Pelvic Floor 101: Signs of dysfunction and how physical therapy can help

What is the Pelvic Floor?

The pelvic floor (PF) is the group of muscles that are found at the base of your pelvis. These muscles have several functions: supporting the pelvic organs (bladder, uterus, ovaries, prostate, rectum), maintaining urinary and bowel continence, sexual functioning, stabilizing the pelvis and spine and helping with fluid flow and blood flow throughout the pelvis. The muscles and tissues of the PF connect to your hip bones, sacrum, and tailbone. Both women and men have PFs, and PF dysfunction can occur in anyone and at any age.

The PF is part of the larger core system that functions to manage pressure in your abdominal cavity. It works closely with the muscles of the abdominal wall, muscles of the spine, and the respiratory diaphragm to create stability, strength, and mobility throughout your trunk.

Dysfunction in this part of your body can cause a lot of unwanted, potentially embarrassing problems.

What are the common signs and symptoms of PF dysfunction?

-Urinary incontinence

-Fecal incontinence

-Urinary or fecal urgency or frequency

-Pelvic pain

-Pain with sexual intercourse

-Pressure or heaviness in your perineal area

-Tailbone pain


-Abdominal cramping/pain

-Chronic low back/hip/knee pain

-Separation of the abdominal muscles (diastasis rectus)

The above-mentioned signs of PF dysfunction can affect anyone at any age. Some of the major risk factors are pregnancy, childbirth, age, obesity, menopause, hysterectomy, chronic coughing, and chronic straining from heavy lifting. PF dysfunction can arise due to weakness, poor endurance, tightness, muscle spasms, and incoordination of the muscles and tissues of the PF and core. Several of those symptoms are quite common; however, none should be considered normal. You might experience one or several of these issues and have tried a variety of things to improve: diet changes, medication, etc. Even traditional physical therapy treatment for back/hip/knee pain might have ultimately proved unsuccessful.

How can physical therapy help?

Physical therapy (PT) is the evaluation and treatment of movement dysfunction, physical disability, and pain using exercise, manual treatment, modalities, and education. Pelvic floor PTs are musculoskeletal experts in areas associated with the pelvis: the sacrum, sacroiliac joints, and the coccyx. This includes the vulvar, vaginal, penile, scrotal, and colorectal regions. Pelvic floor PTs receive specialized training in these areas, as well as advanced education of the gastrointestinal, reproductive, orthopedic, and neurological systems, to treat patients in a more comprehensive manner.

A pelvic floor PT will not only address the muscles and function of the pelvic floor, but she will also perform a general musculoskeletal examination to address other muscles and tissues that might be involved. The body is a dynamic and fluid system with numerous pieces that work together. The benefit of seeking evaluation from a pelvic floor PT is the comprehensive assessment, treatment, and care that you will receive to help decrease pain and improve overall function.

So, if symptoms of PF dysfunction are common, but not normal, don’t delay in seeking thorough evaluation and treatment from a pelvic floor PT.


  • Blog post courtesy of Dr. Kelly Weisner PT, DPT is co-founder of Flourish Columbus, Inc. located in Columbus, Indiana.


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