Six Common Myths About the Pelvic Floor

Have you ever received advice about your pelvic floor from a friend, family member, coworker, or even a stranger? Everyone seems to have an opinion about this sometimes mysterious and often misunderstood part of our bodies.

With so much information available on the internet and social media, it can be difficult to know what is actually true.

Let's bust some of the most common pelvic floor myths—and talk about what you should know instead.

1. Myth: If you're having pelvic floor problems, kegels are the answer. 

Maybe not.

Kegels—or pelvic floor muscle contractions—can be helpful for some people, but they aren't the right solution for everyone.

Pelvic floor muscles need to be able to contract, relax, lengthen, and coordinate with the rest of your body. For some people, the pelvic floor is weak and needs strengthening. For others, the muscles are already overactive or unable to relax, and doing more Kegels may actually make symptoms worse.

This is why pelvic floor physical therapy should be individualized. During an evaluation, I look at your symptoms, movement patterns, breathing, strength, coordination, and the function of your pelvic floor to determine what approach makes sense for you.

2. Myth: Pelvic floor physical therapy is only for post-partum women. 

Wrong!

Everyone has a pelvic floor, and pelvic floor physical therapy can help people across the lifespan.

Pregnancy and postpartum recovery are an important part of pelvic health care, but they are certainly not the only reasons someone may benefit from pelvic floor physical therapy.

Common pelvic floor concerns in men include:

• Urinary frequency or urgency

• Urinary or fecal leakage

• Constipation

• Pelvic pain

• Pain with sex or ejaculation

• Recovery following prostate surgery

• Erectile or sexual dysfunction

• Low back, hip, or abdominal symptoms related to pelvic floor dysfunction

Common pelvic floor concerns in women outside of pregnancy include:

• Pelvic pain

• Pain with sex

• Urinary urgency, frequency, or leakage

• Fecal leakage or bowel dysfunction

• Constipation

• Pelvic organ prolapse

• Symptoms following abdominal or pelvic surgery

• Difficulty returning to exercise or running

Pelvic floor physical therapy isn't just about treating a diagnosis—it's about understanding how your pelvic floor is functioning and how it relates to the rest of your body.

3. Myth: It is normal to have leakage after having a baby. 

It's common, but that doesn't mean you have to live with it.

Urinary leakage is very common during pregnancy and after childbirth, but "common" and "normal" aren't necessarily the same thing.

Pregnancy, childbirth, changes in abdominal pressure, pelvic floor muscle injury or weakness, changes in coordination, and other factors can all contribute to postpartum urinary leakage.

The good news is that postpartum pelvic floor symptoms can often be improved with the right evaluation and treatment.

If you're leaking when you run, jump, cough, sneeze, lift your child, or exercise, you don't have to simply accept it as part of being a mom

4. Myth: If I have a C section, I'll avoid all problems with my pelvic floor!

Not necessarily.

A cesarean birth can change the recovery process, but it doesn't eliminate the possibility of pelvic floor symptoms.

Pregnancy itself places significant demands on the pelvic floor, abdominal wall, hips, and spine. Changes in hormones, body weight, posture, breathing mechanics, abdominal pressure, and pelvic floor function can occur throughout pregnancy regardless of how you ultimately deliver your baby.

A C-section is also abdominal surgery, which means recovery involves healing of the abdominal tissues and scar.

Whether you've had a vaginal birth, C-section, or both, your postpartum recovery should be individualized to your body, your symptoms, and your goals.

5. Myth: If sex is painful, just have a glass of wine and try to relax.

Absolutely not.

Pain with sex—also called dyspareunia—is common, but it is not something you should simply have to tolerate.

Pain can have many contributing factors, including:

• Pelvic floor muscle tension or difficulty relaxing

• Vaginismus

• Changes following childbirth

• Scar tissue or pelvic surgery

• Hormonal changes

• Pelvic pain conditions

• Nerve sensitivity

• Musculoskeletal dysfunction

• Stress and nervous system sensitivity

Trying to push through pain doesn't address the underlying cause and can sometimes reinforce the cycle of pain and muscle tension.

A pelvic health physical therapist can help identify the physical contributors to painful sex and work with you on an individualized plan. Depending on the cause, care may also involve collaboration with your physician, midwife, gynecologist, or another healthcare provider.

6. Myth: The pelvic floor is a very specific part of the body and doesn’t involve any other body parts 

Definitely a myth.

Your pelvic floor doesn't function in isolation.

The pelvic floor is part of your core and works together with your diaphragm, abdominal muscles, back and hip muscles to manage pressure, provide support, and coordinate movement.

Your pelvic floor is also closely connected to your nervous system. Your brain plays an important role in bladder and bowel function, muscle coordination, pain, and how your body responds to stress.

That's why pelvic floor physical therapy isn't simply about doing pelvic floor exercises.

Sometimes the most important part of improving a pelvic health problem involves looking at your breathing, hips, spine, strength, mobility, movement patterns, daily habits, or nervous system regulation.

 The Bottom Line

Your pelvic floor is part of your whole body—and pelvic floor problems are rarely as simple as "just do more Kegels."

If you're experiencing pelvic pain, urinary or bowel symptoms, painful sex, postpartum changes, or difficulty getting back to the activities you love, you don't have to figure it out on your own.

At Anewu Physical Therapy, I provide individualized pelvic health physical therapy designed around your symptoms, your body, and your goals.

If you're curious whether pelvic floor physical therapy could help you, you can schedule an evaluation or schedule a free discovery call to talk with me about your concerns.

Reviewed and edited by Dr. Amanda Gotschall, PT, D