Pelvic floor physical therapy has started to gain a lot of attention in recent years and I LOVE IT. Weekly, I see clients who are seeking out pelvic PT for themselves and that is awesome. What I have noticed is that in the clinic or in the gym, many people still are unsure of what pelvic PT is! So, I’m going to discuss the “weak vs tight” pelvic floor and how that may present itself for you. 

Note: This is only one part of pelvic PT and is not the EXCLUSIVE thing that we treat. I find this topic to be a helpful one for many who are just unsure of what pelvic PT is outside of leaking urine, being pregnant or postpartum or just being told to see a pelvic PT. We have a plethora of other blogs on our site that go over multiple other benefits of pelvic PT so I encourage you to check those out HERE

As you read, keep in mind that the weak/low tone pelvic floor and tight/high tone pelvic floor are not completely distinct from each other and there is often overlap between the two!

 

The Weak or “Low Tone” Pelvic Floor

Common symptoms:

  • Lack of muscle control-weakness or coordination 
  • Leaking urine (or stool) 
  • Heaviness or bulging
  • Pain

Common people to see these symptoms present:

  • Pregnant
  • Postpartum
  • Pre/postmenopausal 

What can I do about it: 

  • Strength training-pure strength OR working on times to activate and fire these muscles
  • Endurance training 
  • In PT, we will work to get you firing these muscles to either get stronger or time the muscle contraction correctly! 
  • 2 ways you can try at home: 
    • The “knack”: do a preparatory kegel before activities that would normally cause lifting (ex-a sneeze, lifting something heavy)
    • Let the pelvic floor move through its full range of motion-contract it, let it go to its resting baseline, bear down

The Tight or “High Tone” Pelvic Floor 

Common symptoms: 

  • Low back pain
  • Hip pain 
  • Painful intercourse
  • Constipation
  • Difficulty/incomplete emptying
  • Leaking urine (or stool) – this is a common symptom of both a weak OR tight pelvic floor 
  • Urgency (having to go frequently) 

Common people to see these symptoms present: 

  • Type A personality 
  • High levels of stress/anxiety
  • History of trauma, especially sexual trauma 
  • Pregnant
  • Postpartum 
  • Menopause

What can I do about it: 

  • Exercise to work on relaxation and letting go of the pelvic floor or stretching the pelvic floor 
  • Strength in other areas as these often contribute to tightness, such as hips, abs and back musculature 
  • 2 exercises to try at home 
  • Happy baby (watch it here): think about breathing down into the pelvic floor
  • Deep squat (watch it here): hold on for support and just hang out at the bottom of the squat, think about breathing down into the pelvic floor 

 

As always, if you find yourself working through any of these symptoms, we would highly recommend a pelvic PT evaluation! Schedule HERE or at the link at the bottom of this page!