The Missing Link

How Hip and Pelvic Alignment Shape Pelvic Floor Health

When it comes to musculoskeletal health, the pelvis is often treated as a silent partner — stable, fixed, and functional. Between hip function, pelvic alignment, and the pelvic floor muscles, there is a dynamic relationship that exists that holds the key to resolving a range of persistent pain issues.

What is the Pelvic Floor?

The pelvic floor — a complex network of muscles and connective tissue that cradles the bladder, bowel, and uterus — is intimately connected to the hips and lower trunk. Together, these three regions form a muscular axis critical to posture, stability, and movement. Disruption to one part can reverberate across the system causing symptoms in any of the other areas.

The Connection Between the Hip and the Pelvic Floor

For example, take the obturator internus (OI), a lesser-known but essential deep hip muscle. Nestled within the pelvic cavity and anchoring to the femur, it plays a dual role: externally rotating the hip and helping support the pelvic floor through fascial connections. When tight or weak, the OI can contribute not only to hip pain but also to pelvic floor dysfunction — which may manifest as incontinence, pain with intercourse, or even sciatic-like symptoms.

Orthopedic conditions like labral tears, tendonitis, or bursitis often dominate the conversation around hip pain, yet pelvic floor dysfunction remains an under recognized contributor. Poor movement patterns adopted to avoid hip discomfort can stress the pelvic floor, worsening the problem.

Pelvic Floor Physical Therapy

Experts now advocate for a more integrated approach. Physical therapists trained in pelvic health assess the entire kinetic chain — not just the joint — to restore balance, strength, and coordination. For patients, this could mean less pain, better mobility, and a renewed sense of control over their bodies.

The message is clear: when addressing hip or pelvic pain, don’t overlook the floor beneath it all. Pelvic Health Physical Therapy evaluates the hip, pelvis, pelvic floor and beyond when there are symptoms to determine what the root cause. Physical Therapists that specialize in Pelvic Health have additional training and have completed certification in Pelvic Health have multiple treatment options and tools to help alleviate pain and resolve symptoms.

Our clinic spends up to one hour during each session with our patients in private treatment rooms. Body Harmony Physical Therapy, PLLC is located downtown near the Brooklyn Bridge. Call us to schedule an appointment or to speak with our front desk staff about specific questions you have regarding physical therapy.