Pelvic Floor Physical Therapy
Whether you are pregnant, newly postpartum, navigating incontinence, or dealing with pain that no one seems to take seriously, pelvic floor physical therapy can help. Every session is private, 1-on-1 with a Herman and Wallace certified Doctor of Physical Therapy, either in our Holly Springs clinic or in the privacy of your own home.
60
Minute private, 1-on-1 sessions
100%
Confidential, judgement-free care
Home
Appointments or in-clinic, your choice
What is Pelvic Floor Physical Therapy?
Pelvic floor physical therapy is a specialized area of PT focused on the muscles, ligaments, and connective tissue of the pelvis: a group of structures that support your bladder, uterus, and rectum, and that play a central role in core stability, continence, and sexual function. When these muscles are too weak, too tight, or not coordinating properly, the result can show up as pain, leaking, pressure, or difficulty with everyday movement.
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This is one of the most under-treated areas of healthcare. Many women live with pelvic floor dysfunction for years, sometimes decades, because they assume it is a normal part of having children, aging, or being a woman, or because they feel too embarrassed to bring it up. It is not normal, and it is highly treatable. Pelvic floor PT uses targeted manual therapy, biofeedback, breathing retraining, and individualized exercise to address dysfunction directly, often resolving issues that have not improved with any other treatment.
Your Privacy and Comfort Comes First
Every pelvic health session at Carolina Elite is completely private and 1-on-1.
There is no shared treatment room, no other patients nearby, and no rushing. Your PT will explain every part of your evaluation and treatment before it happens, and internal pelvic floor assessment is always optional and only performed with your full understanding and consent.
You are always in control of your own care.
Pelvic Health Conditions We Treat in The Triangle
Pelvic floor PT addresses a wide range of conditions across every stage of a woman's life, from pregnancy through menopause and beyond. If you are not sure whether your symptoms qualify, call or text us. Most of the time, the answer is yes.
Postpartum Recovery
The most common reason patients come to us. We help new mothers reconnect with their core, address scar tissue from vaginal delivery or C-section, rebuild strength safely, and return to running, lifting, and the activities they love without pushing through pain or leaking that gets dismissed as normal.
Prenatal Care and Birth Prep
Pelvic floor PT during pregnancy helps manage pelvic and low back pain, prepares your body for labor through perineal and pelvic floor coordination, and addresses round ligament pain, pubic symphysis dysfunction, and sciatica. Many patients begin care in their second trimester and continue through delivery.
Urinary Incontinence and Urgency
Leaking when you laugh, cough, sneeze, jump, or exercise (stress incontinence) and a sudden, hard-to-control urge to urinate (urgency incontinence) are both extremely common and highly treatable. We assess your specific pattern of dysfunction and build a plan that addresses the actual cause, not a generic kegel handout.
Painful Intercourse (Dyspareunia)
Pain during or after intercourse is common, frequently linked to pelvic floor muscle tension, scar tissue, or hormonal changes and it is treatable. We address the muscular and tissue-level causes through manual therapy, relaxation training, and gradual desensitization, in a setting where you are always in control of the pace.
Diastasis Recti
Abdominal separation is extremely common after pregnancy and often misunderstood. It is not fixed by crunches, and in some cases crunches make it worse. We assess the degree of separation and the function of your deep core system, then build a progressive plan to restore core integrity and function.
Pelvic Organ Prolapse
A feeling of pelvic heaviness, pressure, or bulging can be a sign of prolapse, when pelvic organs shift due to weakened support structures. Conservative PT is a first-line, evidence-based treatment for mild to moderate prolapse and can meaningfully reduce symptoms and improve quality of life without surgery.
Pelvic Pain Syndromes
Chronic pelvic pain, vulvodynia, pudendal neuralgia, and pelvic floor muscle tension (hypertonicity) are complex conditions that often go undiagnosed for years. We take a thorough, whole-body approach to identify contributing factors and build a treatment plan that addresses the muscular and nervous system components of your pain.
Core Weakness and Instability
Whether from pregnancy, surgery, or a sedentary lifestyle, a weak or poorly coordinated core can drive back pain, poor posture, and difficulty returning to exercise. Pelvic floor PT addresses the deep core system (diaphragm, transverse abdominis, multifidus, and pelvic floor) as one coordinated unit, not isolated muscles.
Return To Exercise and Sport
Cleared for exercise but not sure your body is actually ready? We help postpartum and pelvic health patients return to running, lifting, CrossFit, and other high-impact activity safely and confidently, with a progressive plan that accounts for pelvic floor and core function, not just time elapsed since delivery.
Who We Treat
Pelvic health is not just a postpartum issue. We treat women across every stage of life, and we take every concern seriously, no matter how long you have lived with it or how many providers have told you it is normal.
Competitive and Recreational Athletes
From early pregnancy through years after delivery. It is never too late to address postpartum pelvic floor dysfunction. We regularly treat patients whose children are now in elementary school.
Desk Workers and Professionals
Hormonal changes during perimenopause and menopause frequently affect pelvic floor tissue, bladder control, and sexual comfort. We help women navigate this transition with targeted, evidence-based care.
Post-Surgical Patients
Runners, CrossFit athletes, gymnasts, and weightlifters who experience leaking, pressure, or pain during training. High-impact sport places real demand on the pelvic floor. This is common, but it is not something you have to accept.
Longstanding, Undiagnosed Symptoms
If you have lived with pain, leaking, or pressure for years and been told it is normal, or have not been able to get a clear answer from other providers, we take the time to listen and investigate properly.
Techniques Used in Your Plan of Care
Your treatment is always tailored to your specific condition and comfort level. Depending on what is most appropriate for your goals, your plan may include the following, all included in your session fee.
Breathing and Core Retraining
Proper diaphragmatic breathing is foundational to pelvic floor function. We teach you to coordinate your breath with your deep core and pelvic floor, a skill that underlies almost every other part of your recovery.
Progressive Strengthening
Individualized exercise programming that progresses as your strength and control improve, from foundational core and pelvic floor coordination to return-to-sport level training.
Manual Therapy
Hands-on techniques to address muscle tension, scar tissue, and restrictions in the pelvic floor and surrounding structures. Internal assessment and treatment, when appropriate, is always explained fully and is entirely optional.
Scar Tissue Mobilization
Targeted treatment of C-section scars, perineal scarring, and other surgical or delivery-related scar tissue that can contribute to pain, restriction, or dysfunction if left untreated.
Education and Self-Management
Understanding your own body is part of your treatment. We explain the why behind every exercise and technique, and equip you with strategies you can use long after your plan of care ends.
What to Expect from Your Pelvic Health Evaluation
If you have never had pelvic floor PT before, it is completely normal to feel unsure about what happens. Here is exactly what to expect, step by step.
1
A Conversation First, Always
Your first session begins with a thorough conversation: your history, symptoms, goals, and concerns. Nothing happens that you have not been told about and agreed to first. If you are nervous, tell us. We will go at whatever pace makes you comfortable.
2
External Assessment
We assess your posture, breathing pattern, core function, and movement mechanics. This alone provides significant information about what may be contributing to your symptoms.
3
Internal Assessment, ONLY If Appropriate and ONLY With Your Consent
An internal pelvic floor assessment is often the most informative way to evaluate muscle tone, strength, and coordination, but it is never required. Your PT will explain exactly what it involves, why it is recommended, and will proceed only with your clear consent. You can decline or stop at any time.
4
Personalized Plan of Care
Based on your evaluation, your PT builds a plan specific to your symptoms and goals, whether that is eliminating pain, stopping leaking, or returning safely to running and lifting. Treatment begins at this first session.
5
Ongoing, Private, 1-on-1 Care
Every following session is 60 minutes, completely private, with the same PT who performed your evaluation. You will never be passed between providers or asked to re-explain your history to someone new.
Your Pelvic Health Physical Therapists
Every pelvic health patient at Carolina Elite works with one of two Doctors of PT who hold advanced certification through the Herman and Wallace Pelvic Rehabilitation Institute, the most respected pelvic health training program in the country.
Dr. Sara Roberts
PT, DPT, Cert. DN - Founder
Founder of Carolina Elite with advanced training in pelvic floor physical therapy through the Herman and Wallace Pelvic Rehabilitation Institute. Sara earned her DPT from Elon University in 2007 and brings 19 years of clinical experience to her pelvic health patients, with particular depth in complex and longstanding cases. She is also certified in dry needling and has advanced training in IASTM and vestibular rehabilitation, a uniquely broad skill set that allows her to treat the full picture when pelvic health concerns overlap with orthopedic or neurological symptoms.
Dr. Kate Krier
PT, DPT, Cert. DN
Dr. Kate Krier specializes in pelvic health and outpatient orthopedics, with Herman and Wallace pelvic floor certification and five years of clinical experience. She earned her DPT from Marymount University in 2021 and has advanced training in dyspareunia, urinary incontinence, pelvic organ prolapse, and prenatal and postpartum care. Kate has a particular passion for helping postpartum patients return to full activity such as running, lifting, or the sports they love without limitations or compromise.
Pelvic Health PT
FAQs
When should I start pelvic floor PT after having a baby?
Most patients can begin pelvic floor PT around 6 weeks postpartum, once cleared by their OB or midwife, though the right timing depends on your delivery and recovery. If you are not yet cleared for exercise, we can often begin with gentle manual therapy, breathing work, and core reconnection before progressing to more active treatment. It is also never too late to start. We regularly treat patients whose pelvic floor symptoms have been present for years.
Does pelvic floor physical therapy hurt?
It should not. While some techniques may involve mild, temporary discomfort, particularly when addressing tight or restricted tissue, treatment is always performed at a pace and intensity you are comfortable with. Your PT communicates with you throughout every session, and you are always in control. If something feels too intense, you can ask your PT to adjust or stop at any time.
Is an internal pelvic floor exam required?
No. Internal assessment is often the most informative way to evaluate pelvic floor muscle function, and we will explain why it may be recommended for your specific symptoms, but it is always optional. Many aspects of pelvic floor dysfunction can be assessed and treated externally. Your PT will never proceed with internal assessment or treatment without your full understanding and clear consent, and you can decline or stop at any point.
Do you treat pelvic health concerns that are not related to pregnancy?
Yes. While postpartum care is one of our most requested services, we treat pelvic floor dysfunction across all causes and life stages, including athletes, perimenopausal and menopausal women, and patients with chronic pelvic pain unrelated to childbirth. If you are unsure whether your symptoms fall under pelvic floor PT, call or text us and we will help you figure it out.
Can I have mobile pelvic floor PT at home?
Yes. Mobile PT is especially popular for postpartum patients who are not yet comfortable traveling with a newborn, or who simply prefer the comfort and privacy of their own home. Mobile sessions are the same 60-minute, private, 1-on-1 format as our in-clinic visits.
Do I need a referral for pelvic floor physical therapy?
No. North Carolina is a direct access state, which means you can begin pelvic floor PT without a referral from your OB-GYN or primary care doctor. You can book directly with us. If you would like us to coordinate with your physician, we are happy to do that at your request.