5 Signs Your Pelvic Floor Might Not Be Working Optimally

When it comes to pelvic floor symptoms, there are a lot of things that are common,  but that doesn't mean they're normal.

Here are five signs your pelvic floor might not be functioning optimally and could benefit from some focused physical therapy. Some of these signs can be subtle, while others are much louder. Either way, most pelvic floor issues can be addressed with some simple and targeted PT work.

Quick Refresher: What Is the Pelvic Floor?

Your pelvic floor is a group of muscles that lives at the base of your pelvis. Its main jobs are to support your organs, regulate bowel and bladder output, and help with sexual function.

These muscles act like a hammock, providing just the right amount of length, tension, and strength to keep everything working smoothly. When that balance is disrupted (too tight, too weak, or just uncoordinated), your body will usually let you know through one or more of the symptoms below.

Sign #1: Leaking When You Laugh, Cough, or Exercise

Leaking when you sneeze, strain, or jump during a workout is a big clue that your pelvic floor isn't functioning as it should.

This can happen for a few reasons, the muscles might be too tight, too weak, or just not coordinating well with your breath and pressure system. One of the biggest misconceptions is that leaking always means weakness. That's rarely true. In fact, tightness and poor coordination are often the real culprits.

So while Kegels might seem like the answer, they're not always the right move and in some cases, they can actually make things worse.

With a simple pelvic floor physical therapy evaluation, we can pinpoint what's going on and build a plan to retrain those muscles through breathing mechanics, pressure management, strength work, and relaxation strategies.

If you're dealing with urinary leakage, we've got you covered.

Sign #2: Constipation or Difficulty Emptying Your Bowels

Did you know constipation isn't just about what you eat? Yes- that can definitely play a role, but your pelvic floor muscles play a huge role in bowel health.

If the muscles at the back of your pelvic floor (the posterior group) are too tight or can't relax when they're supposed to, you might struggle to fully empty your bowels. Poor breathing mechanics or decreased mobility through your abdominal wall can also slow digestion and contribute to constipation.

Good news! This is usually something we can address quickly in PT. We'll look at how your body moves, how you breathe, and how your pelvic floor responds during those movements.

You don't have to live with bowel dysfunction. Small adjustments can make a big difference.

Sign #3: Pelvic or Low Back Pain That Doesn't Go Away

Pelvic floor dysfunction is one of the most overlooked contributors to chronic back or pelvic pain.

Your pelvic floor connects directly to your sacrum and spine, helping to stabilize and support your entire core. When those muscles aren't firing correctly — whether from weakness, tension, or asymmetry — it can throw off how your pelvis and spine move.

If you've tried all the usual "back stuff" and the pain keeps coming back, it might be time to take a closer look at your pelvic floor.

A detailed assessment can help uncover whether those deep stabilizers are part of your pain pattern and how to fix it.

Sign #4: Pain or Discomfort with Sex

Sex should not be painful. Period.

If it is — whether that's pain with insertion, penetration, or specific positions — it's a sign something's not functioning properly. Pain with sex can be caused by tight or overactive pelvic floor muscles, decreased lubrication, or even a protective nervous system response.

All of these can be treated through pelvic floor PT. We work on helping your muscles relax, improving blood flow and mobility, and calming the nervous system's sensitivity in that area.

We recognize that this can be an intimidating, nuanced, and sensitive topic and that's okay. We're here to support you through it with compassion and expertise.

Sign #5: Pressure, Heaviness, or a "Falling Out" Sensation

Feeling heaviness or pressure in your pelvis or the sensation that something is "falling out" can be a sign of pelvic organ prolapse or general pelvic floor weakness.

This is especially common postpartum and during perimenopause or menopause, when hormonal and tissue changes impact support and stability.

The good news: prolapse and pelvic heaviness are very treatable. With guided strength training, pressure management, and coordination exercises, many people see big improvements.

And just because you've been told you have prolapse doesn't mean you're doomed to live with discomfort. There are so many tools to help address your symptoms. 

It's me. Now what?

If any of these signs sound familiar, it's your body's way of asking for help. 

At Pinyon Physical Therapy, our pelvic health specialists help people across Salt Lake City reconnect with their bodies and restore pelvic floor function. Pelvic health PT is private, individualized, and designed to help you feel like you again.

Pelvic floor dysfunction can be treated at any age or stage of life — and it's never too late to start.

✨ Ready to take the first step?

Book a pelvic floor physical therapy evaluation at Pinyon PT, or schedule a free 15-minute phone consult to chat about your symptoms and see if pelvic floor PT is right for you.