What your PT should tell you about your Pelvic Floor

What Your Physical Therapist / Physiotherapist Should Tell You About Your Pelvic Floor Your pelvic floor is one of the most important, yet often overlooked, parts of your body. It's a group of muscles, ligaments, and connective tissues forming a hammock-like sling at the base of your pelvis.

These muscles support your bladder, bowels, reproductive organs (in women, including the uterus and vagina), and play a key role in core stability, continence, sexual function, and even posture.

As a mama who's helped thousands through pregnancy, birth, and postpartum recovery, I know how confusing pelvic floor health can feel. Many women (and men) come to me frustrated after years of "just do more Kegels" advice that didn't help – or even made things worse.

A good pelvic floor physiotherapist (or physical therapist specializing in pelvic health) will give you clear, evidence-based information tailored to you, not generic tips. Here's what a qualified pelvic floor physio should tell you during your assessment and sessions:

1. Your Pelvic Floor Isn't Just About "Weakness" – It Can Be Too Tight, Too Weak, or Both One of the biggest myths is that all pelvic floor issues come from weakness, so more squeezing (Kegels) fixes everything. In reality: Underactive / weak pelvic floor: Common after childbirth, with aging, or low activity – leads to leaks (stress incontinence when sneezing, laughing, or exercising), heaviness, or prolapse risk. Overactive / tight (hypertonic) pelvic floor: Often from stress, holding patterns, trauma, or overdoing exercises – causes pain (pelvic, lower back, hip, during sex), difficulty relaxing for bowel movements, constipation, or urgency. Many people have a mix – parts weak, parts tight. Your physio should explain this and assess whether strengthening, relaxation, or a balance is needed first. They'll never just say "do more Kegels" without checking.

2. How to Actually Find and Activate Your Pelvic Floor Correctly Most people do pelvic floor contractions wrong – bearing down instead of lifting, or using glutes/abs/legs instead. A physio will teach you: The correct "lift and squeeze" feeling – like stopping urine mid-flow or holding in wind (but never practice while actually peeing, as it can disrupt bladder habits). Full relaxation is just as important as contraction – many issues stem from inability to let go. Breath coordination: Pelvic floor moves with your diaphragm – inhale to gently drop/relax, exhale to gently lift. They'll use cues, mirrors, or tools like biofeedback (sensors/apps) to confirm you're doing it right. If an internal exam is needed (with your consent), it's the gold standard for accurate feedback.

3. What an Assessment Really Involves (And Why It's Private & Comfortable) Your first session should include: Detailed history: Symptoms (leaks, pain, sex issues, bowel/bladder habits), pregnancies/births, exercise, stress, diet. External exam: Posture, hip/back/pelvic alignment, breathing patterns, core strength. Optional internal vaginal/rectal exam (for women/men): To feel muscle tone, strength, endurance, coordination, tenderness, or spasms. You can decline or stop anytime – many use external methods first. Functional tests: Squats, coughs, or movements to see real-life support. They'll explain findings clearly: "Your muscles are tight here, weak there – here's why symptoms occur."

4. Pelvic Floor Issues Are Common – And Treatable (For Everyone) Pelvic floor dysfunction affects men and women of all ages – not just pregnant or postpartum women. Common symptoms include: Urinary/bowel incontinence or urgency Pelvic pain, heaviness, or pressure Pain during/after sex (dyspareunia) Constipation or straining Lower back/hip pain linked to poor support A physio will reassure you it's not "normal" to live with these – and it's not embarrassing. They treat it like any other muscle issue (knee or shoulder). Evidence shows pelvic floor therapy is a first-line, effective treatment for incontinence, prolapse, pain, and more – often better than surgery alone.

5. Treatment Isn't Just Exercises – It's Personalized & Holistic Beyond basic contractions: Relaxation techniques (reverse Kegels, diaphragmatic breathing, stretches) for tight muscles. Strengthening progressions (with holds, speed, endurance) if weak. Manual therapy, massage, or tools like biofeedback/electrical stimulation. Lifestyle advice: Toilet habits (don't strain), fluid intake, avoiding constipation, safe exercise modifications. Integration with core rehab, posture, and daily movements. They'll set realistic goals, track progress, and empower you with home strategies – not endless sessions.

6. When to Seek Help & Red Flags See a pelvic floor physio if you have any symptoms – don't wait for "bad enough." Early help prevents worsening (e.g., prolapse). Always get cleared by your doctor first, especially postpartum. Red flags to mention: Sudden changes, blood in urine/stool, severe pain – see a doctor urgently.

Final Thoughts from a Mama Who's Been There

Your pelvic floor deserves the same care as any other body part. A great physio won't just treat symptoms – they'll educate, empower, and help you trust your body again. Whether preparing for birth, recovering postpartum, or dealing with leaks/pain years later, the right guidance changes everything. Have you seen a pelvic floor physio? What surprised you most?

Share below – let's normalize this conversation! 💪❤️ Our complete PregActive Pelvic Floor Reset is a great option to help you regain your confidence. Start Today! You've got this – and you're not alone.

Always consult your healthcare provider for personalized advice. This is general information based on common pelvic health best practices.