Athletes and active people have a lot to gain from pelvic muscle training. The topic of pelvic health and the research to support it are rapidly evolving, but current awareness is limited in scope and reactive in nature. Too often, and in many cases unknowingly, pelvic floor dysfunction in athletes is dismissed as an inevitable by-product of high-level training or reduced to isolated symptoms rather than being understood as a dynamic system that directly influences performance, recovery, and long-term well-being. Traditional assessments tend to overlook the unique biomechanical demands placed on athletic bodies and the associated nuances of the pelvic structure’s response to load, stress, and adaptation. Athletes train tirelessly to optimize their strength, speed, endurance, and skill. They fine-tune nutrition, optimize recovery, and push limits. Yet the pelvic system remains chronically overlooked despite its central role in both the body and sport.
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. For too long, pelvic health has been relegated to postpartum women or clinical settings even though it is inherently fundamental to sport well before the point when symptoms appear.
The goal of this book is to change the narrative. It’s time to call the pelvic floor muscles off the sidelines and into the starting lineup of training and performance.
We’ll explore how the pelvic floor functions in movement, breath, and sport.
We’ll discuss the reality of pelvic health challenges that athletes contend with and the research that illuminates their experiences.
We’ll review solutions ranging from training strategies and rehabilitation to prevention, performance optimization, and a shift in mindset from bounce-back to comeback.
Yes, you’re an athlete.
I’d like to pause here to note that this book is written for athletes.
If your immediate reaction is
“I’m not an athlete,”
“I work full time,”
“I don’t look like an athlete,” or
“I don’t lift heavy enough or run fast enough for this to apply to me,”
I want you to reconsider.
For the purposes of this book, an athlete is any one who intentionally trains, exercises, or challenges their body in pursuit of a goal, so I think it’s safe to say, You are, in fact, an athlete.
While I have worked with a fair number of professional and college athletes in my career, I remain equally impressed by the recreational athletes who work hard to stay active despite the demands of life when sport is not their career. Convincing my clients that they are athletes allows them to be more intentional, more understanding, and more focused on the work we do together, which makes my job easy. I often joke that I boss people around for a living, as I cannot do the work for you. The approach I will share with you depends on your understanding, compliance, and discipline. It’s up to me and the providers on your team to explain the how and why in a way that prompts you to want better for both your present and future selves. When you consider yourself an athlete, you will be more successful at implementing the approach. Being an athlete is not defined by your appearance, your performance level, or the number of hours you spend training. It is defined by your willingness to show up, put in the effort, and invest in your physical health and performance.
If you are reading this book either for your own development or to triage a problem, understand that as with anything, finding a provider who shares your goals and can help you progress is critical. Nothing in this book is medical advice—it is educational material to help you better understand your body and the way it reaches for the goals you set in front of it. You lead the draft of your health-care team. While the pelvic health realm is vastly underserved, I hope this book gives you the foundational knowledge to address the stigma, better understand your experience, and challenge the narrative that we must accept the aches and pains of an athletic lifestyle. I worked hard to write this book in a way that makes sense both to the athlete and to the coaching or treating professional, but if you come across a concept that doesn’t click for you or terminology that seems confusing, please don’t hesitate to reach out to someone you trust—including me. Every athlete—regardless of level, age, gender, or sport—deserves pro viders and coaches who understand this muscle group.
If you are a professional who is along for the ride—a coach or fellow practitioner—you wouldn’t be here if you didn’t want better for your athletes and clients. I hope that you will be able to empower and equip the people you work with by the end of this book. Elite athletes will have different training demands and volumes that should be considered in the context of the techniques presented in this book, just as you would in programming for any other muscle group or anatomical structure. My goal here is not to relay strength and conditioning or rehab principles but instead to teach you about the role of these muscles and their surroundings in a way that allows you to implement the principles you already know and use for the rest of the body.
Finally, I want to acknowledge and appreciate the fact that you care enough about yourself and/or the athletes you’re working with to read this book. That’s an incredible indicator of how much you honor the work you do and the level at which you expect yourself to perform. Pelvic health is an easy topic to brush off, as we often assume that the responsibility belongs elsewhere or that it doesn’t actually affect us. It’s easier to ignore or delay work for muscles you can’t see. It’s less daunting to assume you’ve reached your peak than to question whether there are bigger goals just waiting to be pursued. You’re choosing to pull this topic into the light, challenge the status quo, and do better, both for your own health and performance and for that of generations to come. Thank you for being here.
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.