What Is Pelvic Floor Weakness?
Pelvic floor weakness is a type of pelvic floor dysfunction where the pelvic floor muscles are not strong enough to support their normal function, resulting in a variety of symptoms and conditions. This is commonly referred to as a hypotonic pelvic floor, or sometimes an “underactive” pelvic floor.
The pelvic floor naturally contracts and relaxes in order to perform daily functions. It can do so involuntarily (naturally without you thinking about it too much, such as during a cough) or voluntarily (on command, such as when you are trying to hold in gas).
However, some individuals with a weakened pelvic floor may struggle to perform these contractions and relaxations. This means that the pelvic floor may struggle to perform them naturally, too.
Everyone has a pelvic floor, and anyone can experience pelvic floor dysfunction, including weakness. Having a weakened pelvic floor can impact your daily life and in some cases can lead to more severe conditions, so it is very important to take note of your symptoms and to take them seriously!
What Does Pelvic Floor Weakness Look Like?
The pelvic floor has many jobs. It supports your pelvic organs, provides stability to the body, allows for continence of your bladder and bowels, provides sensation and function for sexual activity, and more.
Unfortunately, when these muscles are not strong enough to support these functions, it can cause symptoms such as the following:
- Incontinence (urinary, fecal, or gas) especially while sneezing, laughing, coughing, etc.
- Urinary urgency
- Frequent urination
- Pelvic organ prolapse
- Erectile dysfunction
- Difficulty with orgasm
- Reduced sexual sensation
- Pelvic pain
- And more
Pelvic floor weakness can range widely. For some, it may just be a small amount of bladder leakage while laughing or sneezing (stress incontinence)—but for others, it can cause more significant problems and symptoms, such as pelvic organ prolapse. Individuals with a hypotonic pelvic floor can experience multiple symptoms at one time, too.
One important thing to note is that while some of these symptoms are very common (particularly after childbirth), that does not make it normal. These symptoms are not something you simply have to live with. Your pelvic floor can be strengthened to reduce these symptoms and improve your quality of life, thanks to pelvic floor physical therapy!
What Causes Pelvic Floor Weakness?
There are many different factors that can cause your pelvic floor to become weak. Many of the same causes of pelvic floor tension can also cause weakness in the pelvic floor. That’s right, your pelvic floor can be tight and weak at the same time!
This is because many factors—pregnancy, childbirth, chronic constipation, and more—cause a lot of strain on your pelvic floor. While this strain can create a build-up of tension, it can also fatigue your muscles and disrupt their coordination with other organs.
Each person’s pelvic floor dysfunction can vary even from the same causes. It’s important to work with a professional in order to properly identify your body’s needs and the best course of treatment! With that being said, let’s explore some common causes of pelvic floor weakness…
Pregnancy and Childbirth
Some of the most common causes of pelvic floor weakness are pregnancy and childbirth, as you may have heard before. This is because the pelvic floor goes through a lot of strain, stress, and trauma during this time.
When you are pregnant, your center of gravity shifts and the pressure put on the lower body increases, meaning your pelvic floor, lower back, hips, and other lower structures are working overtime. This is partially why so many people have pain in these areas during pregnancy.
The other reason is that your body releases a hormone called relaxin, which loosens your ligaments and joints in preparation for childbirth. This, however, puts even more strain on the pelvic floor and other structures.
Then there’s childbirth, in which the pelvic floor is very involved (for both vaginal delivery or c-section). In terms of a vaginal delivery, the pelvic floor experiences direct trauma from straining, stretching, tearing, and in some cases, incisions. In some more difficult childbirth situations, the pelvic floor may experience damage.
For childbirth via cesarean, an incision is performed on the abdominals. You may be wondering, how does this affect the pelvic floor? The abdominals are actually deeply interconnected with the pelvic floor.
The pelvic floor muscles form the base of your core, and these two areas coordinate to allow for lifting, breathing, and more. Therefore, the incision made during a C-section can cause weakened abdominal muscles, which when left untreated can affect the pelvic floor.
Menopause
Menopause is a natural part of life for those born with a uterus. Put simply, menopause is a turning period where ovaries stop producing hormones and menstruation ceases.
During the years leading up to menopause (perimenopause) and during menopause itself, your levels of estrogen and other important hormones will decrease. The tissues of your vagina, vulva, and urethra can become thinner, less lubricated, and less elastic during this time. All of these aspects can unfortunately weaken the pelvic floor and cause a variety of pelvic floor dysfunction symptoms.
Aging
Similarly to menopause, aging can also affect the pelvic floor. This occurs due to the reduced hormone production as mentioned above, lowered bone density, and in many cases, sedentary behaviors.
However, it is important to note that the pelvic floor is not doomed to dysfunction simply because of age—you can maintain a healthy pelvic floor with an active lifestyle and healthy diet even into your older years.
Stress and Straining
As mentioned before, stress and strain on the pelvic floor can cause weakness. Many people may think of childbirth as a form of strain on the pelvic floor, but that isn’t the only time your pelvic floor is strained. Other examples can include:
- Chronic constipation: Those who experience chronic constipation frequently strain their pelvic floor muscles.
- Heavy lifting: Individuals or athletes who lift with poor form or muscle engagement are likely straining their pelvic floor.
- Intense sports or workouts: There are a wide range of exercises and sports that engage the pelvic floor, even without you noticing. Overuse, repetition, and poor form during any of these high-impact activities can affect the pelvic floor.
- Daily restroom behaviors: Sitting on the toilet too long, holding urine for long periods of time, straining during bowel movements, and other daily restroom habits can affect the pelvic floor in the long run.
Injury or Surgery
Lastly, experiencing injury or surgery to the pelvis or areas interconnected with the pelvic floor can cause muscle weakness. This is due to the possible tissue damage and trauma associated with injury and surgery.
Therefore, it is essential to engage in thorough rehabilitation after any surgery or injury. Proper rehabilitation allows your body and pelvic floor to return to good health and normal function!
How Pelvic Floor Physical Therapy Can Help
Pelvic floor weakness can be frustrating to deal with every day, but luckily it is something that is very treatable! By working with a professional like me, your pelvic floor function and daily comfort can be restored.
I always begin with a thorough evaluation, which will include a discussion of your medical history and symptoms, as well as a physical examination with your consent.
After gaining a better understanding of your pelvic floor’s health, I’ll curate a treatment plan for your individual needs. This will include treatments to build strength in your pelvic floor, address any struggles with coordination, and release tension as needed.
You can expect to engage in a variety of treatment methods, such as stretching, exercises, manual therapy, behavioral modifications, neuromuscular re-education, and biofeedback.
Even if you choose to do in-person treatment sessions, you should also expect to continue practicing at home. This “homework” is absolutely necessary to push progress and to ensure long-term pelvic floor health! Don’t worry—I’ll provide plenty of instruction, resources, and tools for you to engage in pelvic floor exercises effectively and safely at home.
I want to set you up for long-term success not just by teaching you exercises and at-home practices, but also other forms of education. I’m here to answer all your questions and help you improve your understanding of your pelvic floor. I can explain the pelvic floor’s functions and structure, how it is affected by different factors, and why you may be experiencing your symptoms.
Don’t be afraid to ask questions! I want you to feel confident in your pelvic floor treatment and health goals. Allow me to be your biggest motivator as you work towards better pelvic floor health and relief from your symptoms!
If you’d like to get started, feel free to book an appointment! Or if you have some more questions, book a discovery call.
