Pelvic floor dysfunction is often associated with common concerns like bladder leaks or postpartum recovery. But here’s the twist: symptoms can be more subtle and unexpected than you might think. These muscles do a lot more than just control your bladder and bowels. They play a crucial role in posture, pressure regulation, core stability, and circulation.
When the pelvic floor isn’t functioning well—whether it’s tense, too weak, or uncoordinated—you can end up with a variety of symptoms that may seem unrelated at first glance. Let’s break down some common symptoms you might not have realized are linked to pelvic floor dysfunction.
1. Unexplained Low Back, Hip, or Tailbone Pain
Persistent low back or hip discomfort can often be traced back to pelvic floor dysfunction. The pelvic floor is part of a group of muscles called the “deep core,” which also includes the diaphragm, deep abdominal muscles (transversus abdominis), and spinal stabilizers (like the multifidus). These muscles work together to stabilize your trunk.
When the pelvic floor isn’t coordinating properly with the rest of the core, your body may compensate with increased tension or strain in the surrounding musculature. This may result in referred pain to the low back, hips, sacroiliac joints, or tailbone (coccyx).
2. Pelvic Heaviness or Pressure
Do you have a sense of pressure, heaviness, or that “something is falling out” down there? It could be a sign of pelvic organ prolapse (POP), a condition commonly associated with pelvic floor dysfunction. This happens when one or more pelvic organs (bladder, uterus, or rectum) begin to descend into the vaginal canal due to insufficient support from the pelvic floor.
Prolapse symptoms may feel worse later in the day, after standing for long periods, or following intense activity. While prolapse is common postpartum, it can affect anyone with a pelvic floor, and depending on the stage of prolapse, it is treatable with conservative options like pessaries and pelvic floor physio.
3. Bladder or Bowel Emptying Issues
Do you find yourself sitting on the toilet, waiting (maybe not so patiently) for the flow to start? Do you have to push to pee or poop? Or are you left feeling like you can never quite fully empty your bladder or bowels? These could be signs of pelvic floor dysfunction, particularly when the muscles are overactive.
When the pelvic floor muscles are hypertonic (too tight), they can prevent complete relaxation, which is necessary for urination and defecation. Straining to go or needing to void frequently can become habitual problems. Tight pelvic floor muscles may also lead to incomplete bowel movements or even functional constipation. Left untreated, this can contribute to other issues such as urinary urgency or bladder infections.
4. Pain with Penetration or Internal Exams
Pain during penetrative activities—whether it’s intercourse, using a tampon, undergoing a Pap test, or during internal exams—is more common than many people realize, and it’s never something you just have to live with. This kind of pain can stem from a variety of physical causes, including pelvic floor dysfunction, muscle tension, trigger points, or scar tissue from surgery (like a C-section or episiotomy).
It’s important to note that not all sex involves penetration, and painful penetration doesn’t define your overall sexual health—but if discomfort is getting in the way of intimacy or routine healthcare, it’s worth exploring support.
Pelvic floor physiotherapists can help reduce pain and tension through hands-on techniques, movement-based therapies, and education. Because pain is also processed in the brain, there can be emotional layers involved too. If your experience includes fear, anxiety, or a sense of disconnection, mental health support—like counselling—can be a key part of your care.
5. Persistent Core Weakness
If your core still feels unstable or weak months (or even years) postpartum, despite doing all the “right” exercises, pelvic floor dysfunction might be the missing link. Core strength isn’t just about crunches—it starts deep with coordination between the pelvic floor, diaphragm, and deep abdominal muscles.
Signs of a poorly functioning deep core might include abdominal doming or coning, a belly that feels disconnected, or difficulty engaging the core during movements like lifting, squatting, or getting out of bed. A pelvic floor assessment can identify gaps in your core activation strategy and help you rebuild strength from the inside out.
6. Jaw Clenching
There’s a strong correlation between jaw tension (TMJ issues) and pelvic floor dysfunction. If you clench or grind your teeth—or if you wear a nightguard—you may also have a tight pelvic floor! These two regions of the body are neurologically linked through fascial and muscular chains (Sulowska-Daszyk et al., 2024).
When we carry tension in the jaw, that often reflects deeper patterns of stress that can also show up as pelvic floor overactivity. Both areas respond to similar stress cues, and addressing one can often help improve the other.
7. Stress and Anxiety
Stress doesn’t just affect your mind—it shows up in your body, too. High levels of anxiety often go hand-in-hand with pelvic floor dysfunction, particularly when the pelvic floor muscles are chronically tense (Physiopedia, 2020). If you live in a state of constant “fight or flight,” your muscles may never fully relax, especially those deep stabilizers, including the pelvic floor.
Over time, this ongoing tension can also increase your chances of developing musculoskeletal issues, particularly in the neck and lower back. Persistent stress can lead to tight, painful muscles and contribute to symptoms like urgency, pain, and fatigue. Learning how to regulate your nervous system is a key part of managing pelvic floor dysfunction.
8. Constipation
Your digestive system and pelvic floor work together more than you might realize. If your pelvic floor muscles aren’t coordinating with your abdominal muscles, intestinal motility can slow down (Beth Israel Deaconess Medical Center, 2015). This can result in bloating, straining, or chronic constipation.
If you’ve addressed diet and hydration but still have GI issues, it may be time to consider whether pelvic floor dysfunction is playing a role. Improving muscle coordination and relaxation strategies can support smoother, more regular digestion.
Getting Help: You Don’t Have to Guess
Pelvic floor dysfunction can affect anyone—regardless of age, gender, or birthing history. If you recognize yourself in any of these symptoms, it’s worth getting assessed. A pelvic health physiotherapist can help uncover the root cause of your symptoms and guide you through a personalized, evidence-based plan to support healing.
Early intervention can prevent symptoms from worsening and improve your overall function and quality of life. Don’t wait to feel like yourself again—you deserve care that addresses the whole picture.
Please follow us along on our socials @bumpphysio.co keep updated on all that is going on and for more information about how the Bump Community can help YOU!
~The Bump Team
Bump Physio & Co. is a pelvic health-focused clinic offering physio, RMT, kinesiology, and counselling in New Westminster, Port Moody, and Langley. Our team specializes in pelvic health, orthopedics, obstetrics, and active rehab—providing personalized care through every stage of life.
References
Beth Israel Deaconess Medical Center. (2015). Constipation and the pelvic floor muscles. https://www.bidmc.org/pelvicfloorpt
Physiopedia. (2020). Impact of stress and cortisol levels on pelvic pain and pelvic stress reflex response. https://www.physio-pedia.com/index.php?title=Impact_of_stress_and_cortisol_levels_on_pelvic_pain_and_pelvic_stress_reflex_response&oldid=241373Sulowska-Daszyk, I., Gamrot, S., & Handzlik-Waszkiewicz, P. (2024). A Single Session of Temporomandibular Joint Soft Tissue Therapy and Its Effect on Pelvic Floor Muscles Activity in Women-A Randomized Controlled Trial. Journal of clinical medicine, 13(23), 7037. https://doi.org/10.3390/jcm13237037