Is Pelvic Floor Therapy Painful?

One common question women ask before starting pelvic floor therapy is: “Is it going to hurt?” It’s an understandable concern—after all, the pelvic floor is a sensitive area of the body, and many people seeking care are already dealing with discomfort, pain, or anxiety. We even get the question “is it going to feel like a cervical check”? To which we answer with a resounding “NO”! More on that later. 

So is the actual examination and assessment of the pelvic floor painful? 

The short answer: pelvic floor therapy should not be painful. While you may feel some mild discomfort at times—similar to how your muscles might feel sore during a new exercise—therapy should never feel overwhelming, intolerable, or unsafe. A skilled pelvic floor therapist works gently, makes sure you are comfortable every step of the way, and uses a trauma-informed approach so that you remain in control of your care. That’s always our goal here at Moms in Motion.

Let’s break down what you can expect and how we make sure the experience is supportive, not painful.

Gentle Techniques—Not Aggressive Treatments

Pelvic floor therapy often includes a combination of education, hands-on techniques, and corrective exercises. If internal work is recommended, it is done with light pressure and only with your full consent. Many people are surprised to learn that effective therapy doesn’t require force or “pushing through” pain. One of my instructors said on repeat during several courses I took from her, “you should NEVER create pain with your treatment”. Many people have heard the classic “no pain, no gain” in relation to physical therapy, but that’s not true! Although there might be residual soreness like when you lift weights, there should not be pain during treatments due to the pressure we use. At Moms in Motion, we work hard to reduce discomfort and pain with both our assessment and treatment techniques.

Techniques may include:

• Breathing, relaxation, and meditation strategies to reduce tension in the muscles and regulate the nervous system.

• Gentle manual therapy externally or internally to release trigger points, improve mobility, and decrease negative associations between the body and the brain.

• Corrective exercises that help retrain coordination and strength of the pelvic floor and core.

• Movement strategies that connect the pelvic floor with the rest of your body for functional improvements.

• Slacking and tensioning techniques that help reduce or increase tension to provide more comfort during internal work.

All of these approaches are performed at a pace your body can handle. If anything feels uncomfortable, we stop, adjust, or change techniques.

Your Comfort Comes First

Every body is different, and every healing journey is personal. That’s why pelvic floor therapy is never a one-size-fits-all approach. Before starting any hands-on treatment, we take the time to listen to your history, symptoms, and concerns. You get to decide what you’re comfortable with and we never pressure you into something you don’t feel comfortable with.

We will let you know the benefits of doing certain assessments and treatments (like internal vaginal or rectal work), and you get to decide whether or not we do them. 

Some patients prefer to start with external work only, while others are ready to include internal assessment. You always have the right to say “no”, to pause, or to change your mind at any time. Therapy is most effective when you feel safe, respected, and empowered. We don’t see great results when our patients attempt to “grin and bear it”, so we always want you to be honest about what you’re experiencing.

A Trauma-Informed Approach

We recognize that for many women, pelvic or medical experiences may have involved trauma, discomfort, or lack of control in the past. That’s why we use a trauma-informed approach in every session. This means:

• We explain what we are doing before we do it.

• We ask for consent at each step.

• We check in frequently to ensure you feel safe and comfortable, listening to your words and also watching your facial expressions and body language.

• We offer options and modifications if something feels triggering.

By practicing trauma awareness, we make sure that therapy supports your healing without re-creating negative experiences.

No Surprises—We Talk Through Everything

One of the biggest sources of anxiety about pelvic floor therapy is not knowing what to expect. That’s why communication is central to our approach at Moms in Motion. We explain what techniques may be used, why they are important, and how they may feel. If something isn’t clear, we welcome your questions at any time. We bring our pelvic models to show you what your muscles and bones look like in the pelvis and what we are planning to assess. You are always in charge of the session and what you feel comfortable with. 

The Bottom Line: Relief, Not Pain

Pelvic floor therapy is designed to help you feel better, not worse. While you might feel some mild muscle soreness—similar to what you’d expect after starting a new workout—you should never feel sharp pain, pressure you can’t tolerate, or discomfort that lingers. If something doesn’t feel right, we stop and adjust. Always let your therapist know if something is painful or feels uncomfortable. 

Our goal is to help you reduce symptoms like leakage, pelvic pain, or prolapse, while restoring confidence in your body. We do this gently, compassionately, and with your full participation.

If you find yourself in a situation where you are experiencing pain during pelvic floor therapy and your therapist is leading you to believe that is normal or the only way to make progress, we would urge you to switch providers. There are many different approaches out there and we believe pain does not have to be part of your experience. 

Final Thoughts

So, is pelvic floor therapy painful? The answer is no—it should feel supportive, safe, and empowering. With gentle techniques, clear communication, and a trauma-informed approach, we make sure you are comfortable every step of the way.

If you’ve been holding back from starting therapy because of fear of pain, know that you are not alone—and that pelvic floor therapy can actually be a source of relief and healing.