Pelvic Floor Problems? Too tight or too loose? The pelvic floor muscles span the bottom of the pelvis and support the pelvic organs (bladder, bowel, and uterus in women). To keep it healthy, it needs to be balanced—neither too tight (hypertonic) nor too weak (hypotonic). But how do you tell the difference? A weak pelvic floor may cause urine incontinence or a heavy feeling, while an overly tight one can lead to pelvic pain or trouble relaxing, it’s more noticeable. Since symptoms can overlap, wo