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The pelvic floor is a network of muscles, ligaments and tissues cradled within the pelvis that serves as the body’s structural foundation in both men and women. As an integral part of the core muscles, with its function to support the pelvic organs, it works together with multiple complex systems of the body including the nervous system to help regulate bowel, bladder and sexual function, as well as to stabilize and support the spine and pelvis. Weakness or dysfunction in the pelvic floor can lead to poor posture, pain and increased risk of injury during physical activities. These issues are particularly common in women during pregnancy and after childbirth, which is why it is important to address pelvic floor health pre, during and postpartum to prevent complications and support recovery.

Symptoms of poor pelvic health include incontinence, poor pressure management often contributing to symptoms of prolapse, painful intercourse, groin pain or mobility issues and may indicate pelvic floor dysfunction that requires assessment by a medical professional.

Incontinence refers to the involuntary loss of control over bladder or bowel functions.

The three primary forms of incontinence include stress incontinence, urgency and mixed incontinence.  Stress incontinence involves unintentional leakage caused from movements such as sneezing, coughing or jumping. Urgency is a sudden and intense need to relieve oneself that is difficult to postpone or control and often results in leakage. Lastly, both types of incontinence can occur and are referred to as mixed incontinence. 

Pelvic organ prolapse is another condition that is often seen after giving birth or may occur years later because of a decrease in pressure management. It refers to having the downward movement of pelvic organs from their normal position. This descent creates the sensation of pressure or bulging in the pelvic area. 

Pelvic floor muscles are also linked to the sexual health of both men and women.  Pain with intercourse is also called dyspareunia or vaginismus. The pelvic floor plays a role in arousal, orgasm and impaired sensation.  These are often linked to erectile function in men and can negatively impact sexual pleasure and make the act difficult to perform.

Exercises that target supportive musculature along with either uptraining or downtraining of the pelvic floor should be done in conjunction with other forms of physical activity such as stretching, yoga, Pilates and weight training.  Attention to breathing, posture, body mechanics, ergonomic seating and supportive footwear further aids in promoting a more balanced musculoskeletal and nervous system, and thus helps pelvic floor activity.  Nutrition and behavior modifications to promote a healthier pelvic environment are also necessary for pelvic floor function.

Taking a proactive approach to pelvic floor health is essential for long-term well-being. By prioritizing and improving your pelvic health early on, you are building the strength and foundation needed to ensure a higher quality of life as you age.

Joy Bylsma, MPT is a pelvic health physical therapist at Vanderbilt Tullahoma-Harton Hospital. She has extensive experience creating treatment plans for pelvic floor conditions.