Pelvic floor therapy isn’t for everyone. But if you pee when you sneeze or awkwardly run to the bathroom after a laughing fit, this is a telltale sign that your pelvic floor needs a little lovin’. Recurring urinary tract infections or battling with interstitial cystitis can also point to your pelvic floor.

A basket that holds your fruit

The pelvic floor is a diaphragm of sorts – a flat floor of muscles that extends from the base of your tailbone to your pubic bone. Like other muscles in the body, it can contract and relax. Also like other muscles in the body – chronically tight, overly-contracted muscles or weak and slack muscles will invariably lead to problems.

If it helps, think of your pelvic floor as a basket holding all your abdominal organs. Nearest and dearest to the pelvic floor are things like your uterus, bladder, and colon.

You want your basket to stay taut and supple as you move through your day. But with all the sitting, lounging, and heel-wearing we do – it’s tough to keep the pelvic floor happy. Here are 5 warning signs to watch out for if you think you might need pelvic floor therapy.

#1 – You pee when you sneeze. Or cough. Or laugh. Or run.

Pee should stay in the bladder until it’s intentionally released. Any accidental “leakage” – whether a dribble or a flood – is a sign that your pelvic floor isn’t as taut and supple as you’d like it to be.

Before you add a 100 Kegels a day to your pelvic floor therapy, bear in mind that tightening the pelvic floor pulls the base of the tailbone to the pubic bone. This is exactly the same position you see when pelvic floor muscles are lax. Kegels won’t stop the pee and they can make incontinence worse.

For more insight on pelvic floor therapy and urinary incontinence, pick up a copy of The Bathroom Key.

#2 – It hurts to pee or you’ve been diagnosed with IC

Sit much? Yeah, me too. Sitting in your car, at the dinner table, at your desk, on the couch – it’s what people do. People also wear heels and carry a lot of mental stress.

The result is tight muscles. And chronically tight muscles means lumpy, wadded-up connective tissue (the stuff that connects muscles and organs).

The problem with lumpy, wadded-up connective tissue is that it ends up pulling on the structures around it. This can mean pain in the bladder or the diagnosis of interstitial cystitis (IC).

Take sitting, for example. When you sit – your hamstrings, the muscles that run from your butt to your knees – are slack like a loose rubber band. Sitting often, as we do, shortens and tightens your hamstrings. These muscles pull on your pelvis and the pelvic floor, causing it to “tuck.” Tuck your birthin’ hips for too long – like, all the time – and you’re going to need pelvic floor therapy as the muscles of the pelvic floor shorten and become tight.

Other areas that may feel weak, tight, and lumpy – ultimately affecting your pelvic floor and its ability to hold up your bladder:

• The side of the legs
• The butt
• The lower back
• The groin

You can release this lumpy, tight tissue with a little DIY pelvic floor therapy: try rolling on Yoga Tune Up balls and some calf stretches.

#3 – It hurts to have sex

A tight pelvic floor, lumpy connective tissue, or scar tissue can make sex painful.

During pelvic floor therapy, internal work – assessing tightness of the pelvic floor and learning how to relax it – can help. Sort of like a pap smear, an internal exam involves a therapist going into the vaginal cavity. Unlike a pap smear, there’s no speculum – only the pressure of one finger along with some coaching to feel and relax the pelvic floor.

Gentle pressure on the muscle will tell it to let go. Along with breathing exercises, you begin to feel where you’re holding tension and how to release it.

#4 – Urinary tract infections are your norm

There’s a clear link between recurring infections down there and problems with your pelvic floor. These problems are obvious things, like incontinence or falling organs.

While an imbalance of good and not-so-good bacteria is an issue, recurring infection also has to do with pressure placed on the valve between the bladder and the ureter – the tube connecting your kidneys to your bladder.

It’s like reflux…of the ureter. This is when bacteria from the bladder can move up into the more sterile ureter and kidneys. So, while remedies for UTI are important – it’s just as important to address falling organs while taking the pressure off of the valve connecting your bladder to your ureter. This is where pelvic floor therapy shines.

#5 – You’re pregnant and you hurt

Sore feet, sore knees, sore hips, a sore back. All of this can point to your pelvic floor. Remember that tight, underused muscles affect your alignment and your pelvic floor.

During pregnancy, it’s normal to feel more pain than usual – but it’s not ideal. With a taut and supple pelvic floor in mind, you want to do all you can to create space and support the extra load you’re carrying in front. Pelvic floor therapy can help you make healthy adjustments as your belly grows and your gait changes – like keeping your weight in your heels or pulling in your lower ribs while untucking your pelvis.

Get on the hunt for pelvic floor therapy

Weirdly, conventional medicine doesn't readily offer pelvic floor therapy. You might have to do a funny dance to be heard and then fight for a referral.

When you do get a referral – or if you find an online program that you love – keep an eye out for the recommendation to do Kegel exercises, which involve contracting and releasing muscles within the pelvic floor. This is a red flag. If you hear this recommendation during pelvic floor therapy, run the other way.

Kegel exercises tighten the pelvic floor and pull the base of the tailbone towards the pubic bone – similar to what happens when you sit down and your pelvis is tucked under you.

During a good pelvic floor therapy session, you will learn how to tone and lengthen the space between the base of the tailbone and the pubic bone.

Ideally, you take away tips that you can practice all the time. Literally every moment you walk, stand, or sit. Pelvic floor therapy is about changing a lifetime of habits. Because the pieces of the body are all connected, you'll often see benefits in other areas that feel stiff or hurt.

 Do you think you need pelvic floor therapy? I would love to hear about your experience below!

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