Pelvic Floor Health: The Overlooked Key To Strength, Stability, And Well-Being

When it comes to building a strong, resilient body, most people focus on abs, glutes, and biceps. They often overlook one of the most important muscle groups of all: the pelvic floor. This powerful network of muscles is essential for more than just bladder control—it may also contribute to core stability, spinal support during movement, and overall sexual well-being. Prioritizing pelvic floor health is key whether you’re running, strength training, or just living your daily life—a strong pelvic floor helps you feel and function your best.

Here’s the truth: Most people don’t think about their pelvic floor until something goes wrong—like unexpected leaks during workouts, lower back pain that won’t quit, or unexplained pelvic discomfort. But waiting until there’s a problem means missing the chance to build real, functional strength where it matters most. 

In this article, we’ll break down why pelvic floor health is crucial at every age, how to spot the signs that yours may need some extra support, and simple, effective exercises to keep these essential muscles strong.

• ABOUT OUR EXPERTS: Zach Smith is a doctor of physical therapy and co-founder of HIDEF Physical Therapy. Kecia Gaither is a double board-certified in OB/GYN and Maternal Fetal Medicine and Director of Perinatal Services and Maternal Fetal Medicine at NYC Health + Hospitals/Lincoln in the Bronx.

What Is the Pelvic Floor?

Think of your pelvic floor like the foundation of a house—supporting everything above it. “The pelvic floor is a set of muscles that make up the bottom or floor of your abdominal space,” explains Zach Smith, doctor of physical therapy, and co-founder of HIDEF Physical Therapy. 

Kecia Gaither, double board-certified in OB/GYN and Maternal Fetal Medicine and Director of Perinatal Services and Maternal Fetal Medicine at NYC Health + Hospitals/Lincoln in the Bronx, likens it to a hammock stretching from your pubic bone to your tailbone. This muscular sling plays a major role in keeping your core stable and your internal organs supported, she explains. And here’s something a lot of people don’t realize: Pelvic floor muscles exist in everyone—regardless of sex. The structure might vary slightly, but the function is critical across the board.

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The pelvic floor plays a foundational role in the core. “It helps support your internal organs, contributes to spine stability, and works in tandem with your diaphragm and core muscles to regulate internal pressure,” notes Smith. “If that system is off, you are more likely to deal with back pain, hip issues, or hernias.”

One of the pelvic floor’s MVP moves? Keeping you dry when you sneeze, jump, or lift, says Smith. These muscles are your body’s built-in support system for the bladder, bowels and—if you’re a woman—the uterus, adds Gaither. They help play a role in supporting bladder, bowel, and sexual health.  

Women who are mothers may have issues with their pelvic floor. “Vaginal delivery, especially with large babies, is associated with a higher risk of pelvic floor dysfunction—inclusive of urinary incontinence, pelvic organ prolapse and anal incontinence compared to cesarean delivery,” explains Dr. Gaither. “The risk is further increased with instrumental vaginal delivery (forceps or vacuum), or severe perineal tears.” On the other hand, Dr. Gaither says Cesarean delivery, particularly performed before labor reduces the risk of pelvic floor dysfunction compared to vaginal delivery.

“When pelvic floor muscles are too weak or too tight, you can end up dealing with issues like urgency, leaking, or incontinence,” Smith explains. And yep—these symptoms are way more common than most people think, including in high-level athletes.

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“A well-functioning pelvic floor may enhance your ability to lift, move with more control, and support recovery,” explains Smith. “It controls intra-abdominal pressure, which is the secret weapon behind powerful movement.” (Think of things like jumping, lifting, and sprinting.) Smith says if your base is unstable, your performance suffers.

Does Your Pelvic Floor Need Support?

Wondering whether your pelvic floor is in good shape? According to Gaither, a strong pelvic floor typically shows up in a few key ways: You’re able to hold your bladder and bowels without issue—even when you cough, sneeze, or hit a heavy lift. You also enjoy healthy sexual function, and there are no signs of pelvic organ prolapse, like pressure or heaviness in the lower abdomen.

On the flip side, a weak pelvic floor often makes itself known. You might notice a frequent or urgent need to urinate, or trouble holding it in. Some people feel a sense of pressure or even like something is “falling out,” which can be a sign of pelvic organ prolapse, notes Gaither. Others experience reduced sexual function or leaking when they laugh, sneeze, or exercise. If any of these symptoms sound familiar, your pelvic floor might need a little extra attention. The good news? With the right exercises and support, this network of muscles can absolutely be strengthened.

Pelvic Floor Exercises You Can Start Now

When you hear “pelvic floor exercises,” chances are your mind jumps straight to Kegels. But, according to Smith, that’s just scratching the surface. “The pelvic floor doesn’t work in isolation—it’s part of a dynamic pressure system that includes your diaphragm, deep core, and hips,” he explains. “If you want to truly strengthen it, not just squeeze it, you’ve got to train it like any other muscle group: with coordination, control, and load.”

Translation? It’s time to think bigger than pulses and holds. To build real resilience and function, your pelvic floor needs to be trained as part of a fully integrated system. Below, Smith breaks down his top go-to moves for building strength from the inside out.

360 Breathing (aka Diaphragmatic Breathing)

Before you hit the squats or deadlifts, start with your breath. Proper breathing isn’t just a nice-to-have—it’s essential for pelvic floor function. “If you cannot breathe well, your pelvic floor will not function well.”

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How to do it: Lie on your back with your knees bent and feet flat. Place one hand on your chest, the other on your belly. Breathe in slowly through your nose and focus on sending the breath all the way around your torso—into your ribs, sides, and low belly. “Don’t just belly breathe,” Smith says. “You want expansion in all directions—front, sides, and even into your back.”

Pro tip: As you exhale, feel your ribs draw inward and your pelvic floor naturally lift. “You shouldn’t have to force anything,” Smith says. “The goal is gentle awareness, not effort.” This kind of breath work lays the groundwork for everything else, activating your core, stabilizing your spine, and setting your body up for better post-exercise movement and recovery.

Hollow Hold (with Breath Focus)

This advanced core move demands full-body tension, deep breath control, and serious pelvic floor engagement, explains Smith. It’s a go-to for gymnasts and functional fitness coaches.

How to do it: Lie on your back with arms extended overhead and legs straight. Press your lower back firmly into the floor, then lift your shoulders and legs a few inches off the ground. Engage your core and hold, but here’s the key: Breathe through it. Inhale deeply and exhale with control while keeping the tension.

Pro tip: “Start with bent knees or arms down if needed,” recommends Smith. “Always prioritize maintaining breath control over just holding the shape.”

Plank Variations

Planks aren’t just a go-to core move; they’re a powerhouse exercise for pelvic floor strength, too. But here’s the catch: They only work if you breathe through them, explains Smith. “When done correctly, planks build deep core endurance and train your pelvic floor to stay engaged under pressure.”

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How to do it: Start in a forearm plank with your elbows stacked directly under your shoulders. Keep your body in one strong, straight line from head to heels. Engage your glutes and quads, then breathe: inhale slowly through your nose, and exhale through your mouth as if blowing through a straw. Each breath should feel controlled and intentional—not forced or rushed.

Pro tip: Can’t breathe? “You’re over-bracing,” states Smith. “Dial it back; try a plank on your knees or elevate your arms to scale it down.”

Gaither says you can also incorporate bird dogs, bridge pose, Kegels, pelvic tilts, and squats. “All of these exercises target the pelvic floor muscles, improving their ability to support organs, maintain continence, and enhance sexual function,” notes Gaither. They’re just as beneficial for men as they are for women.

Putting the Pelvic Floor First

Your pelvic floor isn’t just a niche muscle group—it’s the core of your core. Whether you’re lifting heavy at the gym, chasing your kids around the yard, or navigating postpartum recovery, a strong pelvic floor sets the foundation for total-body strength, control, and confidence. And yet, it’s one of the most overlooked aspects of wellness.

The good news? You don’t need fancy equipment or hours in the gym to start strengthening it. With smart breath work, functional movement, and intentional training, you can build a pelvic floor that may support better movement patterns and stability in your daily activities and workouts.

Don’t wait for symptoms to appear. Focusing on pelvic floor strength now may help support a more stable, resilient foundation, which can have a positive ripple effect on overall movement and wellness.