There Is More To Pelvic Floor Symptoms Than Just the Pelvic Floor
If you’re leaking, feeling pressure, or sensing that something just isn’t right "down there," it makes total sense to think your pelvic floor is the problem. After all, that’s where the symptoms are.
But here’s the thing: just because the symptoms show up in the pelvic floor doesn’t mean that’s where the dysfunction starts.
In fact, in my practice, I’ve seen over and over again that the pelvic floor is often the messenger, not the mastermind. Let’s talk about why that matters (and why a more global approach can get you better results).
Your Pelvic Floor Doesn’t Work Alone. Think of your pelvic floor as part of a pressure system. It coordinates with your diaphragm, your abdominals, your rib cage, your spine, and even your cranial nerves. It’s team-based.
If the diaphragm isn’t moving well (maybe you’re stuck in an apical breathing pattern or dealing with a narrow infrasternal angle), then pressure can’t be regulated properly. The pelvic floor picks up the slack—and sometimes, it just can’t keep up.
When Symptoms Show Up 'Down There,' Look Up Here are a few upstream contributors I often assess when someone presents with pelvic floor symptoms:
Diaphragmatic breathing coordination
Rib mobility and thoracic rotation
Abdominal tension or pressure strategies (hello, bearing down)
Cranial nerve dysfunction (especially vagus and facial)
Lymphatic congestion
Visual or vestibular imbalances
Addressing these pieces can create space for the pelvic floor to start behaving better without hammering away at it with kegels and clamshells.
The Nervous System Runs the Show. You could have the strongest pelvic floor in the world, but if your nervous system is in a state of protection (sympathetic dominance), your pelvic floor is likely holding tension or guarding. That’s why down-training strategies like breathing, vagal nerve stimulation, and sensory input work matter just as much as traditional exercises.
So What Should You Do? Start by asking better questions:
How am I breathing?
Do I feel tension in my jaw, neck, or shoulders?
Am I always in go-go-go mode?
Have I addressed any old injuries, c-section scars, or digestive issues?
If you’re working with a provider who only focuses on the pelvic floor itself, you might be missing the bigger picture.
Final Thought: Your symptoms are real. They’re not in your head. But they may not be coming from where you think. When we treat the body as a whole system, nervous, mechanical, and visceral. We stop chasing symptoms and start creating change.
Curious how this approach could help you? Let’s talk.
