Pelvic Pressure & Heaviness: What Your Pelvic Floor is Telling You
This episode of the Marrón Pelvic Health Podcast, hosted by Dr. Kari Roberts, explores the uncomfortable feeling of pelvic pressure or heaviness that many people experience but rarely talk about. While some assume this sensation is just normal after childbirth or aging, pressure in the pelvis can also be related to pelvic floor muscle weakness, organ support changes, or strain. The podcast highlights the importance of recognizing what your pelvic floor may be signaling and why these symptoms should not be ignored. Dr. Roberts explains that pelvic physical therapy can help through targeted assessments, education, and exercises designed to restore support, reduce discomfort, and improve function. Understanding these signals is key to protecting long term pelvic health.
Book a call with Dr. Kari Roberts today.
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Dr. Kari: Have you ever had pressure around your pelvic area and wondered if it was normal or what it indicates? If so, then stay tuned, because that's our conversation today.
Dr. Kari: Welcome to the Marron Pelvic Health Podcast.
Hi, I'm your host, Dr. Carrie Roberts. On this show, we will be discussing a variety of things regarding your pelvic health. These conversations will be a mix of education,
personal experiences, and a blend of tips you can apply to have a healthier pelvis. The goal of this show is to normalize conversations around pelvic health and help women stop suffering in silence.
Dr. Kari: Today I'm talking all about pelvic pressure and heaviness and what that's telling us. We're going to get into that today and just kind of talk about what your body could be telling you from some of this pressure that you're feeling in your pelvic area.
It could feel like pressure through your ***** or through your urethra or even through your ******. It could even present as, like, lower abdominal pain or lower back pain. And what I'm gonna do is just kind of divide things in half.
So we're gonna talk about the front half, and we're gonna talk about the back half and why,
where it feels matter. So we're gonna talk about where you might feel the pressure first.
So if we're having the pressure in the front,
it usually feels like pressure around or at the bladder and pressure towards the front of our vaginal wall. And some things that can contribute to it is if you're having some sort of bladder issue, you could have an irritation with the bladder.
You could have some in urgency going on. You're trying to squeeze and hold it in. That can cause some front pressure.
Also, other structures can put pressure on those front or those anterior structures, like other things can put pressure on your bladder. So with this, I'm thinking if you have endometriosis or if you have fibroids, depending on where they're located,
other things that can contribute to this pressure that you're feeling or could be why you're feeling pressure in the front is if you are experiencing some pelvic organ prolapse more towards the front.
So it could be a cystocele, which is where the bladder is displaced, or it could be an anterior vaginal wall prolapse.
And also it could also be some GI overlap. So GI can present with symptoms that go towards the front area a little bit.
If you're feeling any of this anterior pelvic pressure,
it's not just a Weakness.
It might be something that has to do with the support or the pressure management in the system.
What does that mean? Well, your pelvic floor is the floor of your core and your,
your diaphragm is the roof of the core and your abdominal muscles and deep back muscles are the front and sides and back of those muscles. So if we're looking at a three dimensional object, it's got a front, a back, a side,
two sides and then a top and a bottom.
So in the middle, between your diaphragm at the top, your pelvic floor at the bottom, the abdominals on the front and sides and the back muscles in the back, you've got your abdomen.
Right. And you've got contents in the abdomen and your diaphragm and your pelvic floor and your voice box fun fact.
All work together to manage the pressure so that nothing goes awry.
So if that pressure system is off,
then it could present where you're having some of this anterior pelvic pain or, excuse me, anterior pelvic pressure.
So that's what that means. I just wanted to kind of explain that just a little bit.
So that's kind of what can be going on. Well, that goes on as a whole. I just want to did a little side to explain what's going what that means to have pelvic, not pelvic goodness, my words today.
Just wanted to do an aside to explain what that means when I'm talking about the pressure issue.
Now, going back to things where you could feel the pressure, we talked about the anterior pressure, but something else that can happen is you can feel pressure on the backside or posterior pressure and that could be pressure in the ****** that could also present like tailbone heaviness or a constant urge to have bowel movement.
And some of these contributing factors are a different type of prolapse where we're thinking more of like a rectocele, which is where the ****** is kind of displaced. We can also have chronic constipation, can give that pressure feelings.
Again, we've got some overlap with some GI concerns. Could give you the back the backside pressure.
Also endometriosis, depending on where it's located,
could be there. And we're thinking low back pain, SI joint dysfunction. Those things can all present with pressure in the posterior area of our pelvis.
Now the key thing I want to point out is if you've got some bowel changes, we're definitely going to want to make sure we're taking a closer look at the hips and the low back, because those are closely related.
Now, just because you have the pelvic pressure, it does not necessarily mean that your pelvic floor muscles are weak.
A lot of times people's pelvic floor muscles can be overactive,
which can contribute to that lack of that core coordination between those core muscles that we talked about earlier.
So it could be from too much tension of the pelvic floor can contribute to this poor coordination.
And like I said before, that pressure, mismanagement, all of those things can be contributing factors and not necessarily just weakness in the pelvic floor.
So we talked about what it is, we talked about where it is. Now let's talk about when,
when you're having the symptoms of pressure does matter. So I just kind of wanted to get into this and this is kind of the meat of the conversation where I titled this.
What is your pelvic floor telling you or what is this pressure telling you? This is what it could be telling you.
So when you feel this pressure, if you're feeling this pressure towards the end of the day or it increases as the day goes on,
that could be a sign of getting some muscle fatigue. So these muscles have been working all day and now they're fatiguing out and now you're feeling the pressure.
Also if you're having those lack of coordination in that core,
that pressure is not managed properly.
Loads cannot maybe be managed as well as we'd like them to be. That's going to present with that end of the day pressure.
That is a sign that those muscular, those muscles and that structure are not necessarily broken, but they could be overwhelmed.
Some muscles might be overworking and some muscles might not be working enough. So you just want to make sure you get a good assessment. So then that way if there is a discoordination going on, then it can be addressed something else.
Another time that people can feel pressure is during or after workouts.
So I talked about that intra abdominal pressure and it's good to understand what the intra abdominal pressure is because if you are not having that pressure managed properly and then you add more pressure onto it, like plyometrics or high intensity interval training or jumping jacks or sneezing or things like that,
then that could contribute to the load not being managed properly, that pressure in the abdomen not being managed property properly.
Also, some people can feel this pressure when they're exercising or after they've exercised because their mechanics might be off. They might be in a habit of holding their breath with all of the hard things or not breathing Properly.
So all of those things could be contributing to why you could have this pressure feeling towards after workouts or during your workouts. Another time that people might feel pressure or heaviness is during their times of the month.
So if you notice when you're different times of your cycle, sometimes it's around the time that you ovulate, sometimes it's around the time that you are menstruating.
But you might notice a pattern. Every time I'm in this spot in the stream of my menstrual monthly cycle, I have this pressure feeling that that could be an indication of, of course, our friends, the hormones, because we cannot ever forget about them.
But also we want to think about things that also feed off the hormones. So again,
we might be considering fibroids, we might be considering endometriosis, and then sometimes our tissues can have inflammation during our menstruation part of the cycle. And that could be contributing factor.
Something else that can be a time when people notice pressure in that lower pelvic area is during your bowel movements.
So if you find that you're straining or if you feel like it's hard to move the bowels, that could be a sign of erectocele, which is a type of prolapse.
That could also be a sign of chronic constipation,
or it could be a sign of your muscles not being coordinated properly when it's time for you to defecate.
And then the last time, the last thing that I want to address is if you feel this pressure all day,
if you feel this pressure all day, then this could be a sign that you have an overactive pelvic floor, meaning that it's working a little bit more than it needs to.
Or you could have your nervous system as a whole could just be more sensitive to things we call that upregulated nervous system.
So then you'd want to do some things to downregulate the nervous system.
And it could be a multifactorial. You could have a little bit of this and a little bit of that, and you could have things that are layered on top of each other.
So that's what our body could be telling us.
So just as a quick review,
it's not normal to have pain or pressure or heaviness or that dragging feeling in our pelvic area. It's not normal. And it usually can tell us something.
And the way that we understand what it's trying to tell us is we have to think is the pressure towards the front,
is the pressure towards the back.
And what time of day or with what activity do you feel the pressure? And when you're able to answer those questions, then you're able to get an idea of where that pressure is coming from.
And then that can drive your treatment. Now of all of this, you're like, okay, I feel the pressure, but I need someone to help me. Cause I don't know,
that's when you wanna call a pelvic floor physical therapist. And if you're in the Atlanta area, definitely check me out because I would love to help you manage the heaviness.
I love to be able to do assessments on patients and see what's going on and put those puzzle pieces together. So I just wanted to put that out there. If this is something that you wanna have more of a conversation on,
don't hesitate to reach out or get on my schedule. I would love to help you.
That's it for our conversation today, and I will be back next week with another episode.
Thank you for listening to this episode
Dr. Kari: of the Marron Pelvic Health Podcast.
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