What is normal (and not) with your pelvic floor?

Anyone and everyone body is different, so it can be difficult to know what is normal and what is not. When it comes to pelvic floor health, there is a wide range of what is considered “normal,” but the most important thing is to know what your own normal is so you can recognize when something doesn’t feel right.

Your pelvic floor is a group of muscles, ligaments, and connective tissues that form a supportive hammock at the base of your pelvis. These muscles attach from your pubic bone to your tailbone and between your sitting bones (also called the ischial tuberosities). Together, these structures help you with many daily functions, from going to the toilet to supporting your organs and even improving sexual satisfaction.

The tricky thing about the pelvic floor is that it rarely receives attention until something doesn’t feel right. Leaking urine, heaviness in the pelvis, pain during sex or discomfort after childbirth are often the factors that bring this part of the body into focus. Most of the time, though, he works quietly, coordinating your breathing, supporting your core, and keeping your bladder and bowels running smoothly. Just like any other system in the body, sometimes it just needs a little extra support.

In this article, we’ll show you what’s normal – and what’s not – when it comes to your pelvic floor, so you can better understand your own body, recognize when something needs attention, and know how a pelvic floor specialist can help you.

What is the function of the pelvic floor?

There are several ways your pelvic floor plays a role in everyday life, but here are the five most important functions that are essential to your overall health and well-being:

1. Support. The pelvic floor muscles rock and support the bladder, uterus, rectum and other organs in the pelvis. Without this support system, you may experience problems such as prolapse (a feeling of heaviness or pressure as the pelvic organs drop).
2. Stability. The pelvic floor works with your diaphragm, abdominal muscles and deep back muscles to stabilize your low back, hips and pelvis. Think of it as part of the ‘core complex’. Every time you lift, turn, or even stand upright, this muscular teamwork is at play.
3. Sexual function. For comfortable intercourse and a powerful, pleasurable orgasm, the pelvic floor must be able to both contract and relax. Weakness and tension can cause pain or affect arousal and orgasm. Weakness alone can reduce the satisfaction that comes from contact with a partner or toy during penetration and can reduce the arousal or intensity of the orgasm.
4. Stay leak-free. A strong, flexible and well-coordinated pelvic floor can protect you against urine or fecal loss (also called urinary or fecal incontinence) or unwanted gas loss. Contrary to popular belief, leaking when you cough, sneeze, or laugh may be common, but it is not normal. That said, it is very treatable.
5. Circulation. These muscles also act like a small pump, moving blood and lymphatic fluid through the pelvis. This circulation supports tissue healing, reduces swelling and bloating, and helps prevent the heavy, bloated feeling that some people notice during their cycle or after long days on the feet.

What is Pelvic Floor Dysfunction?

Pelvic floor dysfunction occurs when these muscles and tissues do not work as they should. Both overactivity (shortness of breath, tension that refuses to release) and underactivity (weakness or lack of coordination) can lead to problems. Here are some of the most common problems:

• Urinary incontinence: Leaking during exertion, sneezing, sex or urgency.
• Pelvic organ prolapse: A feeling of pressure, bulging, or heaviness in the vagina or rectum. This may be due to collapse of pelvic organs such as the bladder, uterus or rectum. Patients often notice bulges that they can touch or see, as if something is “falling out” from within.
• Pelvic pain: This can include pain with sex, menstruation, tampon use, pain associated with bowel or bladder function, or even sitting for long periods of time.
• Constipation or difficulty emptying the bowels. This may be a combination of symptoms, such as fewer than three bowel movements per week, straining, hard stools, constipation or a feeling of incomplete emptying.
• Postoperative changes: For example, after prostate surgery in men, gender confirmation surgery or gynecological surgery in women.
• Changes in life stage: Pregnancy, postpartum recovery, or hormonal changes that occur during perimenopause and menopause can all place additional pressure on the pelvic floor.

It is important to remember that these problems can occur at any age, regardless of sex or gender. But it’s not something you have to live with forever. Think of them as signals from your body that your pelvic floor health deserves attention. That’s where the team at Origin can support you.

How can pelvic floor therapy help?

Pelvic floor physical therapy (PFPT) is a specialized branch of physical therapy that aims to help these muscles function as they are intended. A trained pelvic therapist can assess whether your muscles are too tight, too weak, or poorly coordinated, and then guide you with exercises, breathwork, manual techniques, and education to restore balance.

It is important to mention that our physiotherapists specialize in this area, and are also very aware that treating the pelvic floor area is not just a physical practice. There can be many emotions, sensitivities, and even trauma associated with the physical part of healing. That is why we are happy to listen to you, support you or guide you to additional support if necessary.

They also treat musculoskeletal conditions that may not seem related to pelvic floor function. For example, many new mothers may experience pain while caring for a new baby. Pelvic floor therapists treat more than just the pelvic area, including conditions that affect the breasts such as mastitis, conditions that affect the wrist and hand such as carpal tunnel syndrome, or neck, shoulder or lower back pain. Whatever’s bothering you, here’s what PFPT can do for you:

• Teach you how to properly relax and lengthen your pelvic floor when there is tension.
• Build strength if your muscles don’t provide enough support.
• Teach you better postural habits and desk ergonomics for grooming or working on your computer.
• Retrain your brain-muscle coordination so that your muscles contract and relax at the right times.
• Helps you to start running or exercising again as you want after giving birth.
• Learn breathing techniques to support your body and functional goals.
• Helps you develop strategies for bladder and bowel health that go far beyond just “do your Kegels.”
• Improve sexual comfort by addressing muscle tension and coordination and making recommendations for optimal sexual positions lubricants.
• Support you during pregnancy, birth recovery or menopause with tailor-made strategies.

Like Dr. Megan Stancill from our clinic in Coral Gables, Florida, explains:

“Pelvic floor therapy doesn’t have to take forever. We don’t want you to have to rely on your PT to feel good, we’d rather give you the option to treat yourself if your symptoms return so you don’t have to keep coming in.”

That empowerment piece is key. The goal is not to keep you in therapy indefinitely; the goal is to teach you how to understand your own body and give you tools that will benefit you for a lifetime.

Not sure if you need pelvic floor therapy?

We get it. This all sounds great, but sometimes it can be difficult to know when what you are experiencing is “normal” or if it indicates something worth addressing. That’s where a pelvic health coaching conversation can help. These are one-time, accessible sessions where you can ask questions in a judgment-free space, gain clarity on whether you would benefit from virtual or in-person physical therapy, and learn general strategies to better support your pelvic health yourself.

Talking to a pelvic health coach about your pelvic floor can help you stay proactive instead of waiting for symptoms to arise.

When can you visit Origin Physiotherapy?

If you’re wondering if what you’re experiencing is “normal,” here are some clues that it might be worth reaching out to a pelvic floor physical therapist:

• You lose urine when you sneeze, cough, laugh, squat or exercise
• You feel pressure or heaviness in your pelvis
• You have recurring pain during sex or difficulty inserting tampons or menstrual cups
• You have undergone pregnancy, childbirth, menopause or pelvic surgery and notice changes that you would like to understand better
• You feel like your core is not strong or stable despite doing workouts or exercises

You deserve to feel informed, strong, and confident in your body. There are no stupid questions at Origin. We are here to support you. Make an appointment for an in-person or virtual visit with one of our caring and supportive specialist physiotherapists. Just because something is common doesn’t mean it’s normal, and it certainly doesn’t mean you have to deal with it alone.