If you’ve ever been told to just do kegels or that your pelvic floor is weak, but nothing is actually improving, this might be why...
Your pelvic floor doesn’t work in isolation.
It’s not just a group of muscles at the base of your pelvis that you strengthen or relax and suddenly everything gets better.
It’s part of a system.
A really integrated, constantly communicating system.
And when we only treat one piece of that system, we often miss the reason your symptoms are still there.
Your Pelvic Floor Is Part of a Team
Your pelvic floor is constantly working with other areas of your body:
Your breath
Your diaphragm and pelvic floor move together with every inhale and exhale. If your breathing is shallow, held, or restricted, your pelvic floor often becomes tense or doesn’t coordinate well.
Your hips and glutes
If your hips are tight or your glutes aren’t doing their job, your pelvic floor will often compensate… leading to tightness, pressure, or leaking.
Your core
Your deep core system isn’t just about “strength.” It’s about timing, balance and coordination. If that system is off, your pelvic floor is usually working way harder than it has to.
Your nervous system
Stress, anxiety, and a constantly “on” system can keep your pelvic floor in a state of guarding or tension.
Your hormones and gut
Hormones influence tissue health and symptom patterns. Constipation, bloating, and gut dysfunction increase pressure on the pelvic floor and can make symptoms worse.
Why This Gets Missed
Most people are told to focus on one thing.
Do kegels.
Strengthen your core.
Relax more.
But your body is much more complicated than that.
So when symptoms don’t improve, it’s usually because you’re only being given part of the picture.
A Real Example From My Practice
One of my clients was a runner who came to me postpartum dealing with urinary leaking and a feeling of pelvic pressure.
Like a lot of women, she had been told to focus on strengthening her pelvic floor. Do more kegels. Build more “core strength.”
But when she got pregnant again, her symptoms actually got worse.
When we started working together during her second pregnancy, we did something a little different.
Instead of just looking at her pelvic floor… we zoomed out.
We looked at how her body was functioning as a whole.
On our first session, we did a simple pre-test: a double leg hop.
Within less than 10 seconds, she had to stop because of urinary urgency.
That’s usually where people would double down on kegels.
But instead, we worked on the systems surrounding her pelvic floor:
- releasing and improving mobility through her diaphragm
- opening up her hip flexors while integrating glute engagement
- improving thoracic and side body mobility
- strengthening her adductors, abdominals, and glutes
Then we re-tested the same double leg hop.
No urgency. No leaking. No symptoms.
Nothing about her pelvic floor changed in isolation.
But everything supporting it did.
And that changed everything.
What This Means for You
If you’re dealing with things like:
- urinary leaking or urgency
- pelvic pressure or heaviness
- pain with intercourse
- constipation or bloating
- low back, hip, or tailbone pain
your pelvic floor might absolutely be involved.
But it’s rarely the only thing going on.
Your pelvic floor didn’t fail you.
It adapted to what the rest of your body was doing.
Healing Looks Like Integration, Not Isolation
This is why true pelvic floor healing isn’t just about:
- doing more kegels
- only strengthening
- only relaxing
- or only focusing on your nervous system
It’s about looking at the full picture.
How you breathe.
How you move.
How your body is supported.
How your systems are working together.
Because when you support the system…
your pelvic floor can finally do its job.
Want to Learn More?
If this resonated with you, you’re not alone. I see this every single day in my practice.
You don’t need to keep guessing or piecing things together on your own.
You can learn more in my newsletter here (I share more education + simple ways to start supporting your body at home)
Or reach out if you’re ready for a more personalized approach.
Your body isn’t broken.
It just hasn’t been looked at as a whole… yet!
Dr. Emily Mason
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