Low back pain, hip pain, SI joint instability, sciatica, even abdominal or thigh pain — most people don’t immediately think of their pelvic floor as the cause. But this group of deep stabilizing muscles often plays a much bigger role in pain than we realize.
If you’ve tried stretching, strengthening, massage, orthopedic physical therapy or even medical treatments and still can’t shake your symptoms, your pelvic floor could be the hidden link.
The Pelvic Floor’s Connection to Pain
Your pelvic floor isn’t just about bladder control or postpartum recovery. These muscles:
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Attach to your tailbone, hips, and sacrum
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Work with your deep core and diaphragm
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Help stabilize your spine and pelvis
When the pelvic floor isn’t functioning well — whether it’s too tight, weak, or uncoordinated — it can create a ripple effect of pain and dysfunction. That’s why you might feel:
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Chronic low back pain
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Deep hip or groin pain
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Sciatica-like symptoms down your leg
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Tailbone pain that lingers
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SI joint issues that flare with activity
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Abdominal or thigh pain with no clear source
How Do You Know If the Pelvic Floor Is Involved?
One helpful tool is the Cozean Pelvic Dysfunction Screening Protocol, a questionnaire designed to spot patterns in your symptoms. Research suggests that if you answer “yes” to three or more questions, there’s a strong likelihood your pelvic floor is contributing to your pain.
Want to try it yourself? Sign up for my newsletter and you’ll receive the screening protocol to see if your pain could be connected to your pelvic floor.
How Pelvic Floor Physical Therapy Can Help
If your pain is linked to the pelvic floor, the good news is there are effective, evidence-based treatments available. Pelvic floor physical therapists are trained to:
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Assess how your pelvic floor interacts with your back, hips, and core
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Use gentle hands-on techniques to release muscle tension and scar tissue
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Teach you exercises that restore strength, mobility, and coordination
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Guide you through breathing, posture, and movement strategies to reduce strain
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Support your long-term recovery so pain doesn’t keep coming back
Pelvic floor PT goes beyond treating symptoms — it addresses the root cause, helping you move, exercise, and live with less pain.
Want to learn more about what pelvic floor therapy looks like? Check out my blog post here: What Is Pelvic Floor Physical Therapy and How Can It Help?
So What's Your Next Step?
If you’re living with chronic back, hip, SI, tailbone, or abdominal pain that just won’t resolve, your pelvic floor may be the missing piece. By identifying whether it’s involved — and working with a skilled pelvic floor physical therapist — you can finally get on the path to lasting relief.
Don’t overlook this powerful part of your body. It may hold the key to solving your pain.
Dr. Emily Mason
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