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When most people hear "pelvic floor," they often think Kegels. And when they hear “core,” they picture six-pack abs. But as a pelvic health physical therapist, I can tell you it’s way deeper than that, literally and figuratively. One of the most common things I hear from clients is: “I had no idea the pelvic floor was part of my core.” And honestly, I get it. Most of us grew up doing crunches in gym class, not learning how to breathe or engage our pelvic floor. But let’s change that.
So what is the core, really?
Your core is more than just your abdominal muscles. Think of it as a pressure system (kind of like a canister) with four walls working together:
- Top: Your diaphragm - more to come on this connection in another blog post
- Bottom: Your pelvic floor
- Front & Sides: Deep abdominal muscles, like the transverse abdominis
- Back: Multifidus and deep spinal muscles
These muscles coordinate to support your spine and pelvis, stabilize your body during movement, and manage pressure when you breathe, lift, cough, laugh, or sneeze.
The pelvic floor's role in this system
Your pelvic floor muscles sit like a hammock at the base of your pelvis. They support your pelvic organs (bladder, uterus, rectum), help control bladder and bowel function, contribute to sexual function, and yes—support your core.
When the core works well, the pelvic floor is part of the team. But when that system is out of sync—say, you're constantly clenching your abs, holding your breath during exercise, or never fully relaxing your pelvic floor—it can lead to problems, such as:
- Leaking urine with running, jumping, or sneezing
- Pelvic heaviness or pressure
- Back pain
- Core weakness or that “disconnected” feeling postpartum
Feeling the connection
Here’s a super simple way to feel the connection:
1. Sit or lie down comfortably.
2. Take a slow inhale through your nose. Notice how your belly expands and your pelvic floor lowers or softens a little.
3. Exhale gently through your mouth. Your deep abs gently draw in, and your pelvic floor lifts.
That’s the magic. They move together, like a dance. Breathing is the foundation of core and pelvic floor coordination.
If you're into Pilates, running, yoga, CrossFit, or anything that challenges your core, understanding this connection can be a game changer. It’s not about bracing harder or squeezing tighter. Rather it’s about timing, coordination, and smart engagement.
A well-functioning core includes a responsive pelvic floor. If you’re leaking with workouts, feeling pressure in your pelvis, or just sensing something isn’t quite right—it’s not just “part of being a woman” or “what happens after kids.” It’s a signal. And help is out there.
What you can do
- Start with breath. Reconnect to your diaphragm and pelvic floor.
- Focus on coordination, not just strength.
- If something feels off, see a pelvic floor physical therapist (like me!).
We don’t just treat “leaks” in pelvic floor PT. We look at the whole system, from head to toe, and from breath to bone.
Your core isn’t just your abs. And your pelvic floor isn’t just for Kegels. They are part of a beautifully interconnected system that supports your movement, health, and confidence. So next time you hear someone say “engage your core,” I hope you think deeper. Down to the pelvic floor.
Want help figuring this out in your own body? Pelvic floor physical therapy can help you move, breathe, and feel better from the inside out. If you live in the Atlanta area, please contact us to schedule a consultation.
Disclaimer: The views expressed in this post are based on the opinion of the author, unless otherwise noted, and should not be taken as personal medical advice. The information provided is intended to help readers make their own informed health and wellness decisions.
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