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It's So Much More Than The Pelvic Floor

Updated: Aug 29, 2022

Pelvic floor physical therapy is named after the group of muscles that create the pelvic floor. These muscles are responsible for:

  1. Supporting the organs in the body

  2. Sphincter function

  3. Sexual function

As well as supporting the core to maintain and manage pressure systems, which assist in gastrointestinal function and lymphatic and venous flow to the heart.

The pelvic floor is a very important structure in our body, but it doesn't work alone.

Like anything else in the human body, the pelvic floor is connected and influenced by many other structures. Very rarely is any injury in the human body specific to just one system, and the pelvic floor is no exception.

I have broken down how the pelvic floor is influenced by other systems, and my reasoning behind working with other systems to restore the function of the pelvic floor.

The Abdominal Wall

The abdominal wall, or more specifically the deepest layer of abdominals is an important part of the core system, and works together with the pelvic floor, low back muscles, and diaphragm to manage pressure and forces through the core.

When the abdominal wall is dysfunctional, turned "off" or overstretched from pregnancy, the pelvic floor can present as problematic. This can show up through pee leaks, prolapse, and even pelvic pain at times.

The Pelvis

The pelvic floor is influenced by the bony position of the pelvis. The muscles of the pelvic floor attach to ares of the pelvis such as the pubic bone, tailbone and sacrum.

The position of the pelvis in the body and place certain aspects of the pelvic floor on stretch or in a shortened position, which can cause dysfunction.

Looking at the bony alignment of the pelvis is important for treatment. Sometimes I find this is the cause of half of the pelvic floor being tight and painful, while the other half is fine.

The Hips

Some muscles that are related to the pelvic floor also perform rotational aspects for the hips. Issues with hip strength and range of motion can contribute to pelvic floor issues.

The large muscles of the hips, such as the glute muscles, need to be able to stabilize the pelvis and absorb impact. Without this support, prolapse, pee leaks, and pelvic pain can arise, especially in athletes.

The Shoulders

The upper (thoracic) spine and the shoulders also play a role in pelvic floor function. Without symmetrical rotation and strength in the shoulders, it's difficult to have symmetrical rotation and strength in the pelvis.

Shoulder issues can drive hip muscle and pelvic bony alignment issues, and therefore influence the pelvic floor.

Also, when the shoulders are tight and lack mobility, they often lift the ribcage up, overstretching the abdominal wall and increased stress through the low back.

This can stress the pelvic floor, as the abdominal wall plays a key factor in supporting pelvic health.

The Head and Neck

Head position and posture can affect the shoulders, which affect the abdominal wall and pressure system, which affects the pelvic floor!

Teeth grinding, jaw clenching, and temporomandibular joint issues also have a relationship to the pelvic floor, especially regarding stress response.

Investigating head and neck issues when treating pelvic floor dysfunction is well indicated and can be very helpful in finding the "why" behind pelvic floor dysfunction.

The Foot and Ankle

Foot issues are very frequently related to hip and knee issues, which we know impact the pelvic floor.

Your footfall pattern can be the result of dysfunction in the pelvis, or can be the cause of dysfunction in the pelvis.

The ankle and hip are two very mobile joints in the body. They can use their mobility to compensate for dysfunction elsewhere, but not without consequences overtime.

The bladder is also influenced by the by the Tibial Nerve, which extends down in to the ankle!


Pelvic floor physical therapy is so much more than the pelvic floor. Looking at the entire system is important, as everything is connected!

The pelvis is the crossroads of the body. All forces in the body will travel through the core system into the pelvis.

In fact, pelvic floor disorders can be the final breakdown in a longstanding chain of dysfunctional issues in the body.

That said, pelvic floor issues are really hard to live with, so make sure you get in for physical therapy today!

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