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Pelvic floor
The muscular hammock closing the bottom of the pelvis, supporting the organs above it and controlling continence.
Latin name: Diaphragma pelvis. In plain English, the sling of muscle at the base of the pelvis. It is filed here under core, breathing and pelvic floor.
Reference information, not a diagnosis. Where a symptom is described below, it is there so you can describe your own more precisely to a clinician — not so you can name what you have.
Where it is
The pelvis is a bony ring open at the bottom, and the pelvic floor closes it. Levator ani is the main sheet, sweeping from the pubic bone at the front, along a thickened line of fascia on the side wall, back to the coccyx. Its most forward part, puborectalis, loops behind the rectum like a sling and pulls it forward, which is a large part of how continence of stool is maintained. Coccygeus completes the floor at the back.
The sheet is not solid: the urethra and anal canal pass through it in everyone, and the vagina as well in women. Those openings are the reason the floor is both a support structure and a control structure, and the reason childbirth is the single event that most commonly changes how it works.
| Feature | Detail |
|---|---|
| Muscles | Levator ani — puborectalis, pubococcygeus and iliococcygeus — together with coccygeus |
| Attachments | From the pubic bone, the tendinous arch of the pelvic fascia along the side wall, and the ischial spine, to the perineal body, the coccyx and the anococcygeal ligament |
| Nerve | Direct branches from the sacral plexus, chiefly S3-S4, with the pudendal nerve (S2-S4) supplying the sphincters and perineum |
| Main actions | Supports the pelvic organs, maintains continence, contributes to sexual function, and works with the diaphragm and abdominal wall to manage pressure |
What it does
Three jobs at once. It holds the bladder, bowel and, in women, the uterus up against gravity and against every rise in abdominal pressure. It contributes to continence, through the puborectalis sling and the sphincters. And it participates in sexual function. Beyond that, it works as the floor of the pressure system: when you lift something heavy, cough or sneeze, the diaphragm, abdominal wall and pelvic floor act together, and if the floor does not join in, pressure escapes downward.
Both weakness and excessive tension cause symptoms, which is why self-prescribed pelvic floor exercises are not always the answer. Leaking, urgency, pain with intercourse, difficulty emptying and a dragging sensation can all arise from a floor that will not relax as much as from one that is weak. Distinguishing them requires an assessment, not a guess.
Exercises that load it
| Exercise | Category | Muscles the exercise library lists |
|---|---|---|
| Barbell back squat | Strength | Quads, glutes, core, back |
| Deadlift | Strength | Hamstrings, glutes, back, grip |
| Easy running (8 km/h) | Cardio | Legs, heart, lungs |
| Brisk walking (5.5 km/h) | Cardio | Legs, heart |
| Yoga (hatha) | Mobility | Whole body, balance, breath |
These movements load the pelvic floor rather than train it: every heavy lift and every foot strike in running transmits pressure downward that the floor has to meet. Training it specifically means voluntary contractions of the muscles themselves, and the details — how many, how long, whether to work on relaxation instead — depend on the individual. Pelvic health physiotherapy exists precisely because the right programme is not the same for everyone.
How it is lengthened
Relaxation matters as much as contraction here. Positions that open the hips and let the floor lengthen — a supported deep squat, a child's pose, side-lying with the knees apart — combined with slow breathing, let a tense floor release. If tension rather than weakness is the problem, more clenching makes it worse.
When it goes wrong
| Problem | What it typically feels like | Usual setting |
|---|---|---|
| Stress urinary incontinence | Leaking urine when coughing, sneezing, laughing, running or lifting | Very common after childbirth and around menopause; also seen in athletes |
| Pelvic organ prolapse | A heaviness or dragging in the vagina, sometimes with a bulge that is worse by the end of the day | Weakened support after childbirth, with age, or with chronic straining |
| Overactive pelvic floor | Pelvic pain, pain with intercourse, difficulty starting to pass urine, or incomplete emptying | A floor that holds tension rather than one that is weak; often missed |
Leaking, a bulge or dragging sensation, pelvic pain and pain with sex are all common and all treatable, and none of them should be self-managed from a website. A GP referral to a pelvic health physiotherapist is the right route. Blood in the urine, difficulty passing urine at all, or new numbness in the saddle area needs urgent medical attention.
Nothing on this page is a treatment plan. If a problem is limiting what you do, is not improving, or is getting worse, the right next step is an assessment by a doctor or a physiotherapist who can examine you.
Sources: descriptive anatomy from Gray's Anatomy of the Human Body, 20th US edition (1918), which is in the public domain; Latin names follow Terminologia Anatomica, published by the Federative International Programme for Anatomical Terminology. Nerve root levels are the conventional ranges taught from those sources and vary between individuals and between textbooks. Exercise cross-links use the TempoLife exercise library. Checked 2026-09-06.
Frequently asked questions
Are pelvic floor exercises good for everyone?
No. They help when the problem is weakness, and they can make things worse when the problem is a floor that cannot relax. That is why an assessment beats a generic programme.
Do men have a pelvic floor?
Yes, with the same muscles minus the vaginal opening. Male pelvic floor problems — after prostate surgery, or as pelvic pain — are common and under-discussed.
Is leaking during exercise normal?
It is common, particularly among women who have given birth and among athletes in high-impact sport, but common is not the same as something you have to live with. It is treatable and worth raising with a clinician.
Nearby in this reference
Rectus abdominis
The straight abdominal muscle, the six-pack
Abdominal obliques
The side abdominal muscles that twist the trunk
Transversus abdominis
The deepest abdominal layer, a corset around the waist
Diaphragm
The dome of muscle that does your breathing
Deltoid
The cap of the shoulder
Rotator cuff
The four small muscles that hold the shoulder in its socket
All 34 body parts · Exercise library · Body map
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