Pelvic Floor Physical Therapy in Madison, WI
You don't have to live with it. Leaking, pain, heaviness and the things nobody warned you about are common — and common is not the same as normal. A private room, a full hour, and one therapist who has heard it all before.
The Things That Are Common, But Shouldn't Be Normal
If any of these describe you, pelvic floor physical therapy is very likely to help — and most people wait years longer than they need to.
Leaking When You Laugh, Cough or Run
Stress incontinence is not the inevitable price of having children or getting older. It is a muscle-coordination problem, and it responds extremely well to being trained properly.
Pain During Sex
Painful intercourse has real, treatable physical causes, and it is one of the most common reasons people come to us. It is also the one people are most afraid to say out loud, so we'll say it first.
Heaviness or a Dragging Feeling
Pelvic organ prolapse affects roughly half of people who have given birth. Surgery is not the only option and is rarely the first one — strength, pressure management and load strategy come first.
Urgency and Frequency
Mapping the bathroom on every journey is exhausting. Bladder retraining and pelvic floor work resolve or substantially improve most cases within a few months.
Pregnancy and Postpartum
Pelvic girdle pain, abdominal separation, birth preparation and the return to running. Care through the pregnancy and a proper check-up afterwards — not just the six-week sign-off.
Persistent Pelvic Pain
Endometriosis, vulvodynia, coccyx pain and post-surgical pain. Often years of it, often after being told nothing is wrong. Something usually is, and it is usually treatable.
A Room Where You Can Say the Thing
Ashcombe opened on North Few Street in 2018 because pelvic health was being treated as an afterthought — fifteen minutes at the end of an appointment about something else, in a curtained bay, with someone who had done a weekend course.
Every appointment here is a full hour, one-to-one, in a private room with a door that closes. Your therapist is the same person every visit. Nothing is done to you without being explained first, and you can stop anything at any time — including an internal examination, which is often not needed at a first visit at all.
Most of our patients have been carrying something for years and were told it was normal. It usually isn't, and there is usually something to do about it.
- ✓A full hour, one-to-one, every appointment
- ✓The same therapist from first visit to discharge
- ✓Private rooms with a door — never a curtained bay
- ✓Nothing happens without being explained first
What Treatment Actually Looks Like
Far less clinical and far more practical than most people expect.
Pelvic Floor Rehabilitation
Learning to contract, relax and coordinate muscles most people have never consciously used. Often the surprise is that the floor is too tight rather than too weak — which is why generic Kegels make some people worse.
Postpartum Recovery
The proper check-up nobody schedules: abdominal separation, scar tissue, pelvic floor function, and a graded route back to lifting, running and everything else. Useful at six weeks and equally useful at six years.
Pregnancy Physical Therapy
Pelvic girdle and back pain, rib flare, positioning for birth, and what to expect afterwards. Safe throughout, and the earlier the better.
Bladder & Bowel Retraining
Practical, unglamorous and very effective. Fluid and timing habits, urgency-suppression techniques, and floor coordination — most people notice a real change inside six weeks.
Pain-Focused Care
For pain with sex, endometriosis-related pain and persistent pelvic pain. Manual therapy, desensitisation, breathing and nervous-system work, always at a pace you set.
Prolapse Management
Load and pressure strategy, strength work, pessary support where appropriate, and an honest conversation about when surgery is and isn't the answer.
Four Things We Do Differently
An Hour, Not Fifteen Minutes
Pelvic health cannot be done in the gaps of a general appointment. Every visit is a full hour with the same therapist, and a good part of the first one is just talking.
Consent Before Everything
You will be told what is proposed, why, and what it involves before anything happens — and you can decline any part of it and still be treated. Many first visits involve no internal examination at all.
We Say the Words
Sex, urine, bowels, scars. Being unable to name the problem is a big reason people wait years. We name it first so you don't have to go first.
Care That Ends
This is an episode of care with a plan and a finish, not a standing appointment. Most people are done in eight to twelve visits and leave with a programme they can keep on their own.
Exactly What Happens, Start to Finish
So there are no surprises — the not-knowing is most of what makes people put this off.
We Talk First, Fully Clothed
Twenty to thirty minutes of history in a private room, sitting down. Symptoms, births, surgeries, what you want back. Nothing is examined until we both understand the picture.
An Assessment You Consent To
Usually posture, breathing, abdominal wall and hip strength. An internal examination is the gold standard for some problems but is never assumed, never rushed and can wait for another visit or be skipped entirely.
You Get an Explanation
In plain language, with a diagram if it helps, before you leave the room. Most people say this was the first time anyone told them what was actually going on.
A Plan and Some Homework
Usually three or four things to do at home, taking a few minutes a day, plus a realistic expectation of how long this takes and how we'll know it's working.
Quiet, Private, and Nothing Like a Hospital
A converted house on North Few Street with four private rooms and a movement studio.
What People Say Afterwards
I spent four years being told this was normal after having children. One appointment here and someone finally examined me properly, explained what was actually happening, and gave me a plan. I cried in the car — mostly from relief.
I had put this off for two years because I was dreading the appointment. They spent the first session just talking, explained every single thing before it happened, and told me I could stop at any point. Nothing about it was frightening.
Running was off the table because of leaking, and I had accepted that at 38. Twelve weeks of very unglamorous homework later I ran a half marathon without thinking about it once.
They worked with me through the last trimester and then again from six weeks after. Knowing what was normal and what wasn't took an enormous amount of worry out of the whole thing.
The Things People Ask Us Quietly
Do I need a referral?
No. Wisconsin has direct access, so you can book with us without seeing a doctor first. Some insurance plans still want a referral for reimbursement — we check that for you before your first visit and tell you either way.
Is there an internal exam at the first visit?
Not necessarily, and never without your explicit agreement. It is the most informative assessment for some problems, but plenty of first visits involve only conversation and an external assessment. If you'd rather wait, or never do it at all, say so — we will still be able to help you.
What should I wear?
Whatever you're comfortable moving in. Shorts or leggings and a t-shirt are ideal. You will not be asked to change into a gown.
Isn't this just Kegels?
No, and for a good number of our patients Kegels are actively the wrong thing. A pelvic floor that is too tight to relax produces many of the same symptoms as a weak one, and squeezing it harder makes things worse. That's exactly what the assessment is for.
How long will it take?
Most people are looking at eight to twelve visits over three or four months, and most notice a meaningful change well before the end. You'll get an expected range at the first visit and we'll revise it honestly as we go.
My baby is three years old. Is it too late?
Not remotely. We regularly treat people ten, twenty and thirty years postpartum with very good results. The tissue changes, the habits and the strength are all still addressable — later is harder to hear about, not harder to fix.
What does it cost?
We are in-network with most major Wisconsin carriers including Quartz, Dean Health Plan, Anthem, UnitedHealthcare and Medicare, and we verify your benefits before your first visit. Self-pay is $175 for the initial hour and $120 for follow-ups.
Can I bring my baby?
Yes, absolutely, and plenty of people do. There is a pram in the corner of most of our appointments. If you'd rather have the hour to yourself, that's fine too.
Most People Wish They Had Come Sooner
Book a first visit, or call and ask us anything first — plenty of people do that, and nobody will push you.
North Few Street, Madison
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