be playing a bigger role than you realize.

These muscles work closely with your core and hips to support your pelvis and spine. When the pelvic floor isn’t functioning well—whether it’s too tight, too weak, or out of sync—it can throw off your entire movement system and contribute to pain.

Addressing pelvic floor health often unlocks progress in areas that other treatments alone haven’t been able to fix.

At Auria, we’ve seen it all (really), and we’re ready to meet you exactly where you are—with compassion and a plan that makes sense for your life. Pelvic health is deeply personal—but it doesn’t have to be isolating. Whether you’re just starting to explore these issues or you’ve been dealing with them for years, we’re here to support you every step of the way.

With care, compassion and zero judgement,

Dr. Sasha Speer, DPT

Auria Pelvic Health