What We Get Wrong About the Pelvic Floor

Experts say most people can't even identify these key muscles
Posted Dec 7, 2025 11:24 AM CST
What We Get Wrong About the Pelvic Floor
Stock photo.   (Getty Images / Nadzeya Haroshka)

A mysterious pain at the base of her spine led a new mother and writer to discover the little-understood world of pelvic floor dysfunction—a set of issues that, it turns out, quietly plagues a startling number of people. Writing for Wired, Casey Johnston shares her personal story of being postpartum and stuck in pain after a book tour, despite being a longtime weightlifter. After weeks of worsening symptoms, a pelvic floor specialist finally explained what was happening: Johnston was holding a surprising amount of tension in those hidden muscles, likely compounded by postpartum weakness, old athletic injuries, and even lifelong stress.

The pelvic floor, Johnston writes, is a hammock of muscle at the bottom of the pelvis, important for everything from continence to sexual function. Yet, for decades, medicine barely studied these muscles, and many people—regardless of gender—can't identify or intentionally activate them. Dysfunction can mean pain, incontinence, or prolapse, and even elite athletes aren't immune. While Kegels get all the attention, experts say true pelvic floor training is more involved and can be crucial for recovery after childbirth.

In some countries, such rehab is routine, but in the US, the system often falls short, with drugs and surgery—the more standard treatments in America—doing little for most chronic pelvic pain. Newer approaches favor combinations of exercise, physical therapy, and even psychological support. Johnston's story highlights the frustration of chasing relief for an invisible problem, but also the slow progress that comes with persistence. Read it in full here.

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