3 Causes of Pelvic Floor Symptoms, OUTSIDE of the Pelvis
If you’ve been told your pelvic floor is ‘tight’ or ‘weak,’ it’s easy to assume the solution lives entirely inside the pelvis. But the body doesn’t work that way. I want to shed light on how the pelvic floor really works, which is in a system. That’s right - your bladder leakage, pelvic pain, pressure/heaviness, and constipation are not isolated symptoms and are not always caused by a problem with the pelvic floor muscles. You must ask yourself, why are my pelvic floor muscles not functioning properly in the first place?
The Pelvic Floor is Part of a System
Pelvic floor dysfunction is often not the root cause, but the result of something else. The pelvic floor is part of a larger system of structures that help to manage pressure in the body. These muscle must work in conjunction with your diaphragm, ribcage, hips, foot and ankle. They respond to how well this system absorb and distribute force for walking, running, lifting, jumping, etc. When other areas of the body aren’t doing their job, due to a lack of mobility and/or strength, the pelvic floor compensates. When this occurs, we develop “pelvic floor dysfunction” and symptoms related to urinary function, bowel function, sexual function, and/or pelvic pain. Of course, our nervous system communicates to all of these structures and can play a huge role as well, particularly for those with a history of trauma.
Foot & Ankle
The foot and ankle are so important for functional mobility. As we move through the gait (walking) cycle, the foot and ankle has many jobs to do that require both mobility and stability. It takes on the load of our body weight and propels us while absorbing force from contacting the ground. How well it’s able to do these things affects how the leg moves and consequently how the pelvic floor muscles respond as well.
Stiffness throughout the foot and ankle joints will not allow for for absorption, which will alter your gait pattern and lead to pelvic floor compensation. This is often why people will experience leakage or pelvic heaviness/pressure with walking or running.
Hips
Your hips directly influence pelvic position and muscle tension at the pelvic floor. Hip rotation (both internal and external) will cause your pelvic floor muscles to either me lax or taught and supportive, much like a trampoline that can descend as well as ascend and support what’s on top of it.
When we lack range of motion at the hip, the muscles cannot produce their usual force. This means they are seemingly weak and unable to do things such as clamp off the urethra to keep you continent. When the hip muscles are at a mechanical disadvantage to produce force, they get weak and underutilized. This often results in the pelvic floor compensating for stability and can lead to pelvic pain from overactivity.
Ribcage & Breathing
Think of your body like a can of soda. When the can is closed and stiff, pressure builds up inside. If you shake it and then try to open it, the pressure has nowhere to go—so it explodes out the weakest spot. Your body works the same way.
Your diaphragm lies within the ribcage and is the primary muscle for breathing. When you breathe well and your rib cage can move, pressure spreads out evenly, just like gently opening the soda so it doesn’t spray everywhere. A stiff ribcage or shallow breathing increases downward pressure on the pelvic floor which can lead to symptoms of heaviness/pressure associated with prolapse, hemorrhoids, and bladder leakage.
Why Internal-Only Treatment Falls Short
If we don’t change how pressure is created, transferred, and absorbed in your body, the pelvic floor is stuck compensating. Internal work can be very helpful, but it’s rarely sufficient alone in treating pelvic floor dysfunction. Treating symptoms without addressing the underlying cause of the pelvic floor dysfunction leads to temporary relief. Sustainable change requires addressing the why.
What comprehensive Pelvic Floor Therapy looks like:
Full-body assessment
Evaluating movement patterns, posture, breathing
Individualized treatment—not one-size-fits-all
Internal work used thoughtfully and intentionally, when appropriate.
Resolve Your Pelvic Floor Symptoms
If you’ve tried pelvic floor therapy before and felt like something was missing—or if you’ve been piecemealing together TikTok videos and online exercise programs, this is your sign to try a better approach. You deserve care that looks at your whole body, not just one piece of it.
✨If you’ve been struggling with any symptoms of pelvic floor dysfunction, I’d love for you to consider working with us and getting you relief. We have both in-person and virtual options available, for your convenience.
