PELVIC HEALTH & POSTPARTUM · STAFFORD, VA
Pelvic Health: The Conversation Should Start Before Something Goes Wrong
Pelvic health is more than internal examinations, postpartum rehabilitation or Kegels. It is learning how the bladder, bowel, pelvic floor, abdominal wall, hips, breathing and pressure system work together, and having language for symptoms that people are often taught to hide. Divine Physical Therapy pairs women's pelvic floor rehabilitation with prevention and community education designed to make these conversations normal, practical and easier to ask about.
THE BASICS
What Does Pelvic Health Mean At Divine Physical Therapy?
It means two things at once: providing individualized physical therapy when pelvic symptoms need skilled care, and teaching people about pelvic health early enough that pain, leaking, constipation, pressure, puberty changes or body questions do not have to become years of silence before someone asks for help.
Dr. Paige practices as an orthopedic pelvic health physical therapist, so the pelvis is never separated from the rest of the movement system. Clinical care may include breathing, pressure management, abdominal wall, hips, spine, strength, movement and pelvic floor assessment. Internal pelvic assessment is not required, is never part of community or adolescent education, and at Divine is offered only to women when clinically appropriate, with informed consent and in accordance with practice policy.
This is one of the most important parts of Divine Physical Therapy's mission. Pelvic health has historically been treated as private, embarrassing or something people should simply tolerate. Dr. Paige's approach is the opposite: use accurate language, explain what is happening, protect dignity, and make it easier to seek care before symptoms become normalized.
Where This Comes From
Dr. Paige's interest in pelvic health grew from being comfortable talking about the parts of health people often avoid: bladder leakage, bowel habits, pelvic pain, sexual pain, scars, postpartum changes and the anatomy people sometimes do not even have words for.
“Not being afraid to say the words for the ‘private places’ out loud, plainly and without embarrassment, is most of the job. My goal is not to make private health public. It is to remove unnecessary shame from normal health conversations so people can recognize concerns, ask informed questions and know when help exists.”
Dr. Thea Paige, PT, DPT, CMTPT, PCES
THE SCALE OF IT
How Common Is Pelvic Floor Dysfunction, In Women And In Men?
Common enough that silence about it is the anomaly, not the symptoms. Pelvic floor dysfunction is not only a women's condition, even though internal treatment approaches differ by sex at Divine.
WOMEN'S HEALTH STATISTICS
Nearly 1 in 4
In adult women in the United States, nearly one in four women experiences at least one pelvic floor disorder, including urinary incontinence, fecal incontinence, or pelvic organ prolapse (Nygaard et al., 2008). Rates climb with age, reaching roughly 40% of women aged 60 to 79 and 50% of women aged 80 and older.
Scope of Care: Divine Physical Therapy provides comprehensive women's pelvic floor rehabilitation, including internal assessment when clinically indicated and consented, coupled with whole-body movement training.
MEN'S HEALTH STATISTICS
Up to 15% & 87%
Men experience pelvic floor dysfunction as well. Chronic pelvic pain syndrome affects up to 15% of men across their lifetime (Schaeffer 2008), while post-prostatectomy urinary incontinence affects up to 87% of men immediately after surgical intervention (Murphy 2014, Gacci et al. 2023).
Scope Clarification: While men experience these conditions, Divine Physical Therapy provides internal assessment exclusively for women. Men are treated through external orthopedic rehabilitation, pressure management, and referred to dedicated male pelvic health specialists when internal care is indicated.
BEFORE ANY EXAM
Pelvic Health Education Should Not Start With An Internal Exam.
For many people, the most important first intervention is understanding the system: where the pelvic floor is, what it actually does, what normal bladder or bowel function looks like, why leaking can happen with sports, why a pelvic floor can be both tight and weak, why breathing affects pressure, and when pain, constipation or urgency should be discussed with a healthcare professional.
Those questions can be taught without an examination and without anyone disclosing personal medical information in a group. That opens the door for community workshops, parent-and-teen education, puberty education, athlete education, pregnancy and postpartum classes, and prevention-focused programs for adults.
BODY LITERACY, EARLY
For Girls And Teens
Puberty changes the body quickly, while pelvic-health education often remains surprisingly limited. Age-appropriate education can teach girls the names and basic functions of pelvic anatomy, bladder and bowel habits, menstrual and puberty-related body changes, what the pelvic floor is, and which symptoms deserve a trusted adult or healthcare conversation.
SELECTED EVIDENCE: In a school-based study of 168 adolescent girls (mean age about 14), six weekly educational sessions raised pelvic-floor awareness from 20% to 89%, knowledge of pelvic-floor exercise benefits from 31% to 78%, and recognition that urine leakage was not normal from 25.4% to 60%.
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Hebert-Beirne et al., 2017
A separate study found urinary incontinence was already reported by 10.3% of women ages 19 to 30, with younger participants showing significantly less education and understanding about pelvic-floor disorders, pointing to a case for earlier prevention. Parden et al., 2016
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Divine's vision for adolescent pelvic-health education is educational, age-appropriate and confidence-building. It is not an internal pelvic examination program. Community or teen education does not include internal assessment or treatment. The goal is body literacy, healthy habits, symptom awareness, respectful language and knowing when to involve a parent, guardian or qualified healthcare professional.
BROADER THAN ONE MUSCLE
Prevention Is Not “Do Kegels Before You Have A Problem.”
Preventive pelvic health is broader than strengthening one muscle group. It can include bladder and bowel habits, constipation prevention, breathing and pressure management, appropriate pelvic-floor contraction and relaxation, strength and mobility through the hips and trunk, exercise confidence, postpartum recovery education, and knowing when symptoms are not something you simply have to live with.
SELECTED EVIDENCE: A 2025 systematic review and meta-analysis of 65 studies and more than 21,000 participants found postpartum pelvic-floor muscle training was associated with 37% lower odds of urinary incontinence compared with control groups; evidence for prolapse prevention was more limited but also favored training.
Davenport et al., 2025
That caution runs in both directions. Active women returning to running, lifting or high-impact sport after birth are often eager, understandably, to get back to what their body used to do, and that eagerness is exactly where the risk lives. Progressing load, impact or intensity faster than the pelvic floor, abdominal wall and connective tissue have actually recovered can produce or worsen leaking, heaviness, pelvic pain or diastasis symptoms that a slower, staged return would have avoided. Prevention here is not about talking someone out of returning to activity; it is about sequencing the return so the tissue can keep up with the ambition.
That does not mean everyone needs the same exercise. Prevention works best when education teaches people what the pelvic floor does, how to recognize symptoms, and when individualized assessment is appropriate.
WHERE THE VISION STARTED
What Could Community Pelvic-Health Education Look Like?
Divine's long-term pelvic-health vision extends beyond one-on-one visits. Community education can bring clinically accurate information into settings where people already live, learn, exercise and raise families.
Long before any of this lived on a website, it was happening in an inpatient rehab hospital. Dr. Paige has taught pelvic-floor education classes there for people recovering from surgery, coming off a urinary catheter, managing a new UTI diagnosis, living with a history of incontinence, or working through the pressure demands of a chronic or acute cough. Those are not abstract topics for a hospital population; they are daily, practical questions people are often too embarrassed to ask out loud. Teaching that material plainly, before someone leaves the hospital, is where this interest in pelvic-health education actually started, and it is the same model Divine wants to bring further into the community: treat by educating, not only by assessing.
COMMUNITY OUTREACH
Topics In Development
Puberty & Pelvic Health For Girls
Age-appropriate anatomy, bladder and bowel basics, menstrual and puberty changes, healthy habits and when to ask for help.
Teen & Youth Athletes
Leaking during sport, pressure management, constipation, hydration, menstrual considerations and why symptoms should not automatically be accepted as "normal for athletes."
Parent & Daughter Education
shared language that makes body changes and pelvic-health questions easier to discuss at home.
Pregnancy Preparation
Pelvic-floor function, pressure management, constipation, movement, birth preparation concepts and what rehabilitation may look like after delivery.
Postpartum Education
What recovery can realistically involve after vaginal or cesarean birth, returning to exercise, abdominal-wall recovery, pelvic symptoms and when to seek evaluation.
Midlife & Menopause
Pelvic-floor symptoms, tissue and hormonal changes, strength, bone and movement health, bladder/bowel changes and maintaining physical activity.
General Adult Pelvic Health
Bladder and bowel health, pelvic pain awareness, movement, lifting and pressure strategies, and recognizing when symptoms deserve care.
THE HONEST EVIDENCE
Can Education Actually Make A Difference?
Education is not a replacement for treatment, but it can change what people understand and when they seek help.
SELECTED EVIDENCE: In a randomized controlled trial of 145 women, pelvic-floor education significantly improved pelvic-floor knowledge; the education groups also reported fewer pelvic-floor dysfunction symptoms and improved quality of life compared with controls.
Berzuk & Shay, 2015
The evidence also keeps the message grounded: a separate randomized trial found that education improved women's knowledge but did not by itself significantly improve pelvic-floor muscle contraction, urinary incontinence or sexual function. In other words, education creates awareness and better decisions; individualized rehabilitation is still necessary when there is a clinical problem to treat. de Andrade et al., 2018
THE CLINICAL FRAMEWORK
When Pelvic Health Becomes Physical Therapy
When symptoms are present, the next step is not automatically an internal exam and not automatically Kegels. Divine uses the same clinical framework as the rest of the practice: Assess → Restore → Own It → Reset When Needed.
Assessment may include breathing mechanics, ribcage motion, abdominal wall, spine, hips, functional movement, pressure strategy and external pelvic-floor observation or palpation when appropriate. For women, an internal pelvic-floor assessment may be offered when it would meaningfully add information, but it remains optional and requires informed consent.
SCOPE, BY SEX: Internal pelvic assessment and internal pelvic interventions are currently provided by Divine Physical Therapy only for women. Men may receive pelvic-floor and core education and appropriate external orthopedic, breathing, pressure-management and movement care, but Divine does not currently provide internal pelvic assessment or treatment for male clients.
THE KEY DISTINCTION
Tight, Weak, Or Both?
Pelvic-floor symptoms do not reliably tell us whether a muscle needs more strengthening, better relaxation, improved coordination or a different movement strategy. A higher-tone pelvic floor may have difficulty relaxing or lengthening; a lower-capacity pelvic floor may lack strength or endurance; and some people have both problems at different times or in different parts of the task.
This is why Divine avoids blanket advice. Kegels can be useful when strengthening is indicated, but they are not the universal starting point for leaking, pressure, pain or urgency. The direction of care comes from the examination.
WHY ORTHOPEDIC AND PELVIC
Why An Orthopedic Pelvic Therapist?
The pelvic floor lives inside the same body as the hips, abdominal wall, spine, diaphragm and ribcage. That matters when someone has pelvic symptoms plus back pain, hip restriction, return-to-running concerns, postpartum weakness, lifting problems or sports goals.
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Dr. Paige's orthopedic background is part of the pelvic-health model rather than separate from it. Manual therapy, myofascial and visceral-fascial concepts, mobility work, strength training, pressure management and pelvic-floor coordination may all be integrated when examination findings support them.
The goal is not for every person to become a pelvic-health client. The goal is for more people to understand their bodies well enough to prevent avoidable problems, recognize symptoms earlier, know that treatment exists, and talk about pelvic health without believing that "private" has to mean shameful.
THE DIVINE RESTORE & RESET MOVEMENT METHOD™
Understand The Body First. Then Decide What Care Actually Makes Sense.
Educate
Give you language for the anatomy, symptoms and choices before asking you to do anything.
Assess
Look at the whole system: breathing, core, hips, spine, movement and pelvic floor. Internal assessment is optional for women when indicated and consented.
Restore
Address mobility, pain, tissue sensitivity, pressure or coordination problems with the least invasive effective strategies first.
Own It
Build the movement, strength, habits and confidence needed to manage your body outside the treatment session.
Reset When Needed
Use skilled care strategically for new needs or flare-ups without making lifelong treatment the goal.
PELVIC HEALTH BEYOND THE TREATMENT TABLE
Community Education Is Part Of The Care Model.
Girls & Teens
Puberty, anatomy, bladder/bowel basics, body literacy, healthy habits, self-awareness and confidence, and knowing when symptoms deserve a conversation.
Women Across Adulthood
Prevention, pregnancy, postpartum, exercise, constipation, pelvic symptoms, menopause and staying active through life transitions.
Parents & Caregivers
Accurate language and practical education that helps adults answer questions with confidence, without shame, fear or misinformation.
Community Partners
Educational workshops for gyms, schools, family programs, maternal-health groups and other organizations seeking evidence-informed pelvic-health education.
RESEARCH & FURTHER READING
Sources Referenced On This Page
01. Nygaard I, et al. (2008). Prevalence of symptomatic pelvic floor disorders in US women. JAMA. PubMed.
02. APTA Pelvic Health. Evidence Highlight: Male Pelvic Health, summarizing Murphy (2014), Schaeffer (2008) and Gacci et al. (2023) on chronic pelvic pain syndrome and post-prostatectomy incontinence prevalence.
03. Hebert-Beirne JM, et al. (2017). A Pelvic Health Curriculum in School Settings: The Effect on Adolescent Females' Knowledge. Journal of Pediatric and Adolescent Gynecology. PubMed.
04. Parden AM, et al. (2016). Prevalence, Awareness, and Understanding of Pelvic Floor Disorders in Adolescent and Young Women. Female Pelvic Medicine & Reconstructive Surgery. PubMed.
05. Berzuk K, Shay B. (2015). Effect of increasing awareness of pelvic floor muscle function on pelvic floor dysfunction: a randomized controlled trial. International Urogynecology Journal. PubMed.
06. de Andrade RL, et al. (2018). An education program about pelvic floor muscles improved women's knowledge but not pelvic floor muscle function, urinary incontinence or sexual function: a randomised trial. Journal of Physiotherapy. PubMed.
07. Davenport MH, et al. (2025). Impact of postpartum exercise on pelvic floor disorders and diastasis recti abdominis: a systematic review and meta-analysis. British Journal of Sports Medicine. PubMed.
KEEP READING
Where To Go Next
Pelvic Health & Postpartum
What pelvic floor physical therapy treats and how sessions work at home.
Pelvic Pain
Persistent and painful-intercourse presentations, finding the driver, not just the site.
Urinary Incontinence
Leaking is common. It is not something you have to keep dealing with forever.
YOUR QUESTIONS, ANSWERED
Frequently Asked
BEGIN WITH A DISCOVERY CALL
Pelvic Health Should Be Easier To Talk About.
Need individual women's pelvic health care? Start with a complimentary Discovery Consultation.