Is Your Pelvic Floor the Missing Link in Your Pain? Here's What You Need to Know
You’re in pain. Your body is sounding the alarm—something isn’t right down there. But what’s causing it? Maybe it burns when you pee, lingers as a dull internal ache, or flares up when you sit. Tests come back normal, and your doctor is either clueless, or if you’re lucky, hands you a diagnosis: pelvic floor dysfunction. But what does that really mean? And is there anything you can do to help?
We all recognize sharp, immediate pain—the kind that comes from a pulled muscle, a broken bone, an infection, or even tearing during childbirth. But what about when that pain lingers, long after the obvious cause is gone? Pelvic pain can feel complicated and overwhelming, but looking at it through the lens of the pelvic floor helps make sense of it.
What is pelvic pain?
The term “pelvic pain” is broad and vague. It simply refers to pain below the bellow button and between the hips —but a quick refresh on anatomy reminds us that a myriad of organs, muscles, connective tissues, and nerves are housed in within your pelvis, making determining the exact cause or location of pain difficult. Thankfully, there is a common link between these bodily organs and systems, one that often is implicated in pelvic pain— the pelvic floor.
What is the pelvic floor?
The pelvic floor is a group of muscles that forms the base of your pelvis. These muscles are intricately connected to the pelvic and hip bones, with deep fascial links to the reproductive urogenital, and gastrointestinal organs. What makes the pelvic floor unique is its dual role: it not only provides structural support and is a key component to movement, but it also plays a crucial part in the proper functioning of internal organs. The pelvic floor has the following “jobs” within the body:
Stabilization: Works with other core muscles (like the diaphragm and deep abdominal muscles) to stabilize the pelvis and spine, supporting balance and movement.
Support: Provides structural support for the pelvic organs (bladder, uterus, rectum) and helps maintain their proper positioning.
Sphincter Control: Controls the opening and closing of the urethra, anus, and vagina, essential for urination, defecation, and sexual function.
Sexual Function: Contributes to sexual pleasure, arousal, and orgasm by allowing the muscles to contract and relax in response to stimulation.
Reproductive: The pelvic floor supports the baby during pregnancy, stretches to allow childbirth, and aids in postpartum recovery by helping restore bladder, bowel, and core function
Sump-Pump: Works with the diaphragm to regulate intra-abdominal pressure during activities like coughing, sneezing, and lifting,
Respiratory Function: Works with the diaphragm to regulate intra-abdominal pressure during activities like coughing, sneezing, and lifting, while also managing the flow of blood and lymph.
How does the pelvic floor contribute to pelvic pain?
Since the pelvic floor is intricately connected to various systems in the body, including the muscular, nervous, and connective tissue networks, if any of these systems are not functioning properly they can compound and create persistent pelvic pain. Dysfunctional pelvic floor muscles—whether too tight (hypertonic) or too weak (hypotonic)—can lead to imbalances, restrict blood flow, and cause irritation to the surrounding nerves.
Things like connective tissue tightness, scarring from surgery, childbirth, or trauma can further restrict movement, leading to chronic discomfort. Additionally, the nerves that pass through the pelvic floor can become compressed, irritated, or sensitized, leading to misfiring pain signals. Over time, this can contribute to a phenomenon known as central sensitization—where the nervous system becomes hypersensitive to pain signals, even in the absence of an ongoing injury. This means that even minor stimuli, such as sitting or wearing tight clothing, can trigger a pain response, making pelvic pain a confusing and frustrating condition to navigate.
Because pelvic pain often has interconnected causes, the path to healing requires a comprehensive and individualized approach that addresses the full picture of dysfunction.
How to Start Healing Your Pelvic Floor
The good news is that pelvic floor dysfunction is treatable, and there are many ways to begin improving your symptoms. You need someone who can address the multifaceted causes of pelvic pain and guide you on the path to relief—a person who can provide you with a healing blueprint for your pelvic health. That person is your friendly neighborhood pelvic floor physical therapist at Tonic & Phasic!
At Tonic & Phasic Physical Therapy, we specialize in helping individuals uncover and address the complex causes of pelvic pain with a personalized, whole-body approach.
What to Expect on Your Healing Journey
While each person’s healing path is unique, many of our patients begin noticing improvements after a few sessions. Initially, we start by assessing your posture, movement patterns, and the overall function of your pelvic floor muscles. This helps us understand what may be contributing to your pain and how we can tailor your treatment plan. You might work on manual therapy, strengthening or relaxing certain muscles, or learning new movement patterns to relieve tension or support better function. We also assess for hormonal and nutritional imbalances, gut health, systemic inflammation, and other whole body causes that can exacerbate pelvic pain.
Importantly, healing the pelvic floor also involves healing your nervous system. Pelvic pain can often become chronic when the nerves in the area are sensitized, meaning the brain starts interpreting sensations as pain—even when there's no ongoing injury. A key component of healing involves reprogramming the brain’s response to pain through techniques like pain reprocessing, vagus nerve stimulation, HRV retraining, breathing exercises, and more. Over time, the goal is to help your nervous system become less reactive to triggers, allowing you to feel safer and more comfortable in your body again.
Healing is possible, and you don’t have to live with pelvic pain forever. If you suspect your pelvic floor may be the missing link in your pain, reach out to us at Tonic & Phasic Physical Therapy for a free 15-minute discovery call to start your journey toward relief!
