Postpartum women are often distressed by changes that happen to their bodies after delivery, especially if these changes persist past what they perceive as an acceptable recovery time. There is the desire to ‘have my body back’ as part of a fulfilling quality of life. Women having children now are less likely to accept symptoms like incontinence of urine or faeces, vaginal wind, or sexual dysfunction than women of past generations. Because surgery is often not the answer for a woman considering future childbearing, pelvic floor physical therapy (PFPT) has been posited as a solution. Strong radiological data have determined that musculoskeletal trauma results from vaginal delivery. It is a logical extrapolation from the sports and rehabilitation literature that this trauma should respond well to physical therapy. The authors of this secondary analysis of a randomised controlled trial investigate female sexual dysfunction (FSD) in primiparous women having a term singleton delivery without major tears. FSD is an under-studied area that is now receiving greater scientific attention, paralleling population interest in this important arena of a woman's life. The positive effects of PFPT for urinary incontinence, at least in the short term, are better known, but few trials have looked at FSD. For the whole cohort, the authors did not see a difference, which is common in studies concerning physical therapy. Most women (88%) were able to happily resume intercourse with few complaints in either group. As a secondary analysis, this trial is not powered for this outcome and is probably hampered by small numbers. PFPT is not a ‘one size fits all’ treatment, and can be difficult to study objectively; sexual function is also a highly subjective concept with few robust, validated measures in this population, as the authors mention. But as with any novel area of study, this trial could help to power and design future work. Most interestingly, the authors report on a subgroup of women diagnosed using ultrasound with levator trauma from their deliveries, and in this most at-risk group, PFPT was beneficial at reducing the sensation of vaginal laxity. As this is a particularly vexing complaint after a ‘normal’ delivery, this finding carries strong potential. Work at other centres is focusing on levator trauma and pelvic floor complaints. Focusing rehabilitation resources on these women immediately after injury is logically the most efficient course. Like many other PFPT studies, heterogeneity of the intervention and then outcome quantification are limiting factors. The authors here mention these difficulties in establishing power. A Cochrane review of peripartum physical therapy was sharply limited by this problem, precluding meta-analysis (Boyle et al. Neurourol Urodyn 2014;33:269–76). In this review, continent women showed some benefit from PFPT, staying continent after delivery. But the authors concluded that the variety of PFPT options combined with the variety of needs with which postpartum women present precluded a universal answer. This study, particularly with the results in women specifically with levator injury, may provide an evidence-based focus of therapy and, hence, its best utility. None declared. Completed disclosure of interests form available to view online as supporting Information. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.