5 Signs It's Time to Support Your Pelvic Floor

The pelvic floor is one of the most powerful—and misunderstood—parts of the body. It supports your bladder, bowel, and reproductive organs. It’s deeply connected to your core strength, stability, and sexual health. And yet… it’s often dismissed, overlooked, or completely ignored until something goes “wrong.”

As a pelvic floor physical therapist (and a mom myself), I want to share five common signs that your pelvic floor might need a little support. These are symptoms I see every week in my practice—things many women have been told are normal, but that actually signal an opportunity to heal.

1. Leaking Urine When You Cough, Sneeze, Run, or Lift

   This is one of the most common symptoms women experience—and one of the most casually dismissed. Whether it’s a few drops or a full loss of control, leaking urine with impact or pressure (like sneezing or jumping) is a sign your pelvic floor muscles may not be activating or coordinating properly. It’s incredibly common postpartum, but it’s not something you just have to live with. Pelvic floor PT helps retrain the timing, strength, and reflexes of the muscles involved in bladder control.

2. Pain With Intercourse or Internal Exams

   Pain during sex or pelvic exams is your body’s way of saying, “Hey, something’s not right here.” Often, this discomfort is caused by muscles in the pelvic floor that are too tight, guarded, or unable to relax. Instead of softening with penetration, the muscles resist—and that can lead to burning, aching, or even sharp pain. Pelvic floor therapy gently restores mobility, helps the muscles release, and reconnects you with your body in a way that supports both healing and comfort.

3. A Feeling of Heaviness or Pressure in the Vagina

   Many women describe this as a sensation that something is “falling out” or “dragging down there,” especially after a long day or a workout. This can be a sign of pelvic organ prolapse—when one or more of the pelvic organs shifts downward due to decreased support. While this sounds scary, prolapse is often manageable with the right guidance. A trained pelvic floor PT can teach you how to move, lift, and breathe in ways that support your pelvic floor and reduce strain.

4. Urinary Urgency or Frequency

   If you feel like you always have to pee—or you can’t make it to the bathroom in time—you may be dealing with overactivity or poor coordination in the pelvic floor muscles. This can be frustrating and isolating, especially if you’ve been told to “just do Kegels” or avoid drinking water. In pelvic floor PT, we focus on restoring balance and retraining your brain-body-bladder connection so you can feel more in control.

5. Lower Back, Hip, or Tailbone Pain

   Your pelvic floor is deeply connected to your posture, movement, and spinal stability. When these muscles are weak, tense, or out of sync, pain often shows up in places like the low back, hips, or even the tailbone. This is especially common postpartum or after a fall, long-term sitting, or compensatory movement patterns. Pelvic floor PT looks at the whole body to address not just the symptom, but the root cause.

If any of these symptoms sound familiar, please know this: you’re not broken. You’re not alone. And you don’t have to just “wait it out.”

Pelvic floor dysfunction is common—but it’s also highly treatable. The first step is simply knowing that support exists. If you’re curious whether pelvic floor physical therapy could help you, I’m always here to talk.

You deserve to feel strong, supported, and at home in your body again.