What Is The Pelvic Floor?

Introduction

If you've ever heard an instructor tell you to "engage your pelvic floor" and wondered what that actually means, you're not alone. Despite becoming a buzzword in fitness and women's health circles, the pelvic floor remains one of the most misunderstood muscle groups in the body. In this article, we'll explore what the pelvic floor is, what it does, how it relates to your core and breathing mechanics, and why understanding it can improve the way you move, exercise, and feel in your body.

What is the pelvic floor?

The term ‘pelvic floor’ refers to the group of muscles that sit inside the bowl of your pelvis. Just like you have muscles that support your shoulder, your pelvis is supported by layers of muscle tissue that can contract, relax, create, and control movement. When functioning properly, these muscles work involuntarily, reflexively working and coordinating with the rest of your core. You also have voluntary control of them, such as when you stop the flow of urine. 

Although the pelvic floor is often discussed in the context of pregnancy and postpartum recovery, everyone has a pelvic floor. Men, women, athletes, children, young adults, and older adults all rely on these muscles every day.

Part of the reason the pelvic floor can feel mysterious is that we rarely receive any education about it. Most people can point to their biceps or quadriceps and describe what those muscles do, but few of us grow up learning about the pelvic floor. As a result, many people don't think about their pelvic floor until symptoms such as leaking, pain, heaviness, or discomfort begin to appear.

The good news is that the pelvic floor isn't a separate or isolated system. It is deeply connected to the way we breathe, move, exercise, and stabilize our bodies. Understanding how it functions is the first step toward better movement, improved body awareness, and a healthier relationship with exercise.

Understanding the anatomy of the pelvic floor

The pelvis is a complex structure formed by a set of paired hip bones, the sacrum and the coccyx. Your two pelvic bones connect at the pubic symphysis in the front, and your pelvis and sacrum connect at the sacroiliac joint in the back. Our pelvis is what connects our lower extremities to our spine, providing an attachment site for dozens of muscles and supporting several organ systems, including the urinary, reproductive, and digestive tracts. Because the pelvis acts as the bridge between the spine and lower body, changes in pelvic floor function can sometimes show up as symptoms elsewhere, including the hips, tailbone, or low back. 

The pelvic floor is often described as a hammock or sling of muscles spanning the bottom of the pelvis. In reality, it is made up of multiple layers that each play slightly different roles. Some muscles contribute to bowel and bladder control, while others provide support for the pelvic organs and help manage pressure within the trunk.

The pelvic floor also works closely with surrounding muscles of the hips and pelvis, including the piriformis and obturator internus (both hip external rotators). This interconnected system helps explain why pelvic floor function can influence everything from continence and core control to hip and low back comfort.

What does the pelvic floor actually do?

1. Support

The pelvic floor acts like a muscular hammock at the bottom of the pelvis, helping support the bladder, rectum, uterus, and other abdominal organs. When these muscles are functioning well, they provide a stable foundation that helps keep these structures in their optimal position throughout daily activities.

2. Continence (Sphincter Function)

The pelvic floor helps control bowel and bladder function through specialized muscles that surround the urethra and anus. These muscles contract and relax automatically throughout the day, allowing you to maintain continence and appropriately empty your bladder and bowels when needed.

3. Sexual Function

The pelvic floor plays an important role in sexual health and function. These muscles contribute to arousal, sensation, and orgasm, while also allowing for comfortable penetration and movement. Both excessive tension and weakness within the pelvic floor can influence sexual function.

4. Stability and Core Support

The pelvic floor is one component of the body's deep core system, working alongside the diaphragm, abdominal muscles, and muscles of the back. Together, these structures help manage pressure within the trunk, support the spine, and provide stability during movement, exercise, lifting, and everyday activities.

5. Circulation ("Sump Pump")

Like the muscles in your calves, the pelvic floor helps move blood and fluid through the pelvis. As these muscles contract and relax, they assist circulation and help return blood back toward the heart. This pumping action is one of the lesser-known but important functions of the pelvic floor.

Common signs of pelvic floor dysfunction

Like any other muscle group in the body, the pelvic floor can develop problems related to strength, mobility, coordination, or timing. Contrary to popular belief, pelvic floor dysfunction is not always a matter of weakness, and Kegels are often not the solution. In many cases, the muscles may be hyperactive, working too hard, or struggling to coordinate effectively with the rest of the body.

When the pelvic floor is not functioning optimally, symptoms can show up in a variety of ways, including:

• Leaking urine during exercise, coughing, sneezing, or lifting

• A frequent or urgent need to urinate

• Pelvic heaviness or pressure

• Pain in the pelvis, tailbone, hips, or low back

• Discomfort with intimacy or sexual activity

• Difficulty fully relaxing or coordinating the pelvic floor during movement

Because the pelvic floor works closely with the hips, spine, diaphragm, and abdominal muscles, symptoms are not always isolated to the pelvis itself. Sometimes a lingering hip or back issue may have a pelvic floor component, while other times stress, breathing patterns, movement habits, pregnancy, or previous injuries can influence how the pelvic floor functions.

This is one reason why an effective treatment approach to pelvic floor dysfunction looks beyond the pelvic floor alone and addresses the beliefs we carry about pain, stress, sexuality, and our relationship with exercise.

The diaphragm and pelvic floor: how they work together

Our pelvic floor is not a system that works in isolation. It is part of a larger system that includes the diaphragm, abdominal muscles, and the muscles of the back and hips. Together, this system helps create stability to support movement and manage pressure that naturally occurs in our daily lives. 

The diaphragm is our primary muscle of breathing. It sits beneath the ribcage and has a close relationship with the pelvic floor. Think of the diaphragm and the pelvic floor as a piston system, working together with every breath.

As you inhale, the diaphragm gently lowers, and the pelvic floor lengthens to accommodate the natural pressure changes that occur within the abdomen. As you exhale, the diaphragm rises, and the pelvic floor recoils back to its resting position. This coordinated movement happens automatically thousands of times per day.

When this system is working well, the body is able to efficiently respond to the demands of daily life and activity, whether that's lifting groceries, exercising, laughing, coughing, or picking up a child. When breathing patterns, movement habits, or muscle coordination become disrupted, the pelvic floor may struggle to keep up with those demands. For some people, this may contribute to symptoms such as leaking, pelvic heaviness, or discomfort.

This relationship between breath, core function, and movement is one reason Pilates can be such a valuable tool. By emphasizing breath awareness, control, and coordination, Pilates helps us reconnect with the body's natural movement strategies rather than simply focusing on isolated muscle contractions.

Why Pilates can support pelvic floor health

Unlike many exercise approaches that focus primarily on intensity or repetition, Pilates encourages awareness of alignment, breathing patterns, coordination, and control. The importance of breathwork and the breath-to-movement nature of Pilates allows our diaphragm and pelvic floor to work together in an optimal way. For individuals experiencing pelvic floor symptoms, this emphasis on quality of movement can provide an opportunity to reconnect with the body's natural support systems. 

Rather than thinking about the pelvic floor as a muscle that simply needs to be strengthened, Pilates encourages us to consider how the entire system works together. Learning to coordinate breath with movement can help improve the body's ability to manage pressure during everyday activities and exercise alike, whether that’s doing core work, lifting heavy weights or laughing with the girls without leaking.

This emphasis on quality of movement, body awareness, and coordination is one reason Pilates can be such a valuable complement to pelvic floor health and overall movement wellness.

If you're interested in learning more about pressure management, breathing mechanics, and the deep core system, stay tuned for an upcoming article dedicated entirely to this topic. If you're experiencing any of the symptoms described above or want to explore what a Pilates practice designed around your specific needs could look like, I'd love to connect. Learn more about working with me at Coastal Form Pilates in San Diego.