The Missing Link Between Core Strength and Pelvic Floor Health

Why Am I Still Leaking If My Core Is Strong?

Maybe you’ve been doing ab workouts.

Maybe you’ve been lifting weights consistently.

Maybe you’ve even been doing Kegels.

Yet you’re still leaking when you run, jump, sneeze, or exercise.

If that’s you, you’re not alone.

One of the biggest misconceptions in women’s fitness is that a strong core automatically equals a strong pelvic floor. While these systems absolutely influence one another, they are not the same thing.

Most women were never taught this.

As a pelvic floor physical therapist and founder of the No Kegels University® Method, I’ve spent years helping women understand how their bodies actually work. What I discovered is that many traditional approaches miss an important piece of the puzzle.

The goal isn’t temporary relief—it’s long-term strength.

And that requires looking at the entire system.

Understanding the Pelvic Floor Beyond Kegels

The pelvic floor is a group of muscles that supports the bladder, uterus, and rectum while helping control bowel and bladder function. The Cleveland Clinic explains that these muscles also work with your abdominal muscles and diaphragm to stabilize your core. (Cleveland Clinic pelvic floor muscles)

But these muscles don’t work in isolation.

Every day they respond to:

• Breathing
• Movement
• Exercise
• Walking
• Running
• Lifting
• Jumping
• Changes in pressure throughout the body

This is why simply focusing on isolated pelvic floor contractions often leaves women frustrated.

The pelvic floor is designed to work with the rest of your body.

Not apart from it.

The VAB3 Method: A Different Way to Think About Pelvic Floor Strength

Over years of clinical practice, I developed a framework that became the foundation of my approach to pelvic floor strengthening.

I call it the VAB3 Method.

VAB3 stands for:

• V = Vertical
• A = Above
• B = Below
• 3 = All Three Planes of Motion

Rather than focusing solely on Kegels, this method looks at how the pelvic floor naturally functions during everyday life.

Let’s break it down.

V: Vertical Movement Matters

Think about the last time you jumped.

Did you leak while preparing to jump?

Usually not.

Most women leak when they land.

Why?

Because when your body lands, your organs move downward due to gravity and impact forces. Your pelvic floor must react quickly to support those organs and maintain bladder control.

This vertical loading is one of the natural ways the pelvic floor develops strength.

Your body is already practicing this every day.

Walking, hiking, stair climbing, squatting, and jumping all create opportunities for the pelvic floor to respond to vertical forces.

This is one reason functional movement can be such a powerful strengthening tool.

A: What Happens Above Influences the Pelvic Floor

The second piece of the puzzle is everything above the pelvis.

This includes:

• Breathing mechanics
• Core muscles
• Rib cage mobility
• Thoracic spine mobility
• Lumbar spine function

Many women have been taught to constantly suck in their stomach.

Others brace their core all day long.

Some hold tension in their abdomen without realizing it.

The problem?

Your pelvic floor relies on healthy pressure management.

Breathing and the Pelvic Floor

When you inhale:

• Your diaphragm lowers.
• Your abdominal contents gently move downward.
• Your pelvic floor lengthens slightly.

When you exhale:

• Your diaphragm rises.
• Pressure decreases.
• Your pelvic floor naturally recoils.

This movement is supposed to happen.

When breathing mechanics become restricted, pelvic floor function often suffers as well.

This is about more than symptom management.

Root-cause healing matters.

B: The Surprising Role of Your Hips

This is one of my favorite concepts to teach.

Research continues to show strong relationships between hip muscle function and pelvic floor function.

A phrase I often tell my patients is:

“What the hips do or don’t do, the pelvic floor does or doesn’t do.”

Think about it.

Your hips help you:

• Walk
• Run
• Squat
• Climb stairs
• Balance
• Lift

If your hip muscles aren’t working efficiently, your pelvic floor may struggle to keep up.

My Personal Experience

Before I had children, I underwent a major foot surgery.

For months I wasn’t putting normal weight through my foot.

Eventually I returned to dance classes—and started leaking urine.

I was embarrassed.

After all, I was a pelvic floor physical therapist.

But when I looked closer, the explanation became clear.

My foot wasn’t functioning normally.

That affected my ankle.

That affected my knee.

That affected my hip.

And ultimately it affected my pelvic floor.

Once I rebuilt strength through the entire chain, the leakage disappeared.

Understanding your body creates confidence.

The “3” in VAB3: Train Like a Human

The final component of the VAB3 Method involves movement in all three planes.

Most exercise programs primarily train forward and backward movement.

Life doesn’t work that way.

We twist.

We rotate.

We reach.

We change directions.

We move side to side.

Your pelvic floor is unique because its muscle fibers run in multiple directions.

Yet many women only train in one direction.

The Three Planes Include:

Sagittal Plane

Forward and backward movement.

Examples:

• Squats
• Lunges
• Walking

Frontal Plane

Side-to-side movement.

Examples:

• Lateral lunges
• Side stepping
• Skaters

Transverse Plane

Rotational movement.

Examples:

• Twisting
• Rotational reaches
• Diagonal movement patterns

A well-rounded pelvic floor strengthening program should include all three.

Strong Abs Do Not Automatically Mean a Strong Pelvic Floor

Myth #1: Core Work Equals Pelvic Floor Work

Not necessarily.

Your core and pelvic floor influence one another, but they are different systems.

You can have strong abdominal muscles and still experience pelvic floor dysfunction.

Myth #2: Pelvic Floor Strength Requires Hours of Exercise

Not true.

Many women benefit from just 10–15 minutes of intentional pelvic floor-focused movement several days each week.

Myth #3: You Must Stop Doing Activities You Love

Absolutely not.

Love biking?

Bike.

Love yoga?

Do yoga.

Love lifting weights?

Keep lifting.

The key is understanding what may be missing and adding complementary movements when necessary.

You deserve better than fear-based advice.

Action Steps: Start Strengthening Smarter

1. Evaluate Your Current Workout

Ask yourself:

• Am I including vertical loading?
• Am I working on breathing and pressure management?
• Am I strengthening my hips?
• Am I moving in all three planes?

2. Add Missing Components

You don’t need to start over.

You simply need to fill the gaps.

Small adjustments often create meaningful improvements.

3. Prioritize Functional Strength

Choose movements that prepare your body for real life.

The pelvic floor thrives when strength is integrated into movement.

4. Get a Personalized Plan

Every woman starts in a different place.

Complete the Your Pelvic Floor’s Next Step Form to identify what your body may need most: https://beyondthevbypauli.com/nextstep/

You can also learn more about pelvic floor function through resources from the NIH and APTA Pelvic Health.

Strengthen the System, Not Just the Symptoms

If you’ve been focusing only on Kegels or only on core exercises, you may be missing important pieces of the puzzle.

Your pelvic floor does not function alone.

It responds to breathing.

It responds to movement.

It responds to your hips, spine, and the way your body manages pressure.

Your body is not broken.

Most women were never taught how connected these systems truly are.

When you understand how the entire system works together, you can build lasting strength, confidence, and resilience.

The goal isn’t temporary relief—it’s long-term strength.

You don’t need more random exercises. You need a strategy. Book an appointment and let’s create a plan designed specifically for your body and goals.

Pelvic Floor Next Step