Pelvic Floor & Abdominal Therapy


PT/OT | Visceral Treatment | Yoga Therapy

Find true, lasting relief from pelvic pain, abdominal pain, sexual dysfunction, pregnant and postpartum rehab, peri/menopause, prolapse, men’s pelvic health, urinary and bowel urgency or incontinence.

“Helping you get back to doing what you love without pain, leakage, or weakness.”

Located in Richmond, VA I Serving Central Virginia

Schedule an evaluation now!
Pelvic physical therapist demonstrating safe exercise to postpartum woman. Postpartum Woman is on her hands and knees on a treatment table with a baby lying face up looking at her.

Pelvic Floor Therapy
That Helps You Feel Like Yourself Again

If you’re dealing with pelvic pain, leaking, pressure, abdominal discomfort, painful intimacy, or postpartum changes that just don’t feel right — you’re not alone.

Pelvic floor issues are incredibly common. They’re also deeply personal, often frustrating, and sometimes embarrassing to talk about. You might have been told it’s “normal,” something you just have to live with, or that medication or surgery is your only option.

It’s not. And you don’t have to figure it out alone.

At Fettle & Fit, we provide compassionate, 1:1 pelvic health physical/occupational therapy designed to help you understand your body, relieve symptoms, and get back to the activities you love — naturally.

Whole Person Pelvic Healthcare

Your pelvic floor doesn’t exist in isolation — and neither do you.

Whether you're navigating postpartum recovery, pregnancy-related discomfort, incontinence, chronic pelvic pain, abdominal pain, or changes that come with aging, your symptoms are connected to your movement, stress, history, and lifestyle.

Instead of quick fixes, we focus on identifying the root cause of your pelvic floor dysfunction. From there, we create an individualized, personal treatment plan that fits your real life — not a generic protocol. Pelvic health is about quality of life, not just muscles.

Because healing works best when it works for you.

If you’re ready for boutique pelvic floor therapy that feels personal, compassionate, and grounded in real expertise, we’d love to support you.

Specialized, Woman-Owned Care You Can Trust

Fettle & Fit is a woman-owned pelvic health practice led by a Board-Certified Clinical Specialist in Women’s Health Physical Therapy.

While we have advanced training in pelvic floor therapy and women’s health physical therapy, what matters most is how you feel when you’re here: safe, heard, and respected.

We work with people of all genders and at every life stage. Pelvic floor problems don’t discriminate — and neither do we.

What We Help With

Premium pelvic floor therapy can support you if you’re experiencing:

  • Pelvic pain

  • Urinary leakage or urgency

  • Painful intercourse

  • Pregnancy and postpartum rehab and recovery, including perineal scars

  • Abdominal pain or core weakness

  • Diastasis recti

  • Pelvic pressure or prolapse symptoms

  • Difficulty returning to exercise

  • Cancer or surgical recovery

If something feels “off,” that’s reason enough to seek care.

The Fettle & Fit Difference

  • We are here for you

    Goals are achieved by listening, understanding the whole person, researching and providing support that works for each individual. You know what is going on in your body more than anyone else, we help you understand the why. We strive to provide the type of support we would want for our own friends and family.

  • True Pelvic Health Experts

    Our entire team specializes exclusively in pelvic health. We have dedicated our careers to helping those with pelvic health issues find lasting relief.

  • Get “to the Root” for Lasting Relief

    We want to find and treat the underlying cause for true, lasting relief. Many patients have been to multiple practitioners before finding relief with us. We're not content with temporary improvements. We find the underlying cause so it doesn't come back!

  • Maximized Time

    60-120 minute long hands-on sessions completely with your pelvic specialist suited to your unique needs. No aides, assistants, no hooking you up to machines and leaving you there, no telling you to 'just Kegel' or simply watch you exercise.

  • Leaders in the Field

    Dr. Casey is a Board Certified Women's Health Therapist (there are less than 700 in the country!) Our therapists have lectured at universities, trained other physical therapists, and work closely with some of the top pelvic pain MDs in the country!

  • Virtual Option

    If you can't make it to our office, fear not! We offer virtual 1:1 appointments. Great for those who are not local, new parents, and those who would like therapy in the privacy of their own home.

Call Now to Get Started!

What Our Patients Are Saying:

  • "Every postpartum woman needs to come to this practice! As a Physical Therapist myself, I found that I was in great need for the expertise of pelvic PT after a difficult childbirth. Dr. Casey was wonderful and very comprehensive from day one. She really listens and takes a holistic approach to create an individualized treatment plan. It is clear that she is passionate about her field, and she is absolutely an expert in pelvic PT. Highly recommend!"

  • "My pain was misdiagnosed for 15 years while Drs prescribed oxy and told me there wasn't anything else they could do. My own research led me to Dr. Casey; she's amazing! Her extensive knowledge helped pinpoint the problems after the first consult. I'm now almost pain-free and off the narcotics after just a few months."

  • "I have experienced the best care and healing with Dr. Casey Smith of anyone I have ever been to. I came to her to address urinary incontinence issues, but also rebalanced my entire pelvis and lower back. Her most recent treatment addressed issues I was having in my neck, which alleviated my lower back achiness. Dr. Casey has a true gift in seeing the biomechanics of the body and addressing all of it, because she realizes how integrally our bodies compensate. I could not recommend her more whole-heartedly."

Fettle

  • n. State or condition of health, fitness, wholeness, spirit or form

  • adj. Healthy or strong, in good condition

  • v. Get ready, prepare

Fit

  • n. A sudden burst or flurry

  • adj. Adapted to an end, design or environment to be capable of surviving; Sound physically and mentally; Healthy

  • v. To insert or adjust until correctly in place; to be in harmony