A responsive and adaptive pelvic floor is not optional for athletes. It is a critical part of the kinetic chain that not only determines how efficiently force moves through the body but also protects the body against injury.
Let’s explore the floor!
If you place your thumb at the front of your pelvis, you’ll find the hard bone known as the pubic symphysis. Your pelvic floor muscles start here, then wrap between the legs to your back and basically attach at your tail bone. (Clinicians, coaches, or the ultracurious can check out continuing education programs by the Herman and Wallace Pelvic Rehab Institute for a more nuanced explanation of the various attachment sites.)
If you were to sit on your hand with your hand positioned directly under the pelvis, that’s essentially where the pelvic floor muscles sit. They are often described as a hammock or bowl lying at the bottom of the pelvis with the pelvic organs (bladder, uterus, and rectum) resting on top. I know it’s not necessarily dreamy to think of your pelvis as a bowl of fruit, but in terms of imagery, it is a helpful description.
Your pelvic floor includes a team of muscles, including the pubococcy geus, puborectalis, and iliococcygeus, but for the purposes of this book, it’s more important to know what these muscles do for you:
✪ Help absorb and dissipate force from the lower to upper body and vice versa.
✪ Hold up your organs.
✪ Control continence.
✪ Aid in sexual function.
✪ Improve pressure management.
✪ Provide a stable foundation for distal musculature to do all the fun athletic things you enjoy.
When this group of muscles doesn’t work well, there will be compensation throughout the lower and upper limbs in an attempt to create the stability that is lacking at the pelvis. This presents as low back pain, hip strains, pelvic heaviness/pressure, leaking and urinary/fecal urgency, and sexual dysfunction such as pain with penetration or gynecological exam.
In his book Anatomy for Runners, Jay Dicharry describes the effects of pelvic instability as “shooting a cannon from a canoe.”
When your pelvic floor muscles can create and maintain stability and mobility, you are essentially shooting a cannon from stable ground, which minimizes reverberation or deviation from the path to the target. When your pelvic floor muscles lack this ability, the hips and shoulders (which many clinicians consider to be parts of the core) attempt to regain a sense of control that should have started at the pelvis. Do this enough and your hips, back, and shoulders will eventually let you know that they’re tired of working above and beyond their job description.
I want to note here that the pelvic floor is not just muscles; it also includes connective tissue like ligaments, the perineal body, and fascia. We call these “passive” tissues, as they do not actively contract and relax, but that does not mean they are immune to training and load. When repeated load is applied, these tissues can experience a gradual deformation of the collagen, so even in cases where muscle strength and endurance are fabulous, degradation of the passive structures can result in difficulty with force absorption and dispersion.
Fortunately, I have great news—with appropriate recovery cycles, that same collagen is repaired, and with appropriate training, we can likely improve the resiliency and orientation of those fibers to make them more robust for future endeavors.
Think about it this way—if I’m bending a paper clip, at first, it’s no big deal, and I can bend it back into place without repercussions. If I keep bending it, it will eventually begin to lose structure—not because it is fatigued (as it would not be possible for the paper clip to become fatigued) but because I have slowly worn down the actual composition of the paper clip itself. Unlike the paper clip, which cannot repair itself, your passive tissues often can heal and improve with appropriate loading and recovery.
Let’s floor it! See more from Dr. Rachel Selman and her groundbreaking book on pelvic health and sports.
About Floor It
Floor It is the groundbreaking guide to your pelvic floor, the unsung hero of core strength and your hidden powerhouse for sports.
Dr. Rachel Selman, DPT, the NSCA’s 2026 Personal Trainer of the year, offers a fascinating resource to understand pelvic floor dysfunction and pelvic muscle training for endurance sports, team sports, power sports, and sports that involve twisting like tennis and golf.