When to See a Pelvic Floor PT vs. When You Can Strengthen at Home

Jan 5

TL;DR — What You’ll Learn in This Post

If you’re wondering whether you actually need pelvic floor physical therapy—or if at-home strengthening is enough—this guide will help you decide.

You’ll learn:

The clear signs you should not ignore (and shouldn’t DIY)
When at-home pelvic floor and core strengthening works well
How to use a hybrid approach (support + independence)
How breathing, core control, and pressure management fit into both paths
Exactly what to do next based on your symptoms and goals

👉 Before we dive in → Grab my Breathe + Reflect Guide, a short, calming practice to help your nervous system settle so your core and pelvic floor can respond and support you better—especially when you’re feeling overwhelmed or disconnected.

Breathe + Reflect

Do I Need Pelvic Floor Therapy? The Question Most Women Ask

If you’re postpartum and wondering whether your body just needs time—or whether something deeper is going on—you’re not alone. Many women aren’t sure if leaking, core weakness, or pelvic pressure after birth means they need pelvic floor physical therapy or if they can safely strengthen at home.

As a pelvic health physical therapist who now works 100% virtually, I see this question every week:

“Do I need pelvic floor PT… or can I just strengthen at home?”

The honest answer?

It depends on your symptoms, your body, and how well your system is working together.

Some issues truly need individualized assessment and coaching. Others respond beautifully to the right at-home program — especially when breath and pressure are addressed first.

When Pelvic Floor PT (or Coaching) Is Non-Negotiable

If you’re experiencing any of the following, don’t push through with random exercises:

You should seek pelvic floor support if you have:

Pain with sex, pelvic pain, or tailbone pain
Diastasis recti with doming or poor tension
Symptoms that worsen with exercise
A sense that you can’t feel or control your pelvic floor

👉 These are not “normal mom problems.” They’re signs your system needs more than strengthening alone.

If any of these sound familiar, these posts will help you understand what’s happening and what to do next:

Why At-Home Exercises Sometimes Make Symptoms Worse

Strengthening without addressing breath, pressure, and coordination often leads to:

Increased downward pressure
Over-tight pelvic floor muscles
Worsening leaks or prolapse symptoms
Core work that looks “strong” but isn’t functional

This is why how you exercise matters more than what exercises you do.

When At-Home Pelvic Floor & Core Strengthening Does Work

Not everyone needs ongoing 1:1 care.

You may be a good candidate for at-home work if:

You can coordinate breath + core without bearing down
You want preventative support or gentle rebuilding
You’re cleared for exercise and want a structured plan

This is where guided programs — not random workouts — shine.

👉 Breathe + Reflect is often the first step I recommend because it helps:

Restore diaphragmatic breathing
Improve pelvic floor coordination
Reduce tension before strengthening

How to Strengthen at Home — The Right Way (Step-by-Step)

Step 1: Reconnect Breath & Pelvic Floor

Focus on diaphragmatic breathing and gentle pelvic floor awareness. This sets the foundation for everything else.

Learn more here: How to Perform 360° (Diaphragmatic) Breathing for Core + Pelvic Floor Support

Step 2: Build Foundational Core Support

Introduce gentle deep core engagement (no bracing, no bearing down). You should feel support, not strain.

Step 3: Layer in Functional Strength

Squats, hinges, bridges, and daily movement patterns — all coordinated with breath.

Step 4: Address Leaks Specifically (If Needed)

If bladder leaks show up during movement, impact, or urgency, I talk more about this here.

The Hybrid Approach I Recommend Most Often

Most women don’t need either/or — they need both support and autonomy.

My most common recommendations:

Start with breath + awareness
Use a targeted program for your main concern (like leaks)
Add 1:1 virtual coaching if symptoms persist or feel confusing
Transition confidently into independent strengthening

FAQ — Pelvic Floor PT vs. Strengthening at Home

1. Can I fix bladder leaks without seeing a PT?

Sometimes — if leaks are mild and addressed early with breath, coordination, and pressure management. Persistent leaks usually benefit from guided support.

2. Is virtual pelvic floor coaching effective?

Yes. Many pelvic floor issues are movement-, breath-, and habit-based — which makes virtual coaching highly effective when done intentionally.

3. How long does pelvic floor recovery take?

Most people notice changes in 6–12 weeks, but long-term resilience builds over months.

4. Should I just do Kegels?

Not always. Many people leak because their pelvic floor is over-tense or poorly coordinated, not weak.

TL;DR — How to Decide & What to Do Next

See a pelvic floor specialist if you:

Leak urine, gas, or stool
Feel pressure or heaviness
Have pain or worsening symptoms
Don’t feel confident engaging your core

Start at home if you:

Are symptom-free or mildly symptomatic
Want prevention or rebuilding
Follow a structured, breath-led program

Ready to Feel Strong, Connected, and Capable Again?

To get support that actually fits your life, here’s where to begin:

👉 Download the Breathe + Reflect Guide
👉 Explore the Pelvic Floor & Core Strengthening Flash Cards
👉 Learn more about 1:1 support for busy moms

Disclaimer: This post is educational and not a substitute for medical care. If you have concerning symptoms, please consult your healthcare provider.

Ashley Gadelha