Pelvic Floor Dysfunction Is More Common Than You Think — and More Treatable Than You've Been Told
Pelvic floor dysfunction affects an estimated one in three women and a significant but underreported percentage of men. Despite its prevalence, it remains one of the most consistently misdiagnosed, undertreated, and poorly understood conditions in musculoskeletal and primary care medicine.
Patients with pelvic floor dysfunction frequently spend years cycling through providers — gynecologists, urologists, gastroenterologists, primary care physicians — without receiving a musculoskeletal evaluation of the pelvic floor itself.
The result is a pattern that will be familiar to many patients reading this: symptoms that are dismissed as normal, attributed to stress, or treated with generic protocols that provide temporary relief without addressing the underlying cause. Patients are told to do Kegel exercises. They are told the symptoms will improve with time. They are told this is just something they have to manage.
In most cases, that is not accurate. Pelvic floor dysfunction has identifiable musculoskeletal drivers and effective treatment — when it is properly evaluated by a provider with the training and clinical tools to address it.
At Bray Chiropractic & Wellness in Glastonbury, Dr. Bray is one of the few providers in Connecticut offering evidence-based pelvic floor rehabilitation for both men and women — integrated with chiropractic care, soft tissue therapy, and rehabilitative exercise into a comprehensive clinical model.
What Is the Pelvic Floor?
The pelvic floor is a group of muscles, ligaments, fascia, and connective tissues that form the base of the pelvis. These structures support the bladder, bowel, uterus, and prostate, contribute to core stability and spinal load transfer, regulate intra-abdominal pressure, and play a central role in bladder and bowel control, sexual function, and movement.
The pelvic floor does not function in isolation. It works in coordination with the diaphragm, transverse abdominis, and multifidus as part of the deep core system — and it has direct functional connections to the lumbar spine, sacroiliac joints, hips, and surrounding soft tissues. When the pelvic floor is dysfunctional, the effects extend well beyond the pelvis — and dysfunction elsewhere in the lumbopelvic system frequently affects pelvic floor function in return.
What Is Pelvic Floor Dysfunction?
Pelvic floor dysfunction is a broad term that encompasses a range of conditions resulting from impaired pelvic floor function. Contrary to what many patients are told, pelvic floor dysfunction is not simply a matter of a weak pelvic floor that needs more Kegel exercises. In fact, the most common presentation of pelvic floor dysfunction is hypertonicity — excessive tension — not weakness.
The three primary categories of pelvic floor dysfunction are:
Pelvic floor hypertonicity
Excessive tension in the pelvic floor muscles — the most common presentation and the primary driver of the majority of pelvic pain, dyspareunia, urinary urgency, and tailbone pain presentations seen at this practice.
A hypertonic pelvic floor cannot relax appropriately, cannot coordinate with the rest of the deep core system, and produces pain and dysfunction through sustained muscular tension and trigger point activity. Prescribing Kegel exercises to a hypertonic pelvic floor is not just unhelpful — it is counterproductive.
Pelvic floor hypotonicity and weakness
Insufficient strength and neuromuscular activation of the pelvic floor — contributing to stress urinary incontinence, pelvic organ prolapse symptoms, and core instability. More common postpartum and in older patients. Responds to progressive pelvic floor strengthening and neuromuscular retraining when properly prescribed.
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Pelvic floor coordination dysfunction
A category that encompasses impaired timing, sequencing, and coordination of pelvic floor activation — without necessarily being primarily hypertonic or hypotonic. Produces symptoms through poor load management and inefficient neuromuscular patterning rather than simple strength or tension issues.
Common Pelvic Floor Dysfunction Conditions Treated
Pelvic floor hypertonicity and overactivity
The most common presentation — excessive resting tension in the pelvic floor muscles producing pain, urgency, and dysfunction across multiple symptom categories.
Dyspareunia — painful intercourse
Pain with intercourse is one of the most common and most undertreated consequences of pelvic floor hypertonicity. It is not normal, it is not inevitable, and it is not something that should be managed with avoidance. Pelvic floor rehabilitation for dyspareunia produces significant improvement in the majority of patients when the musculoskeletal drivers are properly addressed. Learn more about Pelvic Floor Therapy.
Urinary urgency and frequency
The persistent sensation of needing to urinate — often without a bladder infection or structural cause — is a common manifestation of pelvic floor hypertonicity and bladder hypersensitivity. Pelvic floor rehabilitation addressing the muscular and neuromuscular contributors to urgency is highly effective for this presentation. Learn more about Urinary Urgency & Frequency.
Tailbone pain — coccydynia
Pain at the tailbone is frequently driven by pelvic floor tension and trigger point activity in the muscles that attach to the coccyx. It is often worsened by sitting and relieved by standing — and responds well to pelvic floor treatment when the muscular contribution is identified. Learn more about Tailbone Pain.
Stress urinary incontinence
Leaking with coughing, sneezing, laughing, jumping, or exercise — driven by insufficient pelvic floor support during increases in intra-abdominal pressure. Responds to progressive pelvic floor strengthening and load management strategies.
Urge urinary incontinence
Leaking associated with a strong, sudden urge to urinate — driven by a combination of bladder hypersensitivity and pelvic floor dysfunction. Requires a different treatment approach than stress incontinence.
Constipation-related pelvic floor dysfunction
Pelvic floor hypertonicity is one of the most commonly overlooked contributors to chronic constipation — producing a failure of the pelvic floor to relax appropriately during defecation. Addressing the pelvic floor contribution to constipation — alongside nutritional strategies through Clinical Nutrition — is often the missing piece for patients who have struggled with chronic constipation without resolution.
Postpartum core dysfunction and diastasis recti
Pelvic floor dysfunction is almost universally present following pregnancy and delivery — and it is frequently undertreated in the postpartum period. Learn more about Postpartum Pelvic Floor Care.
Pudendal neuralgia
Nerve pain in the pelvic region driven by irritation or entrapment of the pudendal nerve — frequently associated with pelvic floor hypertonicity. Learn more about Pudendal Neuralgia.
Male pelvic floor dysfunction
Pelvic floor dysfunction in men — including chronic pelvic pain syndrome, urinary urgency, and post-surgical pelvic dysfunction — is significantly underdiagnosed and undertreated. Learn more about Pelvic Floor Care for Men.
How Pelvic Floor Dysfunction Is Evaluated at This Practice
Assessment of pelvic floor dysfunction at Bray Chiropractic & Wellness includes:
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Detailed health history — symptom onset, character, distribution, aggravating and relieving factors, obstetric and surgical history, prior medical and musculoskeletal evaluation
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Full lumbopelvic musculoskeletal assessment — lumbar spine, sacroiliac joints, and hips
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External pelvic floor assessment — tone, tenderness, trigger point activity, and neuromuscular function of the accessible pelvic floor and surrounding musculature
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Internal pelvic floor assessment when clinically appropriate and with full informed consent
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Neurological screening — assessing pudendal nerve and lumbar nerve root contributions
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Functional assessment — identifying activities and positions that provoke or relieve symptoms
First pelvic floor visits are scheduled for 60 to 90 minutes to allow adequate time for a thorough evaluation.
How Pelvic Floor Dysfunction Is Treated at This Practice
Treatment for pelvic floor dysfunction at Bray Chiropractic & Wellness is individualized based on assessment findings and may include:
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Pelvic floor manual therapy — external and internal soft tissue treatment targeting hypertonicity, trigger points, and tissue restrictions
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Chiropractic manipulation and mobilization of the lumbar spine, sacroiliac joints, and hips
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Dry needling for pelvic floor and surrounding musculature trigger points
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Neuromuscular retraining — pelvic floor relaxation, coordination, and progressive strengthening based on specific assessment findings
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Rehabilitative exercise targeting the deep core system, hip musculature, and lumbopelvic stability
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Clinical nutrition guidance when gut health, inflammation, or dietary factors are contributing to pelvic floor symptoms
Pelvic Floor Dysfunction Treatment in Glastonbury, CT
Patients with pelvic floor dysfunction in Glastonbury, South Glastonbury, Hebron, Marlborough, East Hartford, Manchester, and the surrounding Hartford County area will find specialist-level, evidence-based pelvic floor care at Bray Chiropractic & Wellness — for both men and women — that addresses the full clinical picture rather than managing symptoms in isolation.
No referral is required. New patients can schedule directly online or by calling or texting (203) 303-4760. Bray Chiropractic & Wellness is in-network with Aetna, Anthem BCBS, Cigna (ASH), and CT Medicaid (Husky). Self-pay and HSA/FSA options are also available.