Tag Archive for: Core

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

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Why Returning to Exercise After Having a Baby Feels So Hard (And the Surprising Role Your Pelvic Floor Plays)

Returning to exercise postpartum should feel empowering.

Instead, many women feel frustrated.

You start a workout program, only to discover that everything feels harder than expected. Maybe running causes discomfort. Maybe strength training feels impossible. Maybe you’re leaking when you exercise, experiencing pressure, or wondering why your body isn’t responding the way it used to.

If this sounds familiar, you’re not alone.

As a pelvic floor physical therapist, one of the most common things I hear from women is:

“I started exercising again, but everything feels hard.”

Or:

“I don’t know where to start.”

Or even:

“Everything I try feels either too aggressive or too easy.”

Most women assume they’re out of shape, getting older, or simply need to push harder.

But often, the real issue is something that hasn’t been addressed since pregnancy or childbirth.

Your body is not broken.

Most women were never taught this: difficulty returning to exercise postpartum is often connected to pelvic floor dysfunction, core dysfunction, scar tissue restrictions, or unresolved postpartum recovery challenges.

Understanding your body creates confidence—and confidence creates progress.

Why Exercise Postpartum Feels Different

Pregnancy changes your body.

Your abdominal muscles stretch.

Your pelvic floor supports a growing baby for months.

Your posture shifts.

Your breathing patterns change.

Your connective tissue adapts.

Then childbirth—whether vaginal or cesarean—places additional demands on your body.

Yet many women receive little guidance about how to rebuild strength afterward.

Instead, they’re often cleared for exercise at six weeks and left to figure things out alone.

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

That means understanding what may be limiting your recovery.

The Pelvic Floor’s Role in Exercise

Your pelvic floor is a group of muscles that sits at the bottom of your core.

These muscles help:

  • Support your organs
  • Manage pressure inside your abdomen
  • Maintain continence
  • Stabilize your body during movement
  • Work alongside your abdominal muscles and diaphragm

When these muscles aren’t functioning well, exercise can become difficult.

You may experience:

  • Urine leakage during workouts
  • Pelvic heaviness or pressure
  • Core weakness
  • Difficulty progressing exercises
  • Back pain
  • Hip pain
  • Reduced endurance

According to the American Physical Therapy Association Pelvic Health Section, pelvic floor dysfunction can significantly impact physical activity and quality of life.

The Hidden “Leftover Issues” From Pregnancy

In Polly’s words, many women may be dealing with “leftover issues from pregnancy.”

These issues aren’t always obvious.

Sometimes the pelvic floor muscles aren’t activating when they’re supposed to.

Other times the muscles may be overworking, underworking, or struggling to coordinate with the rest of the core.

This can create a situation where every workout feels harder than it should.

You may constantly feel like you’re starting over.

Or you may plateau despite your best efforts.

Root-cause healing matters.

Rather than simply modifying workouts forever, it’s important to understand why your body is struggling in the first place.

The Connection Between Your Core and Pelvic Floor

Many women focus entirely on abdominal exercises after having a baby.

But your core is more than your abs.

Your core includes:

  • Diaphragm
  • Deep abdominal muscles
  • Pelvic floor
  • Back muscles

These systems work together to manage pressure and create stability.

When one part isn’t functioning well, the entire system can become less efficient.

This is especially important if you’ve experienced diastasis recti.

Diastasis recti occurs when the abdominal muscles separate during pregnancy.

While many conversations focus only on the gap itself, the bigger issue is often pressure management.

If pressure isn’t being managed effectively, your pelvic floor may compensate.

That can contribute to symptoms during exercise and daily life.

The Cleveland Clinic offers a helpful overview of diastasis recti and postpartum recovery:

Cleveland Clinic: Diastasis Recti Overview

How C-Section Recovery Can Affect Exercise Postpartum

Many women are surprised to learn that a C-section can affect exercise years later.

A cesarean birth involves multiple layers of tissue being surgically opened and repaired.

The body responds by creating scar tissue.

Scar tissue is important because it helps close and heal the surgical site.

However, scar tissue doesn’t always stay localized.

In clinical practice, women frequently experience restrictions that affect how abdominal muscles move and activate.

This doesn’t mean something is wrong.

It simply means your body may need support.

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

When scar tissue limitations are addressed appropriately, women often notice improvements in movement, exercise performance, and overall confidence.

Myth: If It’s Been Years Since Baby, It’s Too Late

One of the biggest misconceptions women believe is that postpartum recovery has an expiration date.

It doesn’t.

Many women seek help:

  • Two years postpartum
  • Five years postpartum
  • Ten years postpartum
  • Even longer

And they still make meaningful progress.

Your body remains adaptable.

Strength can improve.

Movement can improve.

Symptoms can improve.

You deserve better than fear-based advice that tells you to simply accept discomfort as your new normal.

Signs You May Benefit From Pelvic Floor Assessment

Consider seeking support if you:

Experience leakage during exercise postpartum

Whether it’s a few drops or a larger amount, leakage is a sign that your body may need support.

Feel pressure or heaviness

A sensation of heaviness during workouts should not be ignored.

Can’t progress your workouts

If every exercise feels too hard or causes symptoms, there may be an underlying issue worth addressing.

Have a history of C-section, tearing, or episiotomy

Scar tissue and healing patterns can influence long-term function.

Feel confused about where to start

You don’t need to guess your way through recovery.

Understanding your body creates confidence.

Practical Steps to Rebuild Strength

1. Stop judging yourself

Your body has been through tremendous changes.

Recovery is not a reflection of your worth.

2. Focus on quality movement

More exercise isn’t always better.

Better movement often produces better results.

3. Address symptoms early

Leaking, pressure, pain, and difficulty progressing are signals worth investigating.

4. Get professional guidance

Pelvic floor physical therapy can help identify the root cause of symptoms and create a plan tailored to your goals.

The National Institutes of Health (NIH) has published extensive research supporting pelvic floor muscle rehabilitation for women experiencing pelvic floor dysfunction:

The Bottom Line

If returning to exercise postpartum feels harder than it should, don’t assume you’re failing.

And don’t assume your body is broken.

Many women are unknowingly dealing with pelvic floor dysfunction, scar tissue restrictions, pressure management challenges, or other postpartum recovery issues that were never fully addressed.

This is about more than symptom management.

It’s about helping your body function the way it was designed to.

There are answers.

There is a path forward.

And you don’t have to figure it out alone.

If you’re tired of conflicting advice online and want a clear roadmap, explore the No Kegels University® Method and learn how to build lasting strength and confidence.

Not sure what your next step should be?

Complete the Your Pelvic Floor’s Next Step form and receive guidance tailored to your current symptoms and goals:

Pelvic Floor Next Step

Healing isn’t about perfection. It’s about understanding, consistency, and progression. If you’re ready for support, I’d love to help.

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