When Strengthening Isn’t the Answer: Understanding Your Pelvic Floor

If you’ve been told to “just strengthen your pelvic floor” but your symptoms haven’t improved — or have actually worsened — you’re not alone. At BodyRight Physiotherapy in Drogheda, we regularly support women who have tried exercises, squeezes, apps, programmes, and even high-tech treatments, yet still experience bladder urgency, constipation, pelvic discomfort, or the sense that something isn’t quite right.

One of the biggest myths in pelvic health is this: pelvic floor problems are not always caused by weakness. Sometimes the issue isn’t that the muscles aren’t working hard enough — it’s that they’re already working overtime.

Understanding the Pelvic Floor (It’s More Than a Set of Squeezes)

The pelvic floor is a group of muscles that supports the bladder and bowel, your pelvic, hip and spinal mechanics, and in women, the uterus. The Pelvic Floor should work in harmony and co-ordination with our breathing mechanics and our movement in general. Problems arise when this balance is lost.

A pelvic floor can be too weak, too tight (often described as overactive or hypertonic), or unable to relax fully. Each of these presents differently and requires a different approach — which is why assessment by a Pelvic Health Specialist or Specialist Women’s Health Physiotherapist is so important.

Weak vs Overactive Pelvic Floor Muscles

A weak pelvic floor may struggle to provide enough support or control, contributing to leakage during coughing, sneezing, running, or lifting.

An overactive pelvic floor behaves very differently. When these muscles are constantly “switched on”, they struggle to relax, fatigue easily, and often become painful. This pattern of overactivity is commonly associated with bladder urgency, constipation, pelvic pain, lower back or hip pain, painful intercourse (dyspareunia), and even incontinence. But in these cases, more strengthening can actually worsen symptoms rather than resolve them.

A Word of Caution on High-Tech Pelvic Treatments

Many women now invest in treatments such as Indiba, radiofrequency, and electrical stimulation, often available in beauty clinics or wellness settings. While these technologies can have a place, they are not appropriate for everyone.

When used without a thorough Women’s Health Physiotherapy assessment, these treatments can aggravate symptoms in women with pelvic floor overactivity, urgency, constipation, pelvic pain, or nervous system overdrive. Adding stimulation to muscles that already struggle to relax can leave the system more irritated, not more supported.

Why Tension Can Drive Bladder, Bowel, and Pain Symptoms

A tight or overprotective pelvic floor can disrupt communication between the bladder, bowel, spine, hips, and nervous system. This may lead to urgency even when the bladder isn’t full, frequent trips to the toilet, difficulty emptying fully, pelvic pressure, lower back or hip pain, and pain during intercourse — often despite clear test results.

These symptoms are common, real, and very treatable — when the right cause is identified.

How Pelvic Health Physiotherapy Helps

Pelvic Health Physiotherapy is never a one-size-fits-all approach. At BodyRight Physiotherapy, our Pelvic Health Specialists and Specialist Women’s Health Physiotherapists take time to understand how your pelvic floor is functioning and how it interacts with your breathing, spine, hips, and nervous system.

Treatment may include pelvic floor relaxation and down-training, breathing and nervous system regulation, bladder retraining strategies, gentle movement, and practical education. The aim is always to restore balance — not to force already overworked muscles to do more.

When Should You Seek Pelvic Health Support?

You may benefit from pelvic health physiotherapy if you experience persistent urgency or frequency, bladder symptoms despite clear tests, constipation or difficulty relaxing, pelvic pain, painful intercourse, lower back or hip pain, or symptoms that worsen with exercises or stimulation.

You don’t need to wait until symptoms become severe. Early assessment can make a significant difference.

Pelvic Health Care at BodyRight Physiotherapy

At BodyRight Physiotherapy Clinic, our Pelvic Health Specialists and Specialist Women’s Health Physiotherapistsprovide discreet, evidence-based care in a calm and supportive environment. Our focus is on education, reassurance, and practical treatment — helping you feel informed, empowered, and back in control of your recovery.

📍 BodyRight Physiotherapy Clinic

📅 Pelvic Health appointments available with Orlagh Gaynor, Louise Hynes, and Sarah Plunkett — all CORU-registered Physiotherapists with specialist pelvic health training and extensive clinical experience.

If strengthening hasn’t helped — or has made things worse — it may be time for a more informed approach.