Pelvic Floor Dysfunction

Pelvic Floor Dysfunction is what happens when the muscles, ligaments, and connective tissue that form a hammock across the base of your pelvis don't work the way they should. These muscles support your bladder, bowel, and (in women) uterus, and they play a critical role in continence, sexual function, core stability, and low-back support.

Dysfunction can show up as urinary leakage (with coughing, laughing, jumping, or strong urges), frequency or urgency, painful sex, chronic pelvic pain, constipation, low-back pain, or a feeling of heaviness or 'falling out' (pelvic organ prolapse). It's incredibly common — and incredibly underdiagnosed because so many people are told it's 'just part of being a woman,' 'just part of aging,' or 'just what happens after kids.' It's not. Pelvic floor physical therapy is a specialized, evidence-based treatment that resolves the vast majority of these issues, and it's appropriate for women, men, and people of all ages.

• Urinary incontinence or urgency
• Pelvic pain or pressure
• Pain during intimacy
• Lower back pain associated with pelvic region

• Pregnancy and childbirth (vaginal or C-section)
• Chronic constipation or straining
• Surgeries (prostatectomy, hysterectomy, abdominal)
• Heavy lifting and high-impact sports
• Aging and menopausal hormone changes

• Women postpartum (whether or not symptoms started right away)
• Perimenopausal and postmenopausal women
• Men after prostate surgery
• Anyone with chronic constipation, chronic pelvic pain, or painful sex
• Athletes — especially runners, gymnasts, and CrossFit athletes

Your PT will be specially trained in pelvic floor care and will start with a thorough conversation about your symptoms, history, goals, and what kind of evaluation you're comfortable with. Internal vaginal or rectal exams are the gold standard for assessing the pelvic floor and are done with full consent, in a private room, with care — but they're never required. External assessment, biofeedback, and ultrasound are alternatives that still give us a clear picture.

Treatment depends entirely on whether your pelvic floor is too weak (needs strengthening), too tight (needs relaxing and lengthening), or uncoordinated (needs retraining). It's often the opposite of what people assume — many leakage and prolapse symptoms come from tight, overactive muscles rather than weak ones, and just doing Kegels can make them worse. We use manual therapy, breathing retraining, posture and movement correction, biofeedback, progressive strengthening, and education on bladder and bowel habits. We coordinate with your OB/GYN, urologist, or colorectal physician when relevant. The vast majority of patients see meaningful improvement, and most resolve their primary issue completely.

If your symptoms aren't improving in 2-3 weeks, are getting worse, or starting to limit daily activities, call us or schedule an appointment online today — early intervention almost always means a faster, fuller recovery.

Most patients see real improvement in 6-8 weeks. Full resolution typically takes 3-4 months. Postpartum and post-surgical patients often progress faster when they start early.

• Stop peeing 'just in case' — it trains the bladder to be hypersensitive
• Don't strain on the toilet — use a Squatty Potty-style stool to align the colon
• Breathe diaphragmatically — your pelvic floor and diaphragm move together
• Don't do random Kegels if you have pain or tightness — see a PT first
• Move daily and avoid prolonged sitting or standing in one position

These tips support recovery but don't replace a professional evaluation. If you're unsure or symptoms worsen, please reach out.