Pelvic Pain, Movement, and Learning to Trust Your Body

When pelvic pain affects movement, intimacy, or everyday life, treatment can start to feel like another place where your body is being judged. Another exercise to get right. Another appointment where someone tries to fix you. Another reason to feel disconnected from a part of yourself.

What would care look like if it helped you build trust in your own body?

In this episode, host Daniel Lyman talks with Cait Van Damm, a licensed pelvic floor occupational therapist, sexual health counselor, and advanced pain reprocessing clinician. Cait brings together movement, biomechanics, and pain neuroscience to support people with complex chronic pelvic pain.

Her interest in pelvic health grew out of a desire to offer affirming, inclusive care to people whose needs were being overlooked. Today, that same commitment shapes how she approaches treatment: understanding the person in front of her, offering choices, and helping them become an active participant in their care.

Building safety through movement

Cait describes how PRT changed the way she uses movement with clients. Rather than prescribing a single exercise and asking someone to work through it, she offers a menu of options and helps them find a starting point that feels manageable.

For someone who associates bending forward with pelvic pain, that might begin with standing with their hands against a wall, then shifting their hips back just a little. From there, they can explore more movement while knowing they have a familiar place to return to.

Cait describes moving between a foundation of safety, a zone of interest, and a zone of challenge. The pace looks different for everyone. What matters is helping people notice their sensations, experiment with movement, and build evidence that their bodies can respond differently.

Why safety and challenge belong together

Feeling safer does not mean avoiding every uncomfortable or unfamiliar experience. Cait and Daniel explore how a trusting therapeutic relationship can help people try something challenging without feeling pressured or overwhelmed.

That might mean experimenting with another repetition, a new position, or a slightly larger movement. Along the way, Cait helps clients recognize what they have already done and what that tells them about their capacity for change.

The goal is to help people develop the skills to understand their own bodies and make choices with greater confidence.

Making room for pleasure and intimacy

Pelvic pain can carry layers of shame, fear, relationship pressure, and difficult medical experiences. Cait explains why open conversations about sexual health matter, and why treatment needs to begin with what the person actually wants.

She also shares how she helps clients reconnect with pleasurable sensations outside of sex, whether that is a comforting texture, a favorite scent, or another small experience of delight. These moments can offer a starting point for recognizing that the body has capacity for comfort and enjoyment.

When sexual pleasure or partnered intimacy is a goal, Cait describes a gradual, collaborative approach. There is no single timeline or required outcome. The emphasis stays on curiosity, consent, and the person’s own experience.

Rethinking the role of dilators

Cait shares why she does not typically make dilators her first approach to pelvic pain, and how she may use them later as a tool for graded exposure.

For her, the broader picture matters: movement, muscle guarding, fear, body awareness, and how someone feels about the treatment itself. She also discusses why bringing a partner into the process, when appropriate and wanted, can involve its own learning and communication.

For some people, the starting point is much earlier. Simply becoming comfortable talking about pelvic anatomy or sexual health can be an important step.

When structural conditions and neuroplastic pain overlap

Daniel and Cait also address an important distinction: pelvic pain is not always neuroplastic. Structural conditions, biomechanical factors, and nervous system responses can exist together.

Cait discusses how a painful condition can be accompanied by an additional layer of protective muscle guarding. Exploring that response does not dismiss the underlying condition or make the pain any less real.

Her message to people living with pelvic pain is grounded and compassionate: your experience deserves to be believed, you deserve support, and change is possible without needing to promise a particular outcome.

Find Cait Van Damm, her virtual practice, Tidal Work movement platform, and Adventures in Vaginas and Other Parts

Resources and Additional Links

• Learn More About Pain Reprocessing Therapy (PRT)
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