Ann Greenan Naumann, PT, is a Clinical Lead Physical Therapist at the Orthopedic Specialty Center.

Ann Greenan Naumann, PT, is a Clinical Lead Physical Therapist at the Orthopedic Specialty Center.

Think of your pelvic floor as a hammock — a sling of muscles that sit at your perineum (the part of your body that touches the seat when you sit on a bicycle).

These muscles support and lift the internal abdominal and pelvic organs, and give us control of when we hold or release the contents of our bladder or bowels. When the pelvic floor is healthy and strong, the muscles do these jobs well. When they are weak, however, the result can be loss of bladder or bowel control resulting in leaking, discomfort due to internal organs pushing downward on sensitive tissues, or diminished sexual function.

If these muscles become overworked or spasm the results can include pain, constipation and painful, or diminished sexual function.

Despite the fact that this is an area of the body that we don’t typically talk about, problems with the pelvic floor are extremely common. Consider that:

  • 25-30 percent of adults between the age of 25 and 55 experience bowel or bladder problems at some time, 1
  • 15 percent of women aged 18-50 have pain in this area.

Factors which may contribute to problems with pelvic floor function include:

  • Age
  • Female gender
  • Childbirth
  • Surgeries – such as abdominal or prostate surgery, or other medical treatments such as radiation therapy in the area.

What can you do if you experience problems with leaking, pelvic floor pain or discomfort, or constipation? The first step is to talk with your primary care provider about these symptoms.  Although you may feel embarrassed to talk about these types of problems, rest assured that your provider will not be embarrassed. Having a problem with this part of your body is no different to him/her than having a knee problem or high blood pressure. Your primary care provider may send you to see a specialist for further testing, or may determine that physical therapy is the first step to treating this problem.

Physical Therapists are experts on the function of muscles in the body. The function of your pelvic floor involves good function of muscles as well as your nervous system, which controls those muscles.

pelvic floor

Picture 1 shows a well-functioning Pelvic Floor. Picture 2 shows a poorly-functioning Pelvic Floor.

The physical therapist will:

  • Assess how well your muscles are functioning looking for weakness, or overactivity of the pelvic floor muscles, your fluid intake, activity level, and bowel and bladder habits.
  • Show you exercises
  • Assess and make recommendations about the types and amounts of fluid you take in
  • Educate you about how your bowel and bladder system works and how you can gain more control.

Other tools that the therapist may use include:

  • Biofeedback to help you to know how to contract and relax these muscles
  • Electrical stimulation for pain or muscle activation
  • Manual therapy to help you to relax muscles that are overworking.

Many people make the assumption that problems with bowel and bladder function are a natural part of aging, childbirth, or surgery and that there is nothing to be done to help.  This is not the case! There is much that we can do to help the function of the pelvic floor and improve your life!

Pelvic floor therapy is offered at the the UVM Medical Center Continence Center as well as at the Orthopedic Specialty Center. To make an appointment for at the Orthopedic Specialty Center, call 802-847-7910. To make an appointment at the Continence Center, call 802-847- 4151.


  1. Hulme, Janet A. Beyond Kegels, third edition. Phoenix publishing co., 2012
  2. Mathias SD, Kuppermann M, Liberman RF, Lipschutz RC, Steege JF, Chronic pelvic pain: prevalence, health related quality of life, and economic correlates; Obstetrics and Gynecology 1996. 87(3)321-7.

Ann Greenan Naumann, PT, is a Clinical Lead Physical Therapist at the Orthopedic  Specialty Center. She has specialized training in physical therapy treatment of men and women with pelvic floor dysfunction as well as 30 years of experience treating patients with low back and lumbo-pelvic disorders

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