Editor’s Note: This story is Part 1 of a 2-part series on pelvic health. Part 2 covers pelvic health for men.

Pelvic health is important in daily life, so when things go wrong, it can have a big impact. But physical and occupational therapy can help.

Bobbi Franco, a physical therapist with UCHealth SportsMed Clinic, outlines what women need to know about pelvic health below.

The pelvic floor defined: The pelvic floor is a collection of muscles that create a sling or hammock at the base of the pelvis.

“The muscles run from the pubic bone to the tail bone, and side to side between the sitz bones,” Franco said. “They function to help us hold and release urine and feces, provide a very important sexual function and are also an important part of our deep core muscles.”

Common symptoms: Issues such as urinary or fecal incontinence, frequency and urgency, as well as pain with going to the bathroom or having sex, and even chronic low back or hip pain can all signal pelvic health issues.

While issues can crop up any time, they are especially common during pregnancy, childbirth and after giving birth.

“I see a lot of older women who wish they had had this service when they were pregnant or early postpartum, and have been having incontinence since they had their kid twenty or even fifty years ago,” Franco said.

Another culprit is sitting at a desk all day, which can cause dysfunction in deep core muscles. And don’t underestimate the impact of stress.

“Stress and anxiety are actually some of the biggest causes I see, especially for urinary urgency,” Franco said. “Just like we get a lot of tension in our neck and shoulders when we’re stressed out, we can get the same thing in our pelvic floor.”

When to seek help: Franco encourages people to talk with their primary care provider about symptoms, and not to hesitate to ask about a referral for physical or occupational therapy.

“I tend to be the last stop for a lot of people, and I hear a lot of, ‘I wish I had done this earlier,'” Franco said.

Pregnant women don’t have to wait until after giving birth to receive treatment. “We can start training muscles how to contract and relax or stretch, do coaching on how to push and positions of labor, and work on pain management strategies,” Franco said.

What happens with treatment: In an initial appointment, Franco asks lots of questions, tests muscle strength and does further examinations as needed. “I think there’s a misconception that we have to do internal work, but that’s never something you have to do,” Franco said.

Patients return for visits as needed and work on exercises at home.

“My goal is always to incorporate pelvic floor exercises and activities into your daily life and existing activities – how you’re lifting, walking, doing stairs,” Franco said. “We do those things a hundred times a day and we don’t want to do them wrong a hundred times a day. And it’s a lot easier to get home exercises in when it’s something we’re already doing.”

Some issues, such as urinary urgency and frequency, can often be treated within a week or two.

Healthy habits: Franco recommends supporting good pelvic health with healthy habits, such as only urinating when you have to. Using the bathroom whenever you leave the house, regardless of whether you need to, may train your bladder to signal that it’s full earlier and earlier.

Pelvic floor contractions, or Kegels, can help strengthen the pelvic floor muscles, while deep belly breathing and yoga positions such as happy baby and child’s pose can help stretch them. “Like any other muscle group, as we strengthen, we want to also lengthen and stretch,” Franco said. “A tight, strong muscle doesn’t function as well.”

Franco encourages women to reach out to their health care provider with questions and concerns.

“A lot of it is just getting information to people, and then they can use it and regain control of their lives,” Franco said.

Susan Cunningham writes for UCHealth Yampa Valley Medical Center. She can be reached at cunninghamsbc@gmail.com.