Pelvic Floor 101
What is the pelvic floor and why does it matter?
The pelvic floor is a group of muscles and connective tissues that sit at the base of the pelvis. Despite being relatively small, these muscles play a big role in everyday function, including bladder and bowel control, support of the pelvic organs, sexual function, and core stability.
Many people are never taught what the pelvic floor actually does, what’s considered normal, or when symptoms might be a sign that something isn’t working as well as it could. This page aims to give you a clear, practical understanding of the pelvic floor without jargon or fear-based messaging.
What is the pelvic floor?
The pelvic floor is a hammock-like group of muscles that spans from the pubic bone at the front to the tailbone at the back, and between the sit bones on either side.
These muscles sit underneath the bladder and bowel, and in women, also support the uterus and vagina. In men, they support the bladder and bowel and play a role in sexual function.
The pelvic floor works automatically most of the time, you don’t have to consciously think about it to stay continent, support your organs, or move comfortably.
What does the pelvic floor do?
Bladder & bowel control
The pelvic floor helps:
keep you continent during everyday activities
control the release of urine, wind, and bowel motion
delay urgency when you need to get to the toilet
Support the pelvic organs
The pelvic floor provides support to:
the bladder
the bowel
the uterus and vagina (in people assigned female at birth)
Sexual function
The pelvic floor contributes to:
comfort during penetration
arousal and sensation
orgasm
erectile function and ejaculation (in people assigned male at birth)
Core stability and movement
The pelvic floor works together with the diaphragm, abdominal muscles, and back muscles to support posture and movement. It plays a role in load transfer, balance, and efficient movement during exercise and daily tasks.
How is the pelvic floor meant to work?
A healthy pelvic floor is not just about strength.
It needs to be able to:
contract when support or control is needed
relax fully to allow bladder and bowel emptying
respond automatically to changes in pressure (like coughing or lifting)
coordinate with breathing and movement
This means problems can occur if the pelvic floor is:
too weak
too tight or overactive
poorly coordinated
not responding at the right time
Importantly, these issues can exist even if someone is fit, active, or regularly exercising.
What is considered ‘normal’ pelvic floor function?
While everyone is different, normal pelvic floor function generally includes:
being able to hold on to urine and bowel motions until it’s appropriate to go
emptying the bladder and bowels without straining
no regular leakage of urine, wind, or stool
no ongoing pelvic pain, pressure, or heaviness
being able to exercise, cough, sneeze, laugh, and lift without symptoms
comfortable sexual activity (if sexually active)
Changes can occur at different life stages, such as during pregnancy, after childbirth, around menopause, or with ageing.
Signs your pelvic floor may not be working optimally
Pelvic floor issues don’t always look the same. Some common signs include:
leaking urine with coughing, sneezing, exercise, or urgency
difficulty holding on when you need to open your bowels
a feeling of heaviness, pressure, or bulging in the vagina or rectum
pelvic pain, pain with penetration, or pain using tampons
difficulty starting or fully emptying the bladder or bowels
ongoing urgency or frequent trips to the toilet
pain in the pelvis, hips, lower back, or tailbone without a clear cause
These symptoms can exist on their own or in combination.
Are pelvic floor problems common?
Yes, pelvic floor issues are very common across all genders and ages.
They can occur:
during pregnancy or after childbirth
around menopause
following pelvic or abdominal surgery
with high-impact or repetitive exercise
alongside conditions such as endometriosis or persistent pelvic pain
due to prolonged straining, chronic constipation, or chronic coughing
However, common does not mean normal or untreatable.
How can pelvic health physiotherapy help?
Pelvic health physiotherapists are trained to assess how your pelvic floor muscles are functioning, including strength, relaxation, coordination, and how they work with the rest of your body.
Treatment may involve:
education about bladder, bowel, and pelvic floor function
tailored exercises (not just generic pelvic floor exercises)
strategies to improve relaxation and coordination
advice around toileting habits, posture, breathing, and movement
guidance for returning to exercise or sport
support during pregnancy, postpartum, or menopause
Assessment and treatment are always guided by consent, comfort, and your individual goals.
Where to next?
If you’d like to explore specific topics in more detail, you may find the following pages helpful:
If you’re unsure whether pelvic health physiotherapy is right for you, you’re welcome to get in touch or discuss your concerns at an initial appointment.