UTI Symptoms and Your Pelvic Floor

UTIs and Recurrent UTI Symptoms

Approximately 60% of women will experience an acute UTI during their lifetime, and 25% to

50% of women will experience recurrent episodes.  Antibiotics are the gold standard for

treatment with a positive culture.  But oftentimes, especially with chronic UTIs, the pelvic floor muscles are overlooked as contributing to the lingering symptoms.  This is especially common when cultures continue to come back negative, but the pain is still there.

How the Pelvic Floor Can Contribute to UTI-Like Symptoms

The pelvic floor muscles span the bottom of the pelvis, helping to support the bladder (and

other organs) sitting on top.  Because of this close-knit relationship, the pelvic floor muscles can refer pain and urgency symptoms to the bladder.  This is similar to the concept of having a “knot” in your shoulder or neck muscles, and having the pain radiate into your head or arm. The same thing happens to the pelvic floor muscles, occurring when the muscles are too tight, and is also known as pelvic floor hypertension.

Why Pelvic Floor Muscles Become Tight

There are various reasons why the pelvic floor muscles can become tight – overworked,

childbirth, stress, trauma.  But they can also become tight because of pain.  UTIs can be

extremely painful, causing the surrounding pelvic floor muscles (and sometimes abdominals) to reflexively tense and guard to “protect” the painful area.  

When Pelvic Floor Tension Mimics a UTI

With chronic UTIs, the pelvic floor muscles maintain this tension.  With too much tension, they can begin to refer pain into the bladder or urethra mimicking the signs of a UTI (general

pelvic/abdominal pain, pressure, heaviness, urinary urgency) in the absence of an active

infection.  

How Pelvic Floor Physical Therapy Can Help

An internal evaluation and gentle palpation of the pelvic floor muscles can help identify when reproducing familiar symptoms is connected to muscle tension. Treatment may include hands-on manual therapy and soft tissue techniques to release areas of tightness and reduce sensitivity in the pelvic floor muscles. Treatment may also address the surrounding muscles of the abdomen, hips, and pelvis, depending on what is contributing to the symptoms.

The goal is to not only treat the muscles, but to understand why they have become tense in the first place and help restore more comfortable, coordinated pelvic floor function. For some women, addressing pelvic floor tension can be an important part of reducing persistent UTI-like symptoms when there is no longer an active infection.