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pelvic health

Women’s Health: How Healthy is Your Pelvic Core?

by Christina Christie PT, CCE, FAFS, 3DMAPS, CAFS3 Comments

It seems like everywhere you turn there is a commercial, an advertisement or an article addressing women’s health issues – and for good reason. Many females experience dysfunction with the Pelvic Core Neuromuscular System (PCNS). The PCNS includes the respiratory diaphragm at the top, the abdominals at the front, the back/hip muscles at the back and the pelvic floor muscles at the bottom.4

Let’s start with the statistics:

PCNS Dysfunction can affect a female across her lifespan, starting in elementary school and spanning into the elderly population. All populations may be affected, including athletes of all ages, homemakers, teachers, healthcare professionals, executives and even fitness professionals.

The most common forms of PCNS Dysfunction seen clinically are incontinence, pelvic pain, pelvic organ prolapse and orthopedic injuries influenced by PCNS Dysfunction.1 This dysfunction often starts with weakness throughout the entire core, hips, back, respiratory diaphragm and pelvic floor muscles. Incontinence may present in a variety of forms, including:

  • Stress incontinence (involuntary loss of urine with an increase in intra-abdominal pressure for example if you sneeze, cough or jump)
  • Urge incontinence (the urge to void with small amounts of urine production)
  • Frequency (urinating more than 8 times in a 24-hour period)
  • Nocturia (waking more than one time in the middle of the night to urinate)

        What is Normal?

        Normal voiding patterns that women should be aware of include emptying the bladder every 2-4 hours during the day and 0-1 time in the middle of the night. No amount of urinary leakage should ever be considered normal. Pelvic Pain may affect one in seven females.2 A variety of pain can influence urinary, defecatory and sexual function. No amount of pain in or around the pelvic floor should be considered normal at any time. Pain is a sign that something is wrong and needs to be addressed.

        Pelvic organ prolapse refers to pelvic bowl organs descending within the pelvic bowl. This may include a Cytocele (bladder prolapse), Uterine Prolapse, a Rectocele (rectal proplapse) and Enterocele (prolapse of the small intestines). Pelvic Organ Prolapse (POP) can present as pelvic heaviness or pressure, rectal fullness or a bearing down sensation.1 A Female may also report the sensation of incomplete-emptying of the bladder and/or bowels when POP is present. In addition to PCNS Dysfunction, orthopedic issues may exist. Hip Labrum injuries, Low back pain, sacroiliac joint dysfunction, sciatica, mid-back pain, knee pain, ACL deficiencies and ankle sprains can all be influenced by PCNS Dysfunction.3 Many females do not recognize that the issues they have are abnormal and that treatment exists.

        Ensuring a Healthy Pelvic Core

        Athletico’s Women’s Health Physical Therapists have specialized skills and education in the care of female patients. These clinicians will assess the overall function of a patient’s Pelvic Core Neuromuscular System and design a plan of care that will help each patient meet their health and wellness goals. If you are having concerns about your pelvic health, click the link to take our bladder quiz or to contact our Women’s Health team with any questions in regards to your personal situation.

        Free assessments are available in-clinic and virtually through our Telehealth platform.

        Request a Free Assessment

        The Athletico blog is an educational resource written by Athletico employees. Athletico bloggers are licensed professionals who abide by the code of ethics outlined by their respective professional associations. The content published in blog posts represents the opinion of the individual author based on their expertise and experience. The content provided in this blog is for informational purposes only, does not constitute medical advice and should not be relied on for making personal health decisions.

        1. American Urogynecologic Society. 2016. Pelvic Floor Dialogues. Dec. 2016.
        2. International Continence Society, 2015, ICS Fact Sheets. 2015.
        3. Chaitow L. Chronic Pelvic Pain:pelvic floor problems, sacroiliac dysfunction and trigger point connection. J Bodywork Mov Ther. 2007; 11:327-339.
        4. Hodges P. Postural and respiratory functions of the pelvic floor muscles. Neurourol Urodyn. 2007;26(3):362-371.

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        Tina Christie was a physical therapist at Athletico Physical Therapy at the time of this blog.


        1. Nan Parson

          Hi, Tina. I hope everybody in your circle is healthy and happy. I’ve been doing my own pelva-core workout; but it certainly would be nice if we had your video to guide us. Is it possible for you to send one out?

          I can’t wait till we’re back in class; but we must carry on till then. I miss you and my pelva-core buddies. Nan

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