Pelvic Floor Dysfunction: Why January Is the Right Time to Reset, Rebuild, and Realign

When people think about physical therapy, they often picture backs, knees, or shoulders. But one of the most important—and commonly overlooked—areas we treat is the pelvic floor.

Pelvic floor dysfunction is far more common than most people realize, affecting adults across genders, ages, and activity levels. And yet, many people live with symptoms for years before realizing that physical therapy is often the best first-line treatment.

January is about resetting habits, rebuilding foundations, and realigning priorities. If you’ve been ignoring pelvic floor symptoms or assuming they’re just “part of life,” this may be the right time to take a different approach.

What Is the Pelvic Floor (And Why It Matters)?

The pelvic floor is a group of muscles, ligaments, and connective tissues that form the base of your core. These muscles play a critical role in:

• Bladder and bowel control

• Sexual function

• Core stability

• Posture and breathing

• Supporting pelvic organs
  

When the pelvic floor isn’t functioning well—whether it’s too tight, too weak, or poorly coordinated—symptoms can show up in ways that feel unrelated or confusing.

Common Symptoms of Pelvic Floor Dysfunction

Pelvic floor dysfunction doesn’t look the same for everyone. Symptoms we commonly see include:

• Urinary leakage with exercise, coughing, or sneezing

• Urinary urgency or frequency

• Difficulty starting or fully emptying the bladder or bowels

• Constipation or straining

• Pelvic pain or pressure

• Pain with intercourse

• Tailbone, hip, or low back pain that doesn’t fully resolve

• Core weakness that persists despite exercise
  

Many people assume these symptoms are “normal,” especially after childbirth, during menopause, or with aging. Common does not mean normal—and it does not mean untreatable.

Diagnoses Pelvic Floor Physical Therapists Commonly Treat

Pelvic floor physical therapy is evidence-based care for a wide range of conditions, including:

• Stress or urge urinary incontinence

• Pelvic organ prolapse

• Painful intercourse (dyspareunia)

• Endometriosis-related pain

• Postpartum and post-surgical recovery

• Chronic pelvic pain

• Diastasis recti

• Prostatitis and post-prostate surgery symptoms
  

In many cases, physical therapy is recommended as the first-line treatment before medications, procedures, or surgery.

Why Physical Therapy Works for Pelvic Floor Dysfunction

Pelvic floor dysfunction is rarely just a “weak muscle” problem. It often involves:

• Poor coordination between the diaphragm, core, and pelvic floor

• Overactivity or guarding rather than weakness

• Breathing and pressure management issues

• Movement and posture contributors
  

Pelvic floor physical therapy focuses on:

• Detailed assessment of movement, breathing, and muscle function

• Manual therapy (external and, when appropriate, internal techniques)

• Nervous system regulation

• Strength, relaxation, and coordination training

• Education that empowers long-term symptom control
  

This isn’t something a generic exercise sheet can address.

Why Cash-Based Care Matters for Pelvic Floor PT

Pelvic floor therapy requires time, privacy, trust, and expertise. Unfortunately, many insurance-based models make that difficult.

In a cash-based, one-on-one setting:

• Sessions are a full 60 minutes

• You work with the same therapist every visit

• Care isn’t rushed or double-booked

• Treatment plans aren’t dictated by insurance visit limits

• Education and conversation are prioritized
  

For pelvic health specifically, this matters. These are personal symptoms, and progress often depends on feeling heard, safe, and fully supported.

Our patients often tell us that pelvic floor PT was the first place they felt their symptoms were taken seriously.

Reset, Rebuild, Realign

Pelvic floor dysfunction often develops quietly over time—after life changes, stress, injury, or hormonal shifts.

January is an ideal time to:

• Reset habits around breathing, posture, and core engagement

• Rebuild strength and coordination from the inside out

• Realign how you move, train, and manage pressure in daily life
  

Ignoring pelvic floor symptoms doesn’t make them disappear. Addressing them early often leads to faster, more sustainable improvement.

You Don’t Have to “Just Live With It”

Leaking, pain, pressure, or discomfort are not requirements of aging, parenthood, or an active life.

At Nashville Physical Therapy & Performance, our pelvic floor therapists provide individualized, evidence-based care in a private, one-on-one setting designed to support real progress—not rushed checklists.

If pelvic floor symptoms have been on your mental “someday” list, this may be the right season to move them to the top.

References

• Dumoulin, C., et al. (2018). Pelvic floor muscle training versus no treatment for urinary incontinence in women. Cochrane Database of Systematic Reviews, (10).

• Bo, K., et al. (2017). Evidence-based physical therapy for the pelvic floor. Elsevier Health Sciences.

• Hagen, S., et al. (2011). Pelvic floor muscle training for secondary prevention of pelvic organ prolapse. International Urogynecology Journal, 22(4), 487–495.