When BreeAnn Allred was about 10, she asked her mother to join her on the trampoline. Her mother declined because she would leak urine. Running with her children was another activity she avoided. What stayed with Allred was the acceptance behind those decisions: After having children, her mother understood these limitations as something she simply had to live with.
Now a pelvic floor physical therapist with 20 years of experience, Allred challenges that assumption. On Healing at Your Core, she connects symptoms people often keep private—bladder leakage, painful intercourse, constipation, and pelvic pressure—to a part of the body that receives surprisingly little everyday attention. Her central message is direct: “Just because it’s common does not mean it is normal.”
That distinction anchors her approach to education. Rather than treating embarrassment as a reason to avoid difficult conversations, she makes those conversations part of understanding the problem. The goal is not to suggest that every symptom has the same cause, but to help people recognize when something they have quietly accommodated deserves evaluation.
Making Uncomfortable Conversations Useful
Allred initially chose physical therapy because she loved the medical field but struggled with the sight of blood. Her specialization emerged while working in a spine clinic, where, as the only female therapist at the time, she began treating pregnant patients with back and pelvic pain. Those experiences opened a clinical direction that would become her professional focus.
She describes pelvic health as her passion for roughly 18 years and identifies herself as a certified pelvic rehabilitation practitioner. Just as important to her account is the ability to make uncomfortable subjects feel discussable in a safe environment. “TMI is my jam,” she says. Questions about bowel movements, urination, and sex are not distractions from the clinical picture; they help reveal it.
Her intended audience spans adolescence through later adulthood. She emphasizes the changes associated with menstruation, pregnancy, childbirth, and menopause, explaining that pelvic health cannot be reduced to a brief postpartum concern. By placing those experiences within one conversation, she encourages listeners to recognize connections between symptoms and life stages they may previously have considered unrelated.
A Support System With More Than One Job
Allred describes the pelvic floor as a bowl of muscles attached around the pubic bone, tailbone, and sitting bones. Its three layers contribute to support, continence, and sexual function. Because these muscles surround the urethra, vagina, and anus, their function is closely connected to the activities people may find hardest to discuss.
But the pelvic floor is not isolated from the rest of the body. Allred places it at the bottom of a core “canister,” with the diaphragm above and abdominal and back muscles forming the surrounding walls. Her soda-can analogy illustrates the importance of coordinated support: An unopened can resists compression differently from one whose top has been opened. The comparison makes a complex relationship easier to picture.
This perspective also shapes how she thinks about persistent back, hip, and tailbone pain. If conventional treatment has not helped, she raises the question of whether pelvic floor contributions have been considered. She does not present the pelvic floor as the explanation for every unresolved pain problem. Instead, she identifies it as a potentially overlooked component of a larger assessment.
Although her educational focus is women, Allred also emphasizes that men have pelvic floors. She notes that testicular, penile, groin, or hip pain may warrant attention to these muscles as well. The broader point is that pelvic health involves functions and structures shared across bodies, not simply the consequences of childbirth.
Why Similar Symptoms Can Have Different Causes
One of Allred’s most useful distinctions is between muscles that are weak and muscles that are too tense. Bladder symptoms do not automatically reveal which problem is present. Excessive tension, she explains, can interfere with emptying the bladder and may also contribute to leakage, burning sensations, or urinary frequency. Weakness can contribute to some overlapping complaints.
She describes patients who believe they have recurrent urinary tract infections but receive negative infection tests. In some cases, she says, pelvic floor tension may contribute to those symptoms. That observation is not a reason to dismiss possible infection. Rather, it illustrates why persistent symptoms may require an assessment that considers more than one explanation.
Allred also discusses bladder-specific contributors, including painful bladder syndrome, nerve sensitivity, and overactivity of the bladder muscle. Her account leaves room for both organ-related conditions and muscular involvement. Pelvic floor physical therapy, as she presents it, involves understanding those relationships rather than assuming every problem originates in muscle strength.
For bowel function, her analogy is a set of doors controlling what stays in and what leaves. Muscles that do not relax appropriately can contribute to difficulty passing stool and straining; inadequate control can contribute to accidents. The practical implication is that constipation and incontinence may both belong in a pelvic health conversation, even though they appear to be opposite problems.
Intimacy, Protection, and Learned Responses
Allred’s discussion of intimacy extends beyond anatomy. Difficulty relaxing the pelvic floor may affect penetration or make tampon use painful. She also describes how past traumatic experiences can be associated with protective muscle responses. In that context, the issue is not merely whether a muscle can stretch, but what may be contributing to its continued tension.
Working in Utah, she encounters another sensitive consideration: For some patients raised to avoid sex before marriage, getting married does not immediately erase earlier messages that sexual activity is wrong. She describes a possible mismatch between consciously believing sex is now acceptable and experiencing a bodily response shaped by longstanding beliefs.
She presents this as an experience some individuals face, not an inevitable consequence of religious upbringing. Her approach may involve attention to muscle responses and nervous system training, alongside mental health counseling or coaching when appropriate. The discussion broadens the clinical frame without reducing pain to a psychological issue or treating physical symptoms as separate from personal history.
Childbirth Recovery Deserves Attention
Pregnancy adds another layer of complexity. Allred describes a growing uterus, stretching abdominal muscles, hormonal changes, and increased demands on the pelvic floor as it supports the pregnancy. Both vaginal delivery and cesarean birth, she emphasizes, can be followed by pelvic health difficulties. The route of delivery alone does not determine whether someone may need support.
Her rehabilitation analogy is an ACL injury: People readily expect recovery to involve rebuilding muscle function after knee surgery, yet may regard postpartum leakage as an unavoidable new reality. That contrast returns the discussion to her mother’s decision to stay off the trampoline. For Allred, the question is whether a limitation has been accepted before rehabilitation has even been considered.
She also describes pelvic organ prolapse, in which pelvic organs descend and create pressure or a bulging sensation in the vaginal canal. Some patients describe feeling as though they are walking around with a golf ball. Allred identifies this as another condition pelvic floor therapy may help address, while her discussion underscores the importance of understanding the particular structures and symptoms involved.
The strongest thread through Allred’s account is not a promise that one treatment resolves every concern. It is the challenge to a quieter assumption: that familiar symptoms must be endured. When leakage dictates exercise choices, pain complicates intimacy, or bowel and bladder difficulties shape daily life, naming the experience can open a more useful conversation than silently reorganizing life around it.
Her mother’s trampoline refusal captures the cost of that silence in an ordinary family moment. Allred’s work asks what might change when such moments become reasons to seek understanding rather than evidence that a person’s options have permanently narrowed.
This article is for informational purposes only and is not a substitute for medical evaluation, diagnosis, or treatment.
