Pelvic floor dysfunction is more common than most people realize! However, when the criteria are urine leakage, erectile dysfunction, pain in the pelvis, or sexual intercourse, then many subtle symptoms get missed. The lack of proper attention will only lead to more ‘loud’ presentations of pelvic floor dysfunction and many times, the treatment is more complex, timely, and with less than ideal results.

Your pelvic floor plays a crucial role in supporting your body and maintaining overall well-being. And the goal of this blog is to explore how to identify the subtle signs of a weak pelvic floor including poor posture, hip pain, and sacroiliac joint pain. As well as addressing why pelvic stability is essential for pelvic floor health.

Understanding the Pelvic Floor

Before we dive into the signs of a weak pelvic floor, let’s briefly understand what the pelvic floor is. Your pelvic floor is a group of muscles and tissues located at the base of your pelvis. It forms a hammock-like structure that supports your bladder, uterus, ovaries or prostate, and intestine. One thing to remember is that the pelvic floor does not get weak by itself and pelvis instability is a huge player in the fate of the pelvic floor. After all, why think about the floor when the ‘house’ that the pelvic floor is the floor of is unstable? You can read my blog on the anatomy of the pelvic floor in detail.

How is Pelvic Stability Related to Pelvic Floor Health?

Your pelvic floor doesn’t work in isolation; it’s part of a complex system involving your core muscles, hips, and spine. Pelvic stability is crucial because it ensures that your pelvic floor functions optimally. When your pelvis is stable, your pelvic floor muscles can work efficiently to support your internal organs and maintain proper bodily functions.

Addressing pelvic stability involves strengthening not only the pelvic floor but also the surrounding muscles. This comprehensive approach ensures that your pelvic floor is well-supported and can perform its functions effectively. Neglecting the stability of your pelvis can result in an incomplete treatment for pelvic floor issues.

Subtle Signs of a Weak Pelvic Floor

Have you read my blog with an extensive list of the subtle signs of pelvic floor dysfunction? Remember a weak pelvic floor happens when the house that the pelvic floor is the floor of is unstable. Weakness happens in one of two ways. First, as a result of the muscles being overworked and now tired. Second, when movement does not ‘call’ for those muscles to work they become de-conditioned. The question is then why would the ‘blueprint’ of movement change?

This is called negative neuroplasticity! When the brain re-designed the patterns of movement based on injuries, habits, and lifestyles to name a few. Essentially changing the map of movement based on what is ‘thrown’ at it. To learn more about this, please read about Postural Neurology and Functional Movement on my movement-related website which is different than this blog and website.

In this blog, I want to draw your attention to the main culprits that get missed quite often:

  • Poor Posture:

Poor posture is when you lose that upright, neutral spine and body. This IMO starts with our failure to do Biological Breathing! This is the type of breathing that all babies do, that we all have done as babies, automatically. We will notice that the basic presentation of the transitional areas in the body are subpar. That is the areas between the neck and mid-back, mid-back and lower back, lower back to the pelvis, pelvis over the lower extremities, and the whole body over the feet.

In the case of pelvic floor dysfunction, the instability of the pelvis appears as:

  • The forward or backward-tilted pelvis
  • A pelvis that is swayed to one side
  • When you are more comfortable standing on one leg more than the other
  • When your neck and shoulders are rolled forward.
  • When you are slouched or stick the chest out because you don’t want to have the slouched posture

All of these lead to an unstable pelvis and weakness in the floor of the ‘house (pelvis). Here is a video to turn the basic foundation of correcting the posture on.

  • Hip Pain:

The pelvic floor muscles are intertwined with your hip muscles, and when they’re not functioning correctly, it can create imbalances in your hip area. This imbalance can lead to pain and discomfort in the pelvis. Imagine your hips being the leg support of a table. This table, unlike other tables, requires 2 legs though! While you are imagining this, what happens if one of the legs is wobbly?

Your hip joint is a ball and socket joint with the ball coming from the thigh bone side of the joint and the socket being a part of your pelvis. If the ball is not centered within the socket, while dysfunctional movements start happening and becoming your norm, the pelvis stability becomes compromised just as the table ‘imagination’ would conclude. Chronic hip pains always lead to pelvic floor dysfunction and the presentations may be subtle but subtleness does not make the issue go away!

  • Sacroiliac Joint Pain:

The sacroiliac joint connects your spine to your pelvis and the different components of your pelvis to each other. Pain there typically comes as a result of muscles connected, the deeper connective tissues being involved, and/or the dysfunctional movement patterns causing pain. The end result is pelvic floor dysfunction and pelvic floor weakness or tightness.

How to Improve Pelvic Floor Health

If you suspect that your pelvic floor might be weak based on the signs mentioned earlier, it’s essential to take proactive steps to improve its health. Assuming that there are no complex measures needed, here is the list of things I recommend and do with my patients:

Pelvic Floor Exercises:

The only exercise that addresses this correctly IMO is breathing biologically so we go after this component from the get-go and emphasize this heavily at the beginning, during each exercise that is geared toward postural and pelvis stability and activities of daily living reviews. I shared the video explaining breathing above.

Postural Strengthening:

This is more than the core exercises that you may be familiar with and most likely what you know about core strengthening is NOT what I agree with. I don’t consider myself a contrarian and suggest you think about what is being taught out there and the ratio of success with what is being taught. Once you do this assessment you can see why for instance, abdominal crunches don’t do the job.

Posture Awareness:

The majority of your posture is what your brain decides to do based on what you throw at it, so be careful what you wish for, and remember, majority does not mean 100%. Use the small percentage you control strategically and live your day mindfully. There are 4 basic principles of movement that I teach my patients:

  • Neutral spine
  • Glide the neck back
  • Breathe biologically
  • Send the shoulder blades toward your back pocket

If you are not following me on IG, you should! My page on movement is all about this.

Consult a Pelvic Floor Dysfunction Therapist:

That does not mean a physical therapist necessarily. A chiropractor, occupational therapist, nurse, or physician who gets their training in the field of pelvic floor AND focuses their attention on the movement mechanics of the body are all great specialists to look into. This combination is not common but I promise you, I am not the only one who is out there.

If you do have pelvic floor dysfunction and are not happy with your treatment, or if you suspect you may have pelvic floor dysfunction and need treatment, contact me.

Dr. Shakib

Recommended Reading:

How to Tell if You Have Pelvic Floor Dysfunction?

Hypermobility and Pelvic Floor Dysfunction