What it is
The pelvic floor is a hammock of muscles at the base of your pelvis. It supports your bladder, bowel, and (for women) the uterus, helps control when you go to the bathroom, plays a role in sexual function, and works with your deep core and breathing to manage pressure in your abdomen.
“Pelvic floor dysfunction” means those muscles aren’t doing their job well, either because they’re too weak, too tight and overactive, poorly coordinated, or some combination. The symptoms look different from person to person, but the common thread is the same: it’s a muscle and movement problem, which is exactly what physical therapy is built to treat.
What it feels like
- Leaking urine with coughing, sneezing, laughing, lifting, running, or jumping
- Urgency and frequency: feeling like you have to go often, or “right now”
- Pelvic pain, pressure, or a sense of heaviness or “falling out”
- Pain with intercourse, exams, or tampon use
- Constipation, straining, or trouble fully emptying
- A core that feels disconnected after pregnancy, with or without abdominal separation (diastasis recti)
- Low back, hip, or tailbone pain that hasn’t responded to treatment aimed only at the back or hip
Why it’s so often missed
So many people are quietly told this is just part of having kids, getting older, or being a woman. It isn’t. Common isn’t the same as normal, and almost all of it is treatable. Because the symptoms are private, a lot of people live with them for years before finding out there’s a specific, effective way to address them.
How we treat it
Care is one-on-one, private, and paced to your comfort:
- A thorough, respectful assessment of how your pelvic floor, deep core, breathing, and hips are working together, and what’s actually driving your symptoms.
- Down-training or strengthening, depending on what you need. An overactive, guarded pelvic floor needs to learn to relax and lengthen; a weak or uncoordinated one needs to build strength and timing. The right direction matters; defaulting to “do your Kegels” often makes the wrong cases worse.
- Coordination with breathing and pressure management, so your core and pelvic floor share load instead of leaking pressure with every cough, lift, or run.
- Return to what you want to do, whether that’s running without leaking, lifting without pressure, intimacy without pain, or simply getting through the day without planning around a bathroom.
- Education and a home program so the gains hold and you understand what’s changing and why.
This work pairs closely with our pelvic floor physical therapy service, our flagship specialty.
When to seek us out
If any of the symptoms above sound familiar, you don’t have to wait until they’re severe, and you don’t have to live with them. Earlier care usually means a shorter course and a faster return to feeling like yourself.
Seek medical care for any of the red-flag symptoms above, and let your OB, midwife, or physician know about new pelvic symptoms during or after pregnancy.