Pelvic Floor Physical Therapy

By RRM Academy Reviewed by Dr. Naomi Whittaker, MD, Board-Certified OBGYN, MIGS, NFPMC, FCI Updated May 14, 2026

Pelvic floor physical therapy (PFPT) is a specialized rehabilitation discipline that evaluates and treats musculoskeletal contributors to chronic pelvic pain, dyspareunia, voiding and bowel dysfunction, and post-surgical or postpartum pelvic floor impairment. Pelvic floor therapists assess hypertonic or hypotonic pelvic floor muscles, myofascial trigger points, scar tissue restrictions, and neuromuscular coordination patterns. Treatment addresses the physical layer of conditions that also have gynecologic or hormonal contributors.¹

For patients with endometriosis and chronic pelvic pain, pelvic floor dysfunction frequently coexists with the underlying disease. Adhesions, inflammatory lesions, and guarding responses alter muscle tone and neuromuscular coordination. A randomized controlled trial in women with deep infiltrating endometriosis found that pelvic floor muscle physiotherapy produced significant improvements in urinary, bowel, and sexual function compared to controls.² A 2025 systematic review and meta-analysis confirmed that physical rehabilitation reduces endometriosis and adenomyosis-related symptom burden, with locally applied techniques showing the strongest effect.³

PFPT is not an alternative to gynecologic evaluation. It is adjunct care. Surgery addresses the anatomical source of disease. PFPT addresses the neuromuscular sequelae. Post-excision patients often benefit from pelvic floor rehabilitation to resolve guarding and scar tissue restrictions that persist after excision. The same applies after adhesiolysis or other pelvic reconstructive procedures.

Indications for referral to a pelvic floor therapist include chronic pelvic pain with a musculoskeletal component, dyspareunia, postpartum pelvic floor recovery, and voiding or bowel dysfunction. Evaluation by a pelvic floor therapist typically includes internal and external assessment of tone, trigger points, and functional movement patterns.

This content is for educational purposes only and does not constitute medical advice. Consult an RRM clinician or healthcare provider for guidance specific to your situation.