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3 Reasons You Tried Pelvic Floor PT and It Didn't Work

Updated: Jul 25, 2023

Every now and again I hear this from clients or prospective clients, and it's always like nails on a chalkboard for me!

Especially when they are describing issues that are most likely pelvic floor problems.

And although there are certainly times where someone needs additional medical help, or are dealing with an issue that is truly outside what a pelvic floor PT can assist with...

Many people who have "failed" pelvic floor physical therapy in the past did so for reasons that are more closely related to the structure of our medical system.

Here are the Top 3 Reasons I think people are unsuccessful in pelvic floor physical therapy:

Your Provider Did Not Perform A Pelvic Exam

A Physical Therapist trained in Pelvic Floor Physical Therapy will have the skill set to perform both a vaginal and a rectal exam when needed to determine the cause of pelvic floor issues.

Without an internal exam, it is very difficult to know what is really causing your problem and, in my opinion, is not providing the highest level of care possible.

Although there are some in the field that believe this is not truly a necessity, it is my clinical opinion that it absolutely is, and without performing an internal assessment, you cannot know what is really going on in the pelvis and help a client fully heal.

You Were Limited By Insurance

It is no secret that third party payers do not make it easy to receive medical care.

By the time you find a provider who accepts your insurance, jump through the hoops of the referral and pre-authorization system and make it to your first appointment, it may have been 6-months since you started trying to get in to see a pelvic floor physical therapist.

But it doesn't stop there. Once you get in, your provider still has to effectively "prove" you need pelvic floor physical therapy through extensive and detailed documentation, and justify all additional sessions.

You may have limitations on how many physical therapy sessions you receive per year, or your insurance may decide you have met your "maximum potential" far before you are seeing results in pelvic floor physical therapy and stop your sessions.

Pelvic floor physical therapy requires a holistic approach to treatment, and your therapist may find it necessary to work on another part of the body in order to improve pelvic floor function.

It can take a lot of time and effort to unravel the complex layers of an issue that has been going on for a long time.

Insurance companies often refuse to pay if your provider is working on your spine rather than directly on your pelvic floor for example, which is another reason why you may not have received the highest quality of care possible.

In the out-of-network model, we are not restricted by insurance limitations and can work freely on whatever we need to in order to create holistic and lasting improvements. This is why I believe out-of-network services should be the standard of care for pelvic floor physical therapy.

You Needed A Different Approach

As much as we try to standardize medicine and create an environment that is ruled by "Evidence-Based Practice," you cannot take the human out of a healthcare provider.

All practitioners are different in their approach. We all have a fundamental knowledge base, but because we are humans we teach in different ways, explain things in different ways, and have opinions and preferences in where we start for treatment.

I think this is a good thing, because diversity in healthcare delivery means that all different types of people have options in who they go to for their healthcare and can choose someone that best fits their personality and learning styles.

Pelvic floor physical therapy is intimate and requires detailed communication skills in order to effectively deliver care to patients. If you found you didn't quite connect with your healthcare provider, know that you always have options and can choose a different provider to work with.

I say this having been on both the receiving end of clients who are seeking a different approach, and I have had a few clients move on who have needed a different approach than what I was offering.

I really think it's a beautiful thing, and we attract the people who need us the most.


If you have not had success with pelvic floor physical therapy, don't be afraid to give it another try.

Pelvic floor physical therapy is an incredible, full-body solution to many issues that people are dealing with every day.

There are people that have tried pelvic floor PT and simply need specialist medical attention, but there are many people who have tried pelvic floor PT and not had success for the reasons listed above.

If you have not had success in the past but are thinking about giving it another shot, give us a call to book a session today!

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