The Curbsiders Internal Medicine Podcast #521 Tales of the Pelvis
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Apr 13, 2026 Rachel Rosvold, pelvic floor PT and co-founder of Uplift, specializes in pelvic rehab and movement. Nicole Schaffer, pelvic floor PT and co-owner of Uplift, focuses on postpartum and orthopedic-linked pelvic health. They discuss pelvic anatomy and function. They cover postpartum screening, distinguishing tight versus weak pelvic floors, practical referral cues, toileting and posture strategies, and approaches for pelvic pain in people with and without a penis.
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Pelvic Floor Is A Integrated Pressure System
- The pelvic floor has four integrated functions: attachment/support, sexual function, sphincter control, and pressure regulation with the diaphragm.
- Diaphragm–pelvic floor coupling means breathing, thoracic or rib dysfunction, and spine issues all affect pelvic floor behavior.
What Happens At A Pelvic PT Evaluation
- Expect a comprehensive first pelvic PT visit including full-body exam, breathing assessment, diastasis check, hip and spine mobility, and optional internal palpation.
- Internal exam is consent-based (single-finger vaginal or rectal) to assess layer-specific tightness, strength, scars, avulsions, and prolapse support.
Avoid Reflexively Prescribing Kegels
- Don't default to prescribing Kegels; assess first because hypertonic pelvic floors need downtraining not strengthening.
- Progress training from lying to standing to functional tasks and address hips, core, and posture alongside pelvic work.