Written By Charleston Physical Therapy: Cat Lewan
Understanding Pelvic Floor Dysfunction and How Rehabilitation Can Help
Pelvic floor issues are more common than many people realize, and they affect both women and men of all ages. From postpartum recovery to chronic pelvic pain or urinary incontinence, pelvic floor dysfunction can disrupt daily life in ways that are often overlooked or misunderstood. Thankfully, pelvic floor rehabilitation—guided by trained physical therapists—is a proven, non-invasive way to regain strength, function, and confidence.
What Is the Pelvic Floor?
The pelvic floor is a group of muscles and connective tissue that stretches like a sling from the pubic bone to the tailbone. These muscles support key internal organs such as the bladder, bowel, and (in women) the uterus. They also play a crucial role in posture, sexual function, and core stability.
When these muscles become too weak, too tight, or poorly coordinated, it can lead to pelvic floor dysfunction. Symptoms may vary widely, but often include:
- Urinary or fecal incontinence
- Pelvic pain or pressure
- Pain during intercourse
- Constipation or straining
- A feeling of heaviness or bulging in the pelvis
According to the National Institutes of Health, nearly 25% of women in the U.S. experience pelvic floor disorders [1], and it’s believed that number may be underreported due to stigma or embarrassment.
Causes of Pelvic Floor Dysfunction
Pelvic floor issues can stem from a variety of factors, including:
- Childbirth, especially vaginal delivery or trauma during labor
- Aging and menopause, which can lead to muscle weakening
- Chronic constipation and straining
- Heavy lifting or high-impact activities
- Pelvic surgeries like hysterectomy or prostatectomy
- Trauma or injury to the lower back or pelvis
- Neurological conditions such as multiple sclerosis or stroke
In many cases, pelvic floor dysfunction is a functional issue, meaning the problem lies in how the muscles are working—not necessarily in visible damage.
Signs You Shouldn’t Ignore
It’s important to seek help if you experience any of the following symptoms regularly:
- Urine leaks when sneezing, laughing, or exercising
- A constant urge to urinate or incomplete bladder emptying
- Pain or discomfort during sex
- Difficulty controlling gas or stool
- Unexplained pelvic pain or muscle tightness
These issues are not a normal part of aging, nor should they be accepted as inevitable after childbirth. They are common—but treatable.
What Is Pelvic Floor Rehab?
Pelvic floor rehabilitation is a form of physical therapy that focuses on improving the function and strength of the pelvic muscles. A trained pelvic floor physical therapist will assess your symptoms, muscle tone, coordination, and overall core stability to create a customized treatment plan.
Some components of pelvic floor rehab include:
- Biofeedback to help you understand and control pelvic muscle contractions
- Manual therapy to release tight tissue or trigger points
- Pelvic floor exercises (commonly known as Kegels—but more precise and personalized)
- Breathing and relaxation techniques to reduce muscle tension
- Core stabilization and posture correction
- Education on bladder habits, bowel mechanics, and daily ergonomics
A 2020 review in The Journal of Women’s Health Physical Therapy found that pelvic floor physical therapy significantly improved urinary incontinence and pelvic pain compared to no treatment or general exercise [2].
Benefits of Pelvic Floor Rehab
The benefits of consistent, targeted pelvic floor therapy are wide-ranging and can greatly enhance overall quality of life. Many patients report:
- Fewer urinary leaks or urgency episodes
- Improved bowel regularity and control
- Reduced pain with intercourse
- Better posture and core strength
- Enhanced sexual satisfaction
- Decreased pelvic tension and discomfort
It’s worth noting that pelvic floor therapy is not just for women. Men can benefit too, especially those recovering from prostate surgery or dealing with chronic pelvic pain.
Home Practices and Lifestyle Tips
While working with a physical therapist is key, some at-home practices can complement pelvic floor rehab:
1. Avoid Overdoing Kegels
Contrary to popular belief, more Kegels don’t always mean better results. Over-tightening can be just as problematic as weakness. Your therapist will guide you on the right technique and balance.
2. Practice Diaphragmatic Breathing
Deep belly breathing can help relax the pelvic floor and improve coordination between the diaphragm, abdominals, and pelvic muscles.
3. Stay Hydrated and Eat Fiber-Rich Foods
Constipation is one of the major contributors to pelvic floor strain. Aim for a high-fiber diet, drink plenty of water, and avoid excessive straining during bowel movements.
4. Be Mindful of Posture
Slouching puts pressure on the pelvic floor. Sitting upright and engaging your core gently throughout the day can support long-term improvement.
When to Seek Professional Help
If your symptoms interfere with your daily life, relationships, or emotional well-being, it’s time to talk to a specialist. Pelvic floor therapy is confidential, respectful, and empowering. Most sessions involve external assessments, though some may include internal exams if appropriate and consented.
According to the American Physical Therapy Association, “early intervention can prevent worsening symptoms and improve outcomes with fewer sessions” [3].
Final Thoughts
Pelvic floor dysfunction doesn’t have to be a life sentence. Whether you’re recovering postpartum, dealing with incontinence, or experiencing chronic pain, pelvic floor rehabilitation offers hope—and results. With the right guidance, you can regain control, restore comfort, and reconnect with your body.
Sources:
[1] National Institutes of Health. “Prevalence of Pelvic Floor Disorders.” https://www.nih.gov
[2] The Journal of Women’s Health Physical Therapy. “Effectiveness of Pelvic Floor Rehabilitation.” 2020.
[3] American Physical Therapy Association. “Pelvic Floor Physical Therapy.” https://www.apta.org