Pelvic floor occupational therapy (OT) focuses on restoring your ability to perform the everyday activities that pelvic dysfunction has disrupted — from exercising and intimacy to simply going to the bathroom without pain. While physical therapists focus primarily on the musculoskeletal system, occupational therapists bring a whole-person, function-first lens to recovery. At PivOTal Performance in Stony Point, NY, Nicole Muriel combines pelvic floor rehabilitation with neuromuscular re-education, myofascial release, scar treatment, and corrective exercise to treat the root cause — not just the symptom. The goal is always to get you back to your life.

No referral is needed. New York allows direct access to occupational therapy, meaning you can book your appointment at PivOTal Performance without first visiting your primary care doctor or OB/GYN. You can call or book online today. That said, we do communicate with your healthcare team to ensure your care is coordinated and comprehensive — especially if you're postpartum or managing a complex condition.

Your first visit is a thorough 60-minute evaluation. Nicole will have a real conversation with you about your symptoms, medical history, lifestyle, and goals. She'll ask about your bladder, bowel, and any pain you're experiencing — nothing is TMI. She'll then perform an external assessment looking at your posture, core engagement, and pelvic alignment. An internal assessment may be recommended as part of a thorough evaluation — but it is entirely your choice and is never required. You'll leave with a clear picture of what's going on and a personalized plan.

Not even close. In fact, doing Kegels when your pelvic floor is already too tight (called hypertonic pelvic floor) can make your symptoms significantly worse. At PivOTal Performance, treatment may include myofascial release, scar mobilization, biofeedback, breathwork, corrective exercise, and neuromuscular retraining — all guided by Nicole's signature RAP Method: Release → Activate → Perform. She first assesses whether you need to loosen, strengthen, or better coordinate your pelvic floor before building your program.

Pelvic floor therapy should not be painful. Some clients notice mild discomfort in areas of muscle tension or scar tissue, but Nicole prioritizes your comfort throughout every session. You are always in control — no technique is performed without your consent, and you can pause or stop at any time. Many clients are genuinely surprised by how gentle and non-invasive the process feels. The goal is always to reduce your pain, not add to it.