Pelvic floor dysfunction refers to problems with the pelvic floor, a very important group of 26 different muscles found in the pelvis. Everyone has a pelvic floor, regardless of their genitals.

It plays a role in many different parts of daily life, as it holds many different responsibilities. When the pelvic floor is in poor health, it can lead to a variety of uncomfortable symptoms, pain, and a lowered quality of life.

Before we jump into a discussion about pelvic floor dysfunction, let’s first get familiar with the pelvic floor! The pelvic floor holds five main jobs:

1. Continence of the bladder and bowels: The pelvic floor muscles involuntarily and voluntarily contract and relax. This allows continence of your bladder and bowels!
2. Sexual function and appreciation: Having a healthy pelvic floor is necessary for sexual function (maintaining an erection, being able to orgasm) as well as painless sex—no matter your genitals.
3. Support of the back and hips: Your pelvic floor is an important support for both the spine and hips. It helps stabilize your pelvis and works together with your core to allow for balance and a variety of movements.
4. Support of the pelvic organs: The pelvic floor plays an important role in supporting your pelvic organs (bladder, uterus, bowels, etc.). It works against gravity as well as pressure within the body that changes with breathing, pregnancy, or certain movements like lifting.
5. Blood and lymph circulation: Your pelvic floor works together with your diaphragm to help circulate blood and lymph fluid!

As you can see, this group of pelvic muscles is very interconnected with the body. They have many attachment points, and are closely located to many other structures within the body, including bones, ligaments, tendons, organs, and more.

This means that your pelvic floor affects other areas such as your hips, lower back, abdominals, tailbone, genitals, and more.

Pelvic floor dysfunction refers to poor health of the pelvic floor muscles, such as tightness (overactivity), weakness, inflexibility, or poor coordination.

This can create a very wide range of problems, conditions, and symptoms, which can all affect the pelvic floor’s jobs listed previously.

Constipation, painful sex, urinary urgency, pelvic pain, back pain, pelvic organ prolapse, erectile dysfunction, and many other conditions can be caused by pelvic floor dysfunction.

You can view an extensive list of pelvic floor symptoms, conditions, and other related topics on our pelvic floor conditions page!

Pelvic floor dysfunction is actually very common. Many individuals will experience it in their lifetime. However, just because it is common, doesn’t mean it is normal.

For example, many individuals may think it is normal to have a little incontinence when laughing or sneezing, particularly after pregnancy. This is actually a symptom of pelvic floor dysfunction, and is not simply a symptom you have to deal with!

Pelvic floor dysfunction can happen to anyone of any age or sex. It can be confusing when your body doesn’t seem to function as it should, but luckily, pelvic floor dysfunction is very treatable!

Don’t be ashamed of seeking pelvic floor treatment. Caring for your pelvic floor is just as important as caring for any other part of your body.

At Hive Therapy and Wellness, we leave no room for shame! We want to help educate you on your body, relieve you of your symptoms, and put you back in control of your pelvic floor.

Not to mention, our pelvic floor therapists are very educated, trained, and experienced in all things relating to the pelvic floor. They have years of patient-focused care, meaning you aren’t alone in your pelvic health journey.

Pelvic floor dysfunction can unfortunately become worse over time, and does not usually resolve on its own—so it is very important not to ignore your symptoms!

We’ll talk more about treatment soon, but first let’s talk about what causes pelvic floor dysfunction, next!

Start Healing with Hive

Many different things can contribute to pelvic floor dysfunction. It may not always be one main factor that causes it, but can often be a combination of factors that lead to your symptoms.

Below, we’ve outlined some common examples of things that can create or contribute to dysfunction of the pelvic floor muscles:

Pregnancy / Childbirth

Pregnancy and childbirth can significantly affect the pelvic floor. After all, the pelvic floor plays a huge role in supporting the changes a person experiences during pregnancy, and is directly involved in vaginal delivery.

Even individuals who undergo a c-section have their pelvic floor affected in some way.

With all the changes experienced during pregnancy, the pelvic floor can become weak, poorly coordinated, and unable to perform its jobs properly—leading to incontinence, painful sex, pain, and more.

These symptoms won’t simply go away postpartum, and may become long-term struggles if the pelvic floor is not rehabilitated. Therefore, it can be very helpful to engage in physical therapy for childbirth preparation and postpartum recovery.

Other Conditions

Many conditions can affect the pelvic floor and contribute to tight muscles and pain.

Some chronic conditions can especially cause dysfunction, as the frequent long-term experience with pain and other symptoms can gradually build tightness and disrupt coordination of the pelvic floor.

Unfortunately, pelvic floor dysfunction can also worsen the symptoms of these conditions, potentially causing a cycle of pain and discomfort. If you experience symptoms of pelvic floor dysfunction alongside these conditions, it is very important to seek treatment.

While pelvic floor therapy cannot completely cure chronic conditions, it can significantly reduce your pain and other symptoms, allowing for an improved quality of life overall.

Some examples of conditions that can lead to pelvic floor dysfunction include:

• Endometriosis
• Irritable bowel syndrome
• Inflammatory bowel disease
• Pelvic inflammatory disease
• Polycystic ovary syndrome
• Perimenopause and menopause
• And many more!

These are just a few examples, and not an exhaustive list of conditions that can affect the pelvic floor. Practically any condition affecting the pelvis, hips, abdominals, or lower back can have some effect on the pelvic floor.

If you have a chronic condition and are wondering if it can be a contributor to pelvic floor dysfunction, feel free to browse the pelvic floor conditions page mentioned previously.

Behaviors

There are many different behavioral habits in your day-to-day life that may be impacting your pelvic health, even unknowingly. This can include a lot of different things, but some examples can include:

Chronic constipation

Straining on the toilet or sitting on the toilet for long periods of time can create significant tension in your pelvic floor muscles.

Constipation can be a result of many things, including pelvic floor dysfunction. Other factors like poor fiber or water intake, other pelvic conditions, using the restroom too frequently or infrequently, and even toilet posture can make chronic constipation more likely.

Poor posture and movement mechanics

Certain postures can affect your pelvis, causing strain and pressure that can lead to tight muscles or pelvic misalignment.

For example, having poor technique while playing sports, exercising, or lifting can put pressure on the pelvic floor and contribute to dysfunction. Prolonged sitting or standing can have an affect on your posture and pelvis, too!

Age

Age can also contribute to pelvic floor dysfunction. However, it is important to note that even older individuals can maintain a healthy pelvic floor. With regular exercise and care, as well as avoiding the harmful behaviors described previously, your pelvic floor can maintain function and comfort even into old age.

Unfortunately, in many cases, factors such as sedentary habits, other conditions, and changes in hormones or bone density can contribute to a variety of pelvic floor symptoms.

Working to maintain good general health in terms of diet and exercise as you age can significantly support good pelvic health!

Previous Surgery or Injury

Having previous surgeries or injuries to the abdominals, pelvis, or surrounding areas can affect your mobility and tissue health, which in turn can affect the pelvic floor.

Surgeries and injury can cause weakened tissues, and if not properly rehabilitated, may create long-term conditions. This is especially so when these factors cause things like adhesions or scar tissue, which can create restrictions on tissue mobility and may result in pelvic floor tightness.

Some common examples include hysterectomies, genital reconstruction, hip surgeries, and more.

Even though many things can create pelvic floor dysfunction, and the condition is very common, many people don’t realize that their pelvic floor is the cause of their symptoms.

However, pelvic floor dysfunction can be very treatable! Pelvic floor physical therapy is often a primary treatment option for many symptoms or conditions relating to the pelvic floor.

Pelvic floor treatment can seem intimidating, but at Hive Therapy and Wellness, our providers do their absolute best to make pelvic care accessible, comfortable, and educational.

You’ll always be in control of the treatment process, meaning you don’t have to engage in any form of examination or treatment that you are uncomfortable with. Our providers always request consent before treatment and exams, and respect your needs and boundaries.

They’re here to genuinely listen to your needs and concerns, and support your health journey with compassion and sincerity!

That being said, you may be wondering what pelvic floor treatment is like. First, your Hive provider will start with an evaluation.

This can be activities like discussing your medical history, past relevant injuries or surgeries, symptoms, and other necessary information. Then, they’ll engage in physical examinations with your consent.

Physical examinations can be external or internal:

• External examinations can involve assessments of your pelvis, back, hips, or abdominals. Your provider will want to assess your muscle tension, muscle tone, spinal alignment, posture, and more to gain a better idea of any possible contributors to your pelvic floor dysfunction.
• Internal examinations allow the provider to directly assess the pelvic floor muscles via the vagina or rectum. They will typically use a gloved hand to feel for trigger points, muscle tone, and the level of control you have over your pelvic floor.

While this portion of the examination may sound intimidating, it can provide very valuable information for your treatment. Rest assured that your physical therapist will do everything they can to make your experience smooth and comfortable!

Once your provider has finished these assessments, they’ll formulate a curated treatment plan for your unique needs.

This treatment plan will look to reduce pain, improve function, and put you back in control of your pelvic floor. Your treatment plan will vary based on your individual needs, but could include treatments such as the following:

Manual Therapy 

Oftentimes, pelvic floor dysfunction can cause significant pain and discomfort. One form of treatment that can provide both pain relief and improved function is manual therapy.

Manual therapy refers to techniques that manipulate and mobilize tissues and other structures (muscles, nerves, joints, ligaments, or tendons). These techniques involve the provider’s hands or other tools.

Some examples include dry needling, cupping, tissue scraping, and more!

Manual therapy techniques can reduce tension, improve blood flow and range of motion, and encourage better function overall!

Pelvic Floor Training

In order to reduce symptoms of pelvic floor dysfunction, you’ll need to have control over your pelvic floor. It will be hard to reduce tension or regain strength in these muscles if you cannot control them!

Therefore, your physical therapist will lead you through treatments that will help you better understand and feel the contraction and relaxation of these important muscles.

This can include treatments like neuromuscular re-education and biofeedback, which can help you better see or understand these movements in real time!

Dilator Therapy

Another important form of pelvic floor training that can be helpful for many people is dilator training. Dilators are insertable tools of varying lengths, widths, and materials.

They allow you to gently stretch tissues of the vagina or rectum. Dilator therapy lets you practice at your own pace, and can help desensitize the feeling of touch and penetration.

This type of therapy is extremely beneficial for a variety of conditions, such as:

• Vaginismus
• Dyspareunia (painful sex)
• Perimenopause and menopause
• Overactive nervous system
• Constipation
• And more!

Exercise Prescription

Strengthening and stretching your body will be very important for immediate and long-term pelvic health. When the pelvis or other connected parts of the body are imbalanced, misaligned, or inflexible, it can contribute to straining, injury, and pain.

To address this, your pelvic floor physical therapist will lead you through exercises and relaxation strategies for your pelvic floor, as well as a routine for the rest of your body as needed!

Balancing your muscles can help restore proper coordination and function of the pelvic floor, hips, lower back, and abdominals.

Behavioral Modifications

As mentioned before, there are many daily habits, postures, and behaviors that can harm the pelvic floor. Your physical therapist can help address these with a variety of treatments and education.

They’ll correct misalignment, alter your sitting, standing, or toilet posture, teach you how to lift or do other movements more efficiently, and provide other suggestions to lessen strain or pressure from your pelvis.

This comprehensive treatment approach requires consistency and effort on your part—so be sure to do your homework!

Education and Resources

Lastly, your physical therapist can provide a wealth of information to support your pelvic health journey!

Not only can they provide education about your pelvic floor and condition, but they can also support your unique needs in a variety of ways. This can include things like:

• Teaching you how to effectively and safely practice dilator therapy at home.
• Advising how to use pelvic wands during self-massage to relieve pain or target trigger points.
• Providing support or education on the use of pessaries (tools used for those with prolapse).
• Providing advice and suggesting resources for sexual appreciation, such as books, tools, sexual aids, lubricants, and more.

The examples we listed throughout this section are some common treatments used to address pelvic floor dysfunction at Hive.

However, our providers value comprehensive and individualized treatment—meaning your care plan could look different than the methods described above. In fact, your treatment plan could include any of the following:

• Neuromuscular re-education 
• Manual therapy
• Exercise prescription 
• Dry needling 
• Cupping 
• Tissue scraping 
• Behavioral modifications 
• Therapeutic activities 
• Electrical muscle stimulation
• Spinal manipulation 
• Therapeutic modalities 
• Biofeedback