My Pelvic Floor Physical Therapy Journey

I found out that I don't know how to breathe. And that was only the second session.

I want to talk about how a gynecologist appointment turned into an unexpected need, suggested by my gynecologist. Pelvic Floor Physical Therapy. And if you just tilted your head the way I did when they said it, good. Stay with me.

I had been dealing with some pain for a while. One of those things where it is there, it is manageable, and you kind of just keep moving. Until it increased and I finally brought it up to my provider. My gynecologist ran some tests and then recommended that I see a Pelvic Floor Physical Therapist. I said okay, I'm open to that...

What followed has been one of the most eye opening, humbling, and educational experiences I have had in a long time. And as someone who educates people about sex, intimacy, and the body for a living, let me tell you, I had a lot to learn about my own.

Session One: The Questions and the Testing

The first session started with a lot of questions. My PT (Physical Therapist) asked about my everyday movement, how long I had been experiencing the pain, how it showed up in my daily life, and yes, how it felt during sex. She also asked about things you do not typically discuss in polite conversation, like the way I pee and poop. I appreciated the directness. This is a space where honesty matters more than modesty, and she made it feel that way from the beginning.

Then she told me this session would include both external and internal testing. She explained what each would involve so I would know what to expect. I appreciated that. But even with the explanation, when we were actually in the moment, I still was not fully prepared. Knowing what is coming and experiencing it are two very different things.

The external portion start with movement and flexibility testing, have me go through different body motions while she observed my range and how my body responded. This is where she identified something important. Because of my back issues from the military, my mobility is limited in certain areas. When my back hurts and restricts my movement, my pelvic area compensates. It picks up the slack. Essentially, my pelvic floor has been doing overtime in my everyday life because my back and diaphragm are weakened. She could see that in the way my body moved, where the tension was, and where the pain originated from. My back was not the only thing carrying the weight. My pelvic floor had been silently absorbing the load.

Then came the internal testing. She put on gloves and used her fingers to do a clockwise assessment around my pelvic floor area. At each point, she would pause and ask me how it felt. Tender? Painful? And if so, how much? I noticed that when she stopped before asking, that is when she felt something specific. She was not just randomly checking. She was responding to what my body was telling her before I even said a word.

This also included movements that mimicked sex. In real time. To see how those specific motions affected me and where the pain or tension showed up during those types of movements.

It was uncomfortable. But here is what I kept reminding myself, both as a woman and as a sex educator...these are the things that need to be checked for the betterment of my health. And being able to share this experience from a personal place, not just an educational one, matters. That is exactly why I am writing this.

Taking care of your pelvic floor is taking care of your pleasure. And the fact that most don't even know that is exactly the problem. ~Velvet Lenae

Session One: Breathing, Heating Pads, and a Humbling Realization

The second session came with a twist I was not expecting. My back issues from the military were flaring up. I am not going to go into all of the details, but it affects my everyday life in ways that show up whether I am sitting, standing or trying to do anything physical. My PT could tell it was really hurting me that day, probably by the way I was sitting, and she started me off with a heating pad.

Now. Let me talk about this heating pad for a second because I don't typically care for them. I have used them from time to time and they do what they need to do, but usually the relief is temporary at best. This one was different. Medical grade, clearly, because the heat was deeper, more effective, and the relief lasted noticeably longer. I am now on a personal mission to find one just like it because I need that in my everyday life.

After letting me sit with the heat for a while, we moved into breathing exercises. And this is where I found out something genuinely embarrassing. I do not know how to breathe. I know how that sounds. But when she walked through specific inhale and exhale patterns, timed and intentional, I wasn't doing it correctly. She told me, and I just sat there like, wow. I have been out here breathing wrong this whole time. Low key, I have not been breathing correctly, and I am just now finding out.

Here is the part that connects everything, and I mean everything. The diaphragm and the pelvic floor are directly connected. They work together as part of a pressure system in your body. When you inhale, the diaphragm moves down and the pelvic floor gently lengthens and lowers along with it. When you exhale, the diaphragm lifts and the pelvic floor follows, drawing back up. They mirror each other. So when you are breathing properly, that system stays balanced, your pelvic floor gets the natural movement it needs to stay flexible and strong.

When you are breathing improperly, holding tension in your chest, breathing shallow (which, hello, stress does that to all of us), or not fully exhaling, that pressure system gets thrown off. The diaphragm is not moving the way it should, and the pelvic floor stops getting the natural lengthening and contracting it needs. Over time, this weakens the pelvic floor. It becomes tight in some areas and weak in others. And that combination creates pain, discomfort, and dysfunction that shows up in your everyday life and in your sex life.

Because here's the thing, if your pelvic floor is tight and restricted, arousal, penetration, and orgasm can all be affected. The muscles that are supposed to relax and expand during sex are holding tension instead. And if you're someone who carries stress in your body (and who among us is not), your pelvic floor is absorbing that too. During exertion, whether that is lifting something heavy or certain sexual positions, if the pressure is not distributed properly through the breath, the pelvic floor takes the hit. That is how you end up with pain during sex that feels like it came out of nowhere when really it has been building quietly for years.

And here is where my back comes into the picture again, specifically when it comes to sex. My PT explained that when my back is hurting and I am stressed about it, I am unconsciously holding onto my pelvic floor. Gripping it. Clenching it. My body is bracing against the pain, and in doing so, my pelvic floor never fully relaxes. During sex, that translates directly into tightness, discomfort, and pain. The pelvic floor needs to be able to release and soften during intimacy, and when your body is in protection mode because of pain somewhere else, it clamps down instead of opening up. That was a major realization for me. The pain I was feeling during sex was not just about the pelvic floor itself. It was about my back, my breathing, my stress response, and my pelvic floor all talking to each other in a way I never considered.

She gave me breathing exercises to practice at home. I am now hyper-aware of how I am breathing at all times. I practice these exercises because they are about supporting the part of my body that directly impacts my comfort, my movement, and my pleasure.

We also did about four or five seated and laying down pelvic floor exercises that session, which she told me to practice at home. And she had me sign up for an app called Limber, which provides additional exercises to support the work we are doing in sessions. I had some trouble getting signed in, something about the system not confirming my identity based on what my provider entered, but we got it worked out at my next visit. I will be checking it out this week and will probably update you on how it goes.

Session Three: More exercises and a Very Direct Question

The third session included more pelvic floor exercises, building on what we started in session two. And then my PT asked me a question that caught me a little off guard. She wanted to know if I had sex since we last talked about how sex was affecting me. The way she asked it was professional but direct, and for a second, I was like, why would you ask me that? But then it clicked. She was trying to assess whether there had been any improvement or change, based on the work we had been doing in PT and at home. If I had been intimate again, she could retest and measure the difference. That made complete sense once I stopped being caught off guard by the question.

I had not, so we didn't do that particular assessment. But I appreciate that she is tracking progress in a way that includes my actual intimate life, because that is the whole point.

Sweet • Raw • Sticky™

Sweet is giving your body the care and attention it has been asking for, even when the process feels unfamiliar. Raw is being honest about what hurts, what you did not know, and what you have been pushing through in silence. Sticky is the knowledge that stays with you once you start paying attention to how your body actually works, the kind of understanding that changes how you move, how you breathe, and how you experience pleasure from here on out.

I know I am probably missing some details. These are the things I remember most vividly from my first three sessions. But I wanted to share this openly because pelvic floor health is one of those things that directly impacts intimacy and most people have no idea it even exists as a specialty.

And for the fellas, pelvic floor physical therapy is not only for women. Men have pelvic floors too, and the same muscles that affect movement and posture also affect sexual function, stamina, and comfort. If you have been dealing with something you cannot quite explain, this is worth looking into for yourself as well.

Your body has been communicating this whole time. Pelvic floor therapy just taught me how to finally listen. ~ Sweet • Raw • Sticky™

I look forward to sharing more of this as I continue. This is important, not just for me personally, but for what I do as an educator. Being able to speak from lived experience, including the uncomfortable parts, is how we normalize the conversations that actually help people.

Feel free to comment or email me any questions you have. I am an open book on this one.

Stay tuned. I will keep you posted.

6 Comments

Jun 30, 2026, 10:46:06 PM

Velvet Berry - Thank you and appreciate you taking time out to read. Yes, breathing is so important. Stay tuned...

Jun 30, 2026, 8:28:31 PM

Palesa - Velvet thank you so much for sharing this very intimate journey with us. Your ability to be so open and vulnerable is so refreshing! As I was reading your articles I was doing my own mental checks to see if I have any of the listed issues. The one that stuck out to me was the breathing properly part. That I know i definitely need to work and be more cognizant off it during my daily routine!! I am looking forward to reading and being part of this journey with you.

Jun 30, 2026, 6:47:05 PM

Velvet Berry - Thank you! It's going great and thank you for taking the time to read. We are not alone.

Jun 30, 2026, 5:47:46 PM

Velvet Berry - Thank you for taking the time to read. I'm glad it was informative.

Jun 30, 2026, 8:59:50 AM

Sara Clarke - Who knew you could breathe wrong?! lol what a joy to learn that we are not alone in this aging process. Much success on your therapy. Wooosaaaahhhhh

Jun 29, 2026, 6:49:19 PM

Jocelyn - This was so informative! Thank you for sharing!

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