You won’t notice their existence until they stop functioning properly for you!
What is normal pelvic floor function?
Your pelvic floor muscles act like a hammock or trampoline, sitting underneath your organs, and providing support for your bladder, bowel and uterus. These muscles also help you control your bladder and bowels and experience normal sexual function.
Pelvic Floor dysfunction occurs when these muscles become weak or overactive.
Signs and symptoms?
- Do you wet yourself when you laugh, sneeze, jump or are lifting?
- Do you find it difficult to insert a tampon?
- Do you have difficulty holding in, or releasing wee, wind or poo?
- Do you feel that you are not fully emptying your bladder or bowel when you go to the toilet?
- Is your poo coming out skinny and short?
- Do you experience pain during intimacy?
If you have answered yes to any of the above questions then it is likely that your pelvic floor muscles are not performing as they should! They may be weak or overactive.
Common signs of pelvic floor muscle dysfunction?
- Bladder or bowel leakage
- Difficulty emptying your bladder or bowel
- Urinary or bowel urgency
- Vaginal heaviness, aching or bulging
- Pelvic pain (pain in the lower abdomen, vulva or vagina) or sexual pain
How can we help?
Physiotherapy help for your pelvic floor muscles?
Your physiotherapist can teach you how to activate your pelvic floor muscles to either strengthen them, if weak or relax them if they are overactive.
Cues and tailored exercises can improve your pelvic floor
A treatment plan usually includes:
- Helping you identify the three parts of your pelvic floor muscles – front, middle and back
- How to active your pelvic floor muscles
- An exercise plan to increase pelvic floor muscle strength if they are weak and advice on how to build this into your daily activities
- A relaxation plan to release tension if your pelvic floor muscles are overactive before and during your strengthening regime
Related Blogs
Still leaking when you sneeze, run, jump or laugh years after having children? You might have been told it's "just part of having kids." It may be common, but that doesn't mean you have to live with it. Why does leaking happen after childbirth? Pregnancy and childbirth place significant demands on your pelvic floor. Changes can affect the muscles, connective tissues and the way your pelvic floor works with your breathing and abdominal muscles. You may notice leaking when you: Cough or sneeze Run or jump Exercise Lift something heavy Laugh Suddenly need to empty your bladder But leaking doesn't automatically mean your pelvic floor is simply "weak." Sometimes the issue is strength. Other times it's coordination, timing, muscle tension, bladder habits or how your body manages pressure. "But my kids are years old..." It's never too late to address pelvic floor symptoms. You may have adapted by wearing pads, avoiding running or jumping, crossing your legs when you sneeze, or always finding a toilet before leaving the house. These things can become so normal that you forget they're symptoms. You shouldn't have to organise your life around your bladder. What can help? A pelvic health physiotherapist can assess what's contributing to your leakage and develop a treatment plan based on your symptoms and goals. This may include pelvic floor muscle training, breathing and pressure management, bladder strategies, strengthening and movement retraining. And no — it's not always as simple as "just do more Kegels." The bottom line Having children can explain why your symptoms started. It doesn't mean you have to accept them forever. Whether your youngest is six months old or 16 years old, pelvic floor symptoms are worth assessing. If you're leaking after having children, talk to a pelvic health physiotherapist. You don't have to put up with it.
Ever finish urinating and immediately feel like there's still some left? Maybe you find yourself sitting on the toilet for longer, going back for a second wee, or returning to the bathroom shortly after. That feeling of incomplete bladder emptying is common, but it's not something you should automatically ignore. Why might this happen? There are several reasons you might feel like you haven't completely emptied your bladder. Your pelvic floor may not be relaxing properly Your pelvic floor muscles need to relax to allow urine to flow freely. If they're tense or you're unconsciously holding them while trying to wee, the bladder outlet may not open as effectively. This can make it feel like you need to push, wait or try again. You're rushing or hovering Your bladder generally works best when you can sit comfortably, relax and give yourself time to empty. Hovering over the toilet, rushing, or constantly tightening your abdominal or pelvic muscles can make it harder to fully relax. And straining or pushing your urine out isn't usually the answer. Constipation can play a role Your bowel and bladder sit very close together. A full or constipated bowel can put pressure on the bladder and may affect bladder sensation and emptying. You don't necessarily need to be severely constipated for this to have an impact. If you're also experiencing bloating, infrequent bowel movements, hard stools or difficulty fully emptying your bowels, it's worth considering the bowel–bladder connection. Your bladder may be sending confusing signals Sometimes the sensation of incomplete emptying doesn't necessarily mean your bladder is actually full. Bladder irritation, urgency, infection and changes in pelvic floor sensitivity can all affect the way you perceive bladder filling and emptying. This is why the sensation you experience doesn't always tell us exactly what's happening. Should you keep trying to "get the last bit out"? You might find yourself doing a second wee immediately after the first, just to make sure you've completely emptied. Occasionally this is harmless, but repeatedly going back and trying to squeeze out more urine can reinforce the habit of checking your bladder. Instead, try sitting comfortably, relaxing your belly and pelvic floor, and allowing your bladder time to empty without pushing. If you consistently feel unable to empty, however, it's worth getting assessed rather than simply trying harder. When should you get checked? Speak with your GP or pelvic health physiotherapist if you regularly experience: A persistent feeling of incomplete emptying Difficulty starting your urine stream A weak or interrupted stream Needing to strain to urinate Needing to urinate again immediately after finishing Frequent or urgent urination Recurrent urinary tract infections Pain or burning when urinating Difficulty emptying your bladder If you suddenly cannot urinate at all despite having a strong urge, seek urgent medical attention. What can a pelvic health physiotherapist do? Your physiotherapist can look at your bladder habits, bowel function, pelvic floor muscle coordination and how you're actually using your muscles when you urinate. Sometimes the answer isn't to strengthen the pelvic floor — it may be learning how to relax it properly. Treatment may include bladder strategies, pelvic floor relaxation, breathing techniques, bowel management and changes to toileting habits. The Bottom Line Feeling like you haven't fully emptied your bladder doesn't always mean your bladder is the problem. Your pelvic floor, bowel, toileting habits and bladder sensitivity can all play a role. If you're regularly finishing a wee and thinking, "I still need to go," don't just keep pushing or making endless trips back to the toilet. Understanding why you're getting that sensation is the first step towards finding a solution.
If you've been told that your pelvic pain, bladder symptoms or pelvic floor problems are because your core isn't strong enough, you might have been given a familiar prescription: “Just do more core.” Planks. Crunches. Leg raises. More bracing. But for some people, this advice can actually make symptoms worse. Especially if your pelvic floor is already overactive or struggling to relax. Your pelvic floor is part of your core Your pelvic floor works together with your diaphragm, abdominal muscles and back muscles to help support your body and manage pressure. So yes, core strength matters. But more tension doesn't always equal more support. Your pelvic floor needs to be able to contract when necessary and relax when it's supposed to. When can more core work be a problem? If you're already holding a lot of tension through your abdomen and pelvic floor, constantly bracing your core may increase pressure and muscle activity. This can be particularly relevant if you experience: Pelvic pain Pain during sex Difficulty relaxing your pelvic floor Constipation or difficulty emptying your bowel Urinary urgency or frequency Pain that increases with exercise A feeling of constant pelvic tension In these situations, the goal may not be to make everything stronger. It may be to improve coordination and relaxation. But aren't core exercises good for you? Absolutely. Core exercises can be an important part of rehabilitation and general fitness. The problem is assuming that everyone needs more of them. Someone with poor abdominal strength may benefit from strengthening. Someone who is constantly bracing may need to learn how to let go. And many people need a combination of both. What should you do instead? Rather than asking: “How can I strengthen my core?” The better question is: “How is my core and pelvic floor functioning?” A pelvic health physiotherapist can assess how your breathing, abdominal muscles and pelvic floor work together during movement. Your program might involve strengthening—but it might also include: Breathing exercises Pelvic floor relaxation Movement retraining Mobility work Gradual strengthening Pressure management Exercise modification The right exercise depends on why you're having symptoms. When should you get assessed? If you've been exercising your core regularly but your symptoms aren't improving—or are getting worse—it's worth getting an individual assessment. Particularly if you're experiencing pelvic pain, painful sex, constipation, urinary urgency or persistent pelvic tension. The Bottom Line Your pelvic floor doesn't always need more strength. Sometimes it needs better coordination and the ability to relax. Core training isn't bad. But “just do more core” isn't a complete treatment plan for pelvic floor dysfunction. If your symptoms aren't improving, stop guessing and find out what your muscles actually need. A pelvic health physiotherapist can assess your pelvic floor, breathing and core function and help you exercise in a way that supports your symptoms—not aggravates them.
Putting in a tampon should not feel like you're fighting your own body. Yet for many people, tampon insertion can cause: Pain or burning A feeling of tightness Resistance or a “wall” Difficulty inserting it at all Pain when removing it Discomfort that lingers afterwards And often, the response is, “Just relax.” But if you've tried to relax and it still hurts, there's probably more to the story. Why can tampons hurt? There are many possible reasons. Painful tampon use can be associated with: Pelvic floor muscle tension Vaginal dryness Irritation or infection Skin or vulval conditions Hormonal changes Previous painful experiences Conditions affecting the vulva or vagina Sometimes more than one factor is involved. Could your pelvic floor be too tight? It could be. Your pelvic floor muscles surround the vaginal opening and need to relax to allow comfortable insertion. If these muscles are overactive or you're unconsciously tightening them, inserting a tampon can feel painful, difficult or even impossible. This can happen even if you are otherwise healthy. And importantly, a tight pelvic floor isn't necessarily something you can simply “relax” on command. Pain can create a cycle Imagine inserting a tampon hurts. The next time you try, you naturally expect it to hurt. Your body may respond by tightening the pelvic floor muscles before you've even realised it. Then insertion hurts again. Over time, this can create a cycle: Pain → fear or anticipation → muscle tightening → more pain. Breaking this cycle often requires more than simply trying harder to relax. Does painful tampon use mean something is wrong? Not necessarily, but persistent pain deserves attention. If tampon use has always been painful, has suddenly become painful, or is becoming increasingly difficult, it's worth finding out why. A GP, gynaecologist or pelvic health physiotherapist can help identify potential contributors. How can pelvic floor physiotherapy help? A pelvic floor physiotherapist can assess whether your pelvic floor muscles are contributing to the pain. Depending on your symptoms and comfort level, treatment may include: Education about pelvic floor function Breathing and relaxation strategies Pelvic floor down-training Gentle manual therapy where appropriate Gradual desensitisation Advice around comfortable tampon insertion Strategies to reduce muscle guarding An internal examination is not automatically required. Your physiotherapist should explain your options and work within your comfort and consent. Don't force it If inserting a tampon is painful, don't keep pushing through significant pain. Pain is useful information. And if you're experiencing significant pain, burning, unusual discharge, bleeding or other new symptoms, speak with your GP or gynaecologist to rule out medical causes. Frequently Asked Questions Why does inserting a tampon hurt? Tampon insertion can hurt for many reasons, including pelvic floor muscle tension, vaginal dryness, irritation, infection, hormonal changes or vulval conditions. A healthcare professional can help identify the cause. Can a tight pelvic floor make tampons difficult to insert? Yes. If the pelvic floor muscles around the vaginal opening are overactive or unable to relax, insertion may feel painful, tight or blocked. Can pelvic floor physiotherapy help with painful tampon insertion? Yes. When pelvic floor muscle tension or poor relaxation is contributing to symptoms, pelvic health physiotherapy can help with relaxation, coordination and gradually reducing sensitivity and muscle guarding. The Bottom Line Tampon use shouldn't be something you have to grit your teeth through. If inserting a tampon is consistently painful, difficult or impossible, there may be a reason—and it's worth investigating. You don't need to simply “get used to it,” and you certainly don't need to push through pain. If painful tampon use is affecting your periods, exercise, swimming or everyday life, a pelvic health physiotherapist can help you understand whether your pelvic floor is contributing and work with you towards more comfortable, confident movement.
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