The Muscle Nobody Told You to Train
The claim: the pelvic floor is a pregnancy-and-postpartum concern. My claim: it's a lifelong performance and health variable that every woman who trains should understand, and almost none actually do.
The pelvic floor is probably the most quietly important group of muscles in the entire female body, and also the one most consistently absent from fitness conversations that don't involve pregnancy or postpartum recovery. That absence has real consequences, because pelvic floor dysfunction — which includes everything from stress urinary incontinence to pelvic organ prolapse to chronic pelvic pain — affects women across the full age spectrum, not just those who've given birth, and training without any awareness of this muscle group creates a gap with a measurable impact on both performance and long-term function.
The reason it stays out of mainstream fitness conversations is mostly that it's uncomfortable to discuss, involves anatomy people weren't taught to talk about directly, and sits at the intersection of fitness and medical territory that neither side fully owns. So women quietly manage the symptoms — the "just don't jump on a full bladder" workaround, the modified exercise choices made without anyone explaining why — while never getting a clear picture of what's actually happening or what they could do about it.
My thesis: the pelvic floor is a legitimate part of female athletic function, pelvic floor dysfunction is far more common among active women than fitness content acknowledges, and basic pelvic floor awareness belongs in every woman's training knowledge base, not just the postpartum chapter.
Evidence Point One: What the Pelvic Floor Actually Does
The pelvic floor is a group of muscles spanning the base of the pelvis, responsible for supporting the bladder, uterus, and bowel, controlling urinary and bowel function, contributing to sexual function, and stabilising the pelvis and lower spine as part of the core system. That last point is worth pausing on — the pelvic floor is a genuine component of your core stability, meaning it's involved in every heavy lift, every jump, every movement that loads the trunk.
When it's too weak, it can't manage the intra-abdominal pressure spikes that happen during heavy lifting or high-impact activity — which is where stress urinary incontinence during exercise (the "just don't jump on a full bladder" problem) comes from. When it's too tight, it can cause chronic pelvic pain, difficulty with certain exercises, and hip or lower back pain that gets attributed to everything except its actual source. Both dysfunctions are common, and both are addressable — but only if you know they exist.
The pelvic floor is a genuine component of core stability — it's involved in every heavy lift, every jump, every movement that loads the trunk.
Evidence Point Two: Why This Affects More Women Than Anyone Admits
Research estimates put stress urinary incontinence during exercise at somewhere between 28 and 80 percent of female athletes and regular exercisers, depending on the sport and activity type — a range so large it speaks to how differently this gets measured, but even the lower bound is staggering. This is not a rare, edge-case problem. It's one of the most common silent experiences in women's fitness, rarely discussed because the social awkwardness of raising it feels worse than just quietly managing it.
This also isn't exclusively a postpartum or older-women problem, though both pregnancy and menopause do increase risk. Young, nulliparous women — women who have never been pregnant — show meaningful rates of pelvic floor dysfunction related to high-impact sport and heavy lifting, which means the "worry about it after you have kids" advice that most women implicitly absorb is categorically wrong.
The good news is that pelvic floor dysfunction is, in most cases, highly responsive to appropriate rehabilitation — pelvic floor physiotherapy has strong evidence behind it for both hypotonicity and hypertonicity presentations — and the earlier it's addressed, the less complex the management tends to be.
Evidence Point Three: Why It Stays Off-Limits in Fitness Spaces
My honest take: the pelvic floor stays out of mainstream fitness content because it requires using anatomical language people were trained to be embarrassed about, in spaces that have historically avoided anything that might feel clinical or uncomfortable. A video about glute activation is approachable. A conversation about bladder control during deadlifts is not, culturally, even though it directly affects more women than many of the topics that do get discussed openly. The embarrassment is doing more to maintain the gap than any actual lack of available information.
My Verdict — And Your Homework
The pelvic floor is not a pregnancy topic. It's a training topic. If you experience any symptoms during exercise — leaking, heaviness, chronic pelvic pain, discomfort during certain lifts — that's not something to silently adapt around. A pelvic floor physiotherapist can assess what's actually happening in about one appointment, and most presentations are straightforwardly treatable from there.
Stop Modifying Around Something You Never Asked About
If you've quietly modified your training to work around a symptom you haven't named out loud — skipping jump rope, avoiding heavy deadlifts, timing bathroom visits around training — write it down. Give it a name. Then book one appointment with a pelvic floor physiotherapist or bring it up at your next GP visit. One conversation will give you more useful information than months of quietly managing around it.
