Episode 51: Pelvic Floor Therapy: What Every Woman Needs to Know (But No One Tells You)
💫Episode 51: Pelvic Floor Therapy: What Every Woman Needs to Know (But No One Tells You)
Leaking when you sneeze. Pain during sex. Pelvic pressure that just doesn't feel right. These are symptoms millions of women live with daily — and normalize. In Episode 51 of the Collective Guidance Podcast, host Charla Goodnight sits down with Dr. Bri Thornton, pelvic floor physical therapist, certified functional medicine practitioner, and owner of Holistic Health PT and Wellness in Bonita Springs, Florida, for an honest, empowering conversation about women's pelvic health that is long overdue.
The Symptoms Women Normalize That Shouldn't Be
Dr. Bri gets straight to it: leakage is extremely common, but it is not normal. Neither is pain during intercourse, pelvic pressure, or discomfort when sitting for long periods. These are your body's early warning signals — and the sooner you address them, the less likely you are to ever need surgery.
Other commonly dismissed symptoms include:
Leaking when coughing, sneezing, laughing, or exercising
Pain or discomfort during sex
Pelvic heaviness or prolapse symptoms
Chronic pelvic pain or pain when sitting
Difficulty with bladder or bowel control
"Women deserve to feel strong and healthy — not put up with dysfunction just because they've had children or are getting older."
Why You Need an Actual Exam — Not Just Kegel Exercises
Here's what most women don't know: a tight pelvic floor causes just as many problems as a weak one. Dr. Bri herself developed pelvic pain without ever having children — and she's a physical therapist. Pain during intercourse and discomfort when sitting were her primary symptoms, not leakage.
The solution isn't always more Kegels. Strengthening a pelvic floor that's already too tight can make things significantly worse. The only way to know what's actually going on is through a thorough internal examination with a qualified pelvic floor therapist.
Dr. Bri emphasizes that this exam looks at far more than just the pelvic floor — she assesses posture, movement patterns, how you squat and brace, gut health, nervous system state, and the full body picture. One patient eliminated leakage during trampoline class simply by changing her spinal posture — no internal work required.
Non-Surgical Solutions That Actually Work
The good news: most pelvic floor conditions are treatable without surgery, especially when addressed early. Dr. Bri's toolkit includes:
Postural and movement cues — sometimes a single adjustment changes everything
Pessaries — medical-grade silicone devices inserted vaginally to support organs during high-impact activity, easily removable and reusable
Biofeedback devices — tools like the Perifit that connect to your phone and make pelvic floor training interactive
Dry needling — acupuncture-style needles used to release tight pelvic muscles or release scar tissue, including cesarean scars
Nervous system regulation — breathwork, stress management, and jaw or neck work that calm the body's threat response
Surgery is sometimes necessary — Dr. Bri is honest about that. But even then, pelvic floor therapy before and after improves outcomes significantly.
The Nervous System and Pelvic Floor Connection
This is where it gets fascinating. Dr. Bri sees nervous system dysregulation as one of the most overlooked drivers of pelvic floor dysfunction. When your body is stuck in chronic fight-or-flight, it physically tenses and tucks the pelvis — just like a frightened dog tucks its tail.
Releasing those muscles without addressing the nervous system is a temporary fix at best. The body will re-tighten because it still feels threatened. This is why so many of Dr. Bri's treatment sessions look nothing like traditional physical therapy — she may work on the jaw, neck, breathing patterns, or stress response rather than the pelvic floor directly.
She's also seeing an increase in pelvic tension conditions overall, which she links directly to our chronically overstimulated, screen-heavy world — even in children.
Practical Guidance: What to Do Next
If you're experiencing any pelvic floor symptoms:
Find a pelvic floor therapist near you by searching "pelvic rehab provider near me" or checking online provider databases
Look for someone who does a thorough full-body evaluation, not just a quick probe test
Make sure your provider is a good fit — this is intimate work, and your nervous system needs to feel safe
Know that most providers don't take insurance directly, but you can submit for reimbursement — and all out-of-pocket healthcare expenses are tax-deductible. HSA funds can also be applied.
Don't wait. The earlier you address pelvic floor symptoms, the more non-surgical your options will be.
Key Takeaways
Leakage, pelvic pain, and painful intercourse are common but not normal — and all are treatable
Both a weak and overly tight pelvic floor cause dysfunction; only an internal exam reveals which one you have
Most pelvic floor conditions have non-surgical solutions including pessaries, biofeedback, dry needling, and postural correction
The nervous system plays a major role in pelvic tension — regulating stress is part of treatment
Men have pelvic floors too and can develop dysfunction, especially post-prostate surgery
The field of women's pelvic health is growing fast — more providers, more research, more resources than ever before
Connect with Dr. Bri Thornton: 🌐 Holistic Health PT and Wellness — Bonita Springs, FL 📸 Follow Dr. Bri on Instagram for free pelvic health education
Follow Collective Guidance: @collectiveguidance | collectiveguidance.com
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Sending love, remembrance, faith, and creativity,
Charla ❤️
