5 Signs Your Pelvic Floor Needs Support

This post was written as a collaboration between Dr. Laura Palmere, Urogynecologist, and Justine Lallman, PT, DPT.

When we talk about fitness and health, we often focus on our core, our glutes, or our cardio endurance. But there is one crucial group of muscles that often gets ignored until something goes wrong: the pelvic floor.

The pelvic floor is a hammock-like structure of muscles, nerves, and tissues that stretches from your pubic bone to your tailbone. It supports your bladder, bowel, and uterus (or prostate, in men). When it’s working well, you don’t even notice it. But when it becomes too weak or too tight, your body starts sending signals.

If you’ve been experiencing discomfort or "little accidents," you aren’t alone, and it’s not just "part of getting older." In fact, there are professionals who can help with these issues, including pelvic floor physical therapists and Urogynecologists.

Here are 5 signs your pelvic floor might need some professional support.

1. The "Sneezing" Struggle (Leaking)

If you leak a little urine when you laugh, sneeze, cough, or jump, this is clinically known as stress urinary incontinence. Many people view this as a standard rite of passage after childbirth or aging, but it is actually a sign that the muscles responsible for closing the bladder aren't firing correctly. Whether it’s due to weakness or a lack of coordination, it’s a clear sign your pelvic floor needs some TLC.

2. A Persistent Feeling of "Heaviness"

Do you sometimes feel a sensation of fullness, pressure, or a "dropping" feeling in your pelvic area, especially by the end of the day? This can be a sign of pelvic organ prolapse. It happens when the pelvic floor muscles aren't providing enough structural support, causing the bladder, uterus, or rectum to descend slightly. If you feel like something is "falling out," it is time to ask your primary care provider for a referral to a pelvic floor physical therapist or a Urogynecologist.

3. Chronic Lower Back or Hip Pain

It sounds strange—why would your pelvic floor affect your back? Because your pelvic floor is part of your "deep core." When the pelvic floor muscles are weak, the muscles in your lower back, hips, and abdomen have to overcompensate to keep you upright. If you have chronic back pain that won’t go away with standard stretching or chiropractic care, the root cause might actually be hiding in your pelvis.

4. Pain During Intercourse

Painful intimacy is often a sign of a pelvic floor that is too tight (hypertonic). Just like any other muscle in your body, the pelvic floor can get stuck in a state of chronic contraction, often due to stress, trauma, or guarding behaviors. If intercourse is uncomfortable, don’t ignore it. Pelvic floor therapy is highly effective at helping these muscles learn how to release and relax.

5. Frequent or Urgent Trips to the Bathroom

Do you feel like you always need to go, even if you just went? Or do you find yourself mapping out the closest bathroom wherever you go? This "urgency" can be a sign of pelvic floor dysfunction. Sometimes, the muscles that hold back the urge to go are tired or overactive, giving your brain false signals that it’s time to empty your bladder. Pelvic floor physical therapy and lifestyle changes can vastly improve this symptom.

What Can You Do For Pelvic Pain?

If you recognize yourself in any of these signs, the most important thing to know is this: You do not have to live with this.

1. Stop the "Guesswork Kegels": Many people perform Kegels incorrectly, which can actually make certain problems worse. Don't just squeeze harder without guidance. 

2. See a Pelvic Floor Physical Therapist: This is the gold standard of care. These specialists are trained to assess exactly what your muscles are doing and provide a personalized plan to strengthen, lengthen, or coordinate your pelvic floor.

3. Check Your Habits: Simple lifestyle changes, like how you sit on the toilet, how you breathe, and your posture during exercise, can make a massive difference.

The Takeaway: Your pelvic floor is the foundation of your core. Ignoring it doesn’t make the symptoms go away; it usually just leads to more discomfort. 

If you have questions, reach out to our team of experts at the CHI Health Pelvic Health Center, or call (402) 717-7358 to spead with our Pelvic Health Navigator. We are here to help assess your systems and care for you!