“How do I know if my pelvic floor is weak or tight?”

Life is all about balance, and that includes your pelvic floor. Pelvic floor dysfunction (PFD) typically arises from a muscle imbalance - whether they are too shortened and overactive, or too lengthened and underactive. So, that means your pelvic floor can be tight, weak, or a combination of both. Regardless of the scenario, PFD leads to symptoms that often interfere with our day-to-day life. The lists of symptoms below can help you identify which type aligns with your pelvic floor. When you find the right match, a pelvic floor therapist can help you take that next step to get you back on track.

Signs of a tight pelvic floor:

Urine leakage

Urgency, always feeling you have to run to the bathroom

Hesitation on the toilet, difficulty starting or stopping urine flow

Painful urination

Doing the “power pee” push

Urine stream is weak or sprayed out

Dribbing after you pee, like you have to go again right away

Repeated or chronic history of urinary tract infections (UTI)

Chronic abdominal clenching

… & Pain!

Where?

Vagina

Tailbone

Pelvic

Hips

Low back

Groin

Buttocks

Inner thighs

When?

In sitting

With exercise

While performing kegels

While going #1 or #2

Insertion or penetration (i.e. tampons, during a pelvic exam, during intercourse)

In this case, kegels are not the answer for you. These muscles are having a hard time relaxing, tend to be tender to touch and typically lack flexibility. This can seem like a catch 22 because the muscle restrictions and limited movement from a tight pelvic floor can actually cause muscle weakness at the same time. Other factors that can directly contribute to a tense pelvic floor can be more psychological, including stress and anxiety. The bigger the stressors, the worse your symptoms can feel. Focusing on stretching, mobility and relaxation of your pelvic floor muscles will lead you in the right direction.

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Signs of a weak pelvic floor:

Leakage when laughing, coughing, sneezing, or with exercise (even just a little)

Not reaching the toilet in time

Feeling the need to pee constantly

Feeling a bulge, downward pressure, or as if something is slipping down from the vagina

Decreased sensation in the vaginal area, at rest or during sex

Reduced or inability to orgasm

Difficulty feeling your pelvic floor activate

Chronic clenching of the buttocks, inner thigh, or abdomen when trying to contract your pelvic floor

Tampon feels like it’s slipping down

Difficulty controlling gas

You have to use some sort of protection (i.e. pads, liners, tampons)

Stool smearing or leakage (even just a little)

Underactive pelvic floor muscles are the classic case for pelvic floor weakness. These muscles are typically non-supportive and weak, which is more susceptible to leakage of urine, gas, stool and is a risk factor for developing pelvic organ prolapse. Many may have tried kegels in the past, but without proper instruction from a trained professional, it is difficult to distinguish whether this technique was done correctly. Other factors that can contribute to pelvic floor weakness include hormone changes (i.e. pregnancy, menopause), chronic high pressure on your pelvic floor (i.e. constipation, respiratory issues), and your overall fluid intake. In this case, focusing on strengthening and coordination with breathing are key factors to success.

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So, what are your pelvic floor symptoms telling you? Get started with a full evaluation from a pelvic floor therapist who can best understand your symptoms and steer you in the right direction.

It all begins with an idea.

It all begins with an idea.