Understanding & Releasing Pelvic Floor Tension

Recognizing Tension in the Body

You hunch your shoulders without realizing, clenching up throughout the day until you finally stretch, roll, or relax them and think, Oh wow—I didn’t even realize how tight I was. That kind of release feels like a sigh of relief, like letting go you didn’t know you needed.

Now, imagine that same kind of tension and release—but in your pelvic floor.

Just like your shoulders, your pelvic floor is a group of muscles that can hold onto stress, trauma, grief, or even daily life wear and tear. These muscles work behind the scenes to support your organs, enable pleasurable sex, and allow for bowel and bladder control. But unlike your shoulders, most women don’t even realize their pelvic floor exists—let alone that it might be clenched tight like a fist. 

When the pelvic floor is tight, it can contribute to a wide range of problems, including pelvic pain, constipation, and urinary leakage. Pelvic floor tension may also lead to dyspareunia (painful intercourse) and difficulty achieving orgasm.

Why the Pelvic Floor Deserves Attention

You may not realize it, but your pelvic floor could be holding onto tension you’ve never thought to release. Studies have shown that women subconsciously tighten their pelvic floor muscles when watching a horror movie, experiencing stress, or living in chronic pain. Often people carry tension in their neck, jaw, or low back —but for many women, it’s the pelvis that holds the weight of the world. If you’ve ever gone for a massage and discovered that your shoulders or glutes were “hard as a rock,” you know that tight muscles don’t just hurt—they just don’t function well. The same is true here.

Even if you’ve never experienced tearing during childbirth, and even if your sex life seems “fine,” chances are your pelvic floor could benefit from some intentional care and release. In fact, in all my years working with women, I’ve only ever evaluated one who didn’t need some type of pelvic floor treatment. Just one. That’s how common this is.

Life itself tightens us—grief, new workouts, pregnancies, anxiety, performance pressure, aging. It’s no wonder this part of the body often goes ignored, until something starts to hurt or feel disconnected. But ignoring it doesn’t make it go away. Giving it attention can make a difference in your overall health and enjoyment.

The Impact of Pelvic Physical Therapy

After completing the first session of pelvic physical therapy, I often hear women say something similar to this: “It feels like I’ve had a massage to my pelvic floor. I didn’t even realize I was tight, but now I feel a marked difference and a lightness down there. I’m grateful to know how to release my pelvic floor, I feel so empowered!” Many women have told me they didn’t even realize how much pain or tightness they were living with—until they felt what it was like to let it go.

After just one session, they describe feeling lighter, more open, and more connected to their bodies than they had in years. In my professional opinion, every woman should see a pelvic physical therapist for an evaluation.

View this as part of your healthcare. You probably already see a doctor, a dentist and an optometrist for yearly check-ups. Why dismiss a pelvic floor check-up? It’s critical to the optimization of your bladder, bowel and sexual function, which are important parts of everyday life. This shouldn’t be confused with your yearly pelvic exam by your healthcare practitioner. Keep that up and simply add a pelvic floor assessment by a pelvic floor specialist.

Discover more in my upcoming second book, True Intimacy: Embracing a Woman’s Sexuality, available October 14, 2025, on Amazon.

Download the introductory chapter here!

Heather Marra, PT, has more than 25 years of experience specializing in pelvic physical therapy, She offers in home visits in and around Lexington, Kentucky and virtual support for women worldwide navigating pregnancy and postpartum recovery, the menopause transition, and sexual health/intimacy issues.