What’s Normal and What’s Not When It Comes To My Pelvic Floor?

Everybody and every body is different, so it can be hard to know what is normal and what’s not. When it comes to pelvic floor health, there is a wide range of what’s considered “normal,” but what matters most is knowing your own normal so you can recognize when something feels off.

Your pelvic floor is a group of muscles, ligaments, and connective tissues that form a supportive hammock at the base of your pelvis. These muscles attach from your pubic bone to your tailbone and between your sit bones (also known as the ischial tuberosities). Together, these structures help you with numerous daily functions, from going to the bathroom to supporting your organs and even enhancing sexual satisfaction. 

The tricky thing about the pelvic floor is that it rarely gets attention until something feels off. Leaking urine, pelvic heaviness, pain with sex, or discomfort after childbirth are often what bring this part of the body into focus. Most of the time, though, it’s quietly at work coordinating with your breath, supporting your core, and keeping your bladder and bowels running smoothly. Like any other system in the body, sometimes it just needs a little extra support.  

In this article, we’ll walk you through what’s normal – and what’s not – when it comes to your pelvic floor, so you can better understand your own body, recognize when something deserves attention, and know how a pelvic floor specialist can help.  

What is the function of the pelvic floor?

There are several ways your pelvic floor plays a role in daily life, but here are its five key functions that are essential to your overall health and wellbeing:

1. Support. The pelvic floor muscles cradle and support the bladder, uterus, rectum, and other organs in the pelvis. Without this support system, you might experience issues like prolapse (a sensation of heaviness or pressure when pelvic organs drop down).
2. Stability. The pelvic floor works together with your diaphragm, abdominals, and deep back muscles to stabilize your low back, hips, and pelvis. Think of it as part of the “core” complex. Anytime you lift, twist, or even just stand upright, this muscular teamwork is at play.
3. Sexual function. For comfortable intercourse and a strong, pleasurable orgasm, the pelvic floor needs to be able to both contract and relax. Weakness and tension can cause pain or affect arousal and orgasm. Weakness alone can reduce satisfaction that comes from contact with a partner or toy during penetration and may impair arousal or orgasm intensity.
4. Staying leak free. A strong, flexible and coordinated pelvic floor can protect you against urine leaks or stool leakage (also known as urinary or fecal incontinence), or unwanted passing of gas. Contrary to popular belief, leaking when you cough, sneeze, or laugh may be common, but it is not normal. That said, it’s highly treatable.
5. Circulation. These muscles also work like a little pump, moving blood and lymph fluid through the pelvis. This circulation supports tissue healing, reduces swelling and bloating, and helps prevent that heavy, bloated feeling some people notice during their cycle or after long days on their feet. 

What is pelvic floor dysfunction? 

Pelvic floor dysfunction happens when these muscles and tissues don’t work the way they should. Both overactivity (tightness, tension that won’t release) and underactivity (weakness or lack of coordination) can lead to problems. Here are some of the more common concerns:

• Urinary incontinence: Leaking with exercise, sneezing, sex or urgency.
• Pelvic organ prolapse: A feeling of pressure, bulging, or heaviness in the vagina or rectum. This can be due to the descent of pelvic organs such as the bladder, uterus or rectum. Patients often notice bulging that they can touch or see, like something is “falling out” from inside.
• Pelvic pain: This can include pain with sex, menses, tampon use, pain associated with bowel or bladder function, or even sitting for long periods.
• Constipation or difficulty emptying the bowels. This may include a combination of symptoms like fewer than 3 bowel movements a week, straining, hard stools, blockage, or a feeling of incomplete emptying.
• Post-surgical changes: For example, after prostate surgery in men, gender affirming surgeries or gynecologic surgery in women.
• Life phase changes: Pregnancy, postpartum recovery, or hormonal changes that occur during peri-menopause and menopause can all put additional stress on the pelvic floor.

It’s important to remember these issues can happen at any age, regardless of sex or gender. But they’re not something you have to live with forever. Think of them as signals from your body that your pelvic floor health deserves attention. That’s where the team at Origin can support you. 

How can pelvic floor therapy help?

Pelvic floor physical therapy (PFPT) is a specialized branch of physical therapy focused on helping these muscles function the way they’re meant to. A trained pelvic health therapist can assess whether your muscles are too tight, too weak, or poorly coordinated, and then guide you through exercises, breathwork, manual techniques, and education to restore balance. 

It’s important to mention that our physical therapists are specialized in this area, and also very cognizant of the fact that treating the pelvic floor area is not just a physical practice. There can be many emotions, sensitivities and even traumas that come with the physical part of healing, which is why we’re always happy to listen, support you or guide you towards additional support if it’s needed. 

They also treat musculoskeletal conditions that may not seem related to pelvic floor function. For example, many new mothers may experience aches and pains while caring for a new baby. Pelvic floor therapists address more than the pelvic area, including conditions that affect the breasts like mastitis, conditions that affect the wrist and hand like carpal tunnel syndrome, or neck, shoulder or low back pain. Whatever is bothering you, here is what PFPT can do for you:

• Teach you how to properly relax and lengthen your pelvic floor if tension is the issue.
• Build strength if your muscles aren’t providing enough support.
• Teach you better postural habits and desk ergonomics for nursing or working at your computer.
• Re-educate your brain-muscle coordination, so your muscles contract and relax at the right times.
• Help you return to running or exercising the way you’d like postpartum.
• Teach you breathing techniques to support your body and functional goals. 
• Help you build strategies for bladder and bowel health that go far beyond just “do your Kegels.”
• Improve sexual comfort by addressing muscular tension and coordination as well as providing recommendations for optimal sexual positions and lubricants.
• Support you through pregnancy, birth recovery, or menopause with tailored strategies.

As Dr. Megan Stancill from our Coral Gables, Florida clinic explains:

“Pelvic floor therapy doesn't have to last forever. We don't want you to be dependent on your PT to feel good, we'd rather empower you to treat yourself if your symptoms recur so you don't need to keep coming.”

That empowerment piece is key. The goal isn’t to keep you in therapy indefinitely; the goal is to teach you how to understand your own body and give you tools that will serve you for a lifetime.

What if you’re not sure you need pelvic floor therapy?

We get it. All this sounds great, but sometimes it can be hard to know when what you’re experiencing is “normal” or if it signals something worth addressing. That’s where a pelvic health coaching call may help. These are one-time, accessible sessions where you can ask questions in a judgment-free space, get clarity on whether you would benefit from virtual or in-person physical therapy, and learn general strategies to better support your pelvic health on your own.

Talking to a pelvic health coach about your pelvic floor can help you stay proactive rather than waiting for symptoms to pop up.

When to visit Origin Physical Therapy

If you’re wondering whether what you’re experiencing is “normal,” here are some signs that it’s worth checking in with a pelvic floor physical therapist:

• You leak urine when you sneeze, cough, laugh, squat or exercise
• You feel pressure or heaviness in your pelvis
• You have recurring pain with sex or difficulty inserting tampons or menstrual cups
• You’ve gone through pregnancy, childbirth, menopause, or pelvic surgery and notice changes you want to better understand
• You feel like your core isn’t strong or stable despite doing workouts or exercises

You deserve to feel informed, strong, and confident in your body. There are no silly questions at Origin. We’re here to support you. Schedule an appointment for an in-person or virtual visit with one of our caring and supportive specialized physical therapists. Just because something is common doesn’t make it normal, and it certainly doesn’t mean you have to deal with it on your own.