By Shreya Patel · 6 min read · February 2026
The pelvic floor is a hammock of muscles slung from the pubic bone at the front to the tailbone at the back. It supports your bladder, bowel and (if relevant) uterus, and it works automatically every time you cough, sneeze, jump or lift. Most people never think about it — until it stops working quietly.
Signs it might need attention
- Leakage with coughing, laughing or exercise.
- Urgency or frequency that isn’t explained by how much you’re drinking.
- A feeling of heaviness or dragging in the pelvis, especially by the end of the day.
- Pain with intercourse, tampon insertion or pelvic examinations.
- Persistent low back, hip or tailbone pain that no one can quite explain.
What 'doing your kegels' actually means
A pelvic floor contraction is a lift, not a clench. Imagine drawing the back passage gently up and forward toward the pubic bone. The belly should stay soft, the buttocks should not squeeze. Three sets of ten, holding each for 5–10 seconds, is the textbook starting prescription — but a third of people contract incorrectly, so a one-off assessment with a pelvic floor physio is worth its weight.
When the floor is too tight, not too weak
Not every pelvic floor problem is weakness. An overactive pelvic floor — one that never fully relaxes — causes urgency, pain and the very leakage people assume needs strengthening. Pelvic floor physiotherapy includes both ends of the spectrum.
Pregnancy, postnatal and menopause
Three life stages where the pelvic floor changes most. We see women in all three phases at our Castle Hill and Sydney CBD clinics — and yes, you do not have to wait six weeks postnatal before booking an initial conversation.