When women hear “pelvic floor issues,” most immediately think:
weakness.
So they start doing Kegels.
But in the clinic, we often see something different.
Many pregnant and postpartum women are not dealing with a weak pelvic floor — they’re dealing with a tight, overworking, or uncoordinated pelvic floor.
And strengthening something that is already tight can actually make symptoms worse.
The Pelvic Floor Is Part of a System
The pelvic floor doesn’t work alone.
It works together with:
-
your diaphragm (breathing muscle)
-
your abdominal wall
-
your deep core
-
your pelvis and sacroiliac joints
These systems are designed to move together.
When they do, pressure moves efficiently through the body.
When they don’t, the pelvic floor often compensates.
What Changes During Pregnancy
As pregnancy progresses:
-
the rib cage expands
-
the pelvis shifts forward
-
ligaments soften
-
pressure increases through the abdomen
If the ribs stay flared or the pelvis isn’t moving evenly, the pelvic floor often tightens to create stability.
This is protective.
But over time, it can lead to symptoms like leaking, pressure, or discomfort.
If you haven’t read it yet, this connects closely with:
These are often the same system showing up in different ways.
Tight vs Weak: Why It Matters
A Tight Pelvic Floor May Look Like:
-
leaking that doesn’t improve with Kegels
-
difficulty relaxing or “letting go”
-
constipation or incomplete emptying
-
pressure or heaviness
A Weak Pelvic Floor May Look Like:
-
leaking with coughing or sneezing
-
lack of support with movement
-
difficulty managing pressure
The important thing is that leaking can happen with both.
This is why so many women feel confused when strengthening doesn’t fix the problem.
Why Kegels Aren’t Always the Answer
Kegels are helpful when true weakness is present.
But if the pelvic floor is already tight, strengthening without coordination can increase tension.
That’s why some women say:
“I’ve been doing everything, but it’s not getting better.”
In these cases, the missing piece is often coordination and pressure management.
Where Chiropractic Care Fits In
Chiropractic care plays an important role in pelvic floor function because it directly affects the pelvis and nervous system.
At our clinic, we assess:
-
sacroiliac joint motion
-
pelvic alignment
-
rib positioning
-
breathing patterns
-
muscle tension throughout the core
If the pelvis is not moving evenly, the pelvic floor often tightens to compensate.
When we restore motion and reduce tension through the pelvis and surrounding structures, the pelvic floor can begin to relax and coordinate more naturally.
The Role of Breath
The pelvic floor and diaphragm work together.
On inhale → the pelvic floor lengthens
On exhale → it recoils and supports
If breathing becomes shallow or stays in the chest, this coordination breaks down.
Start here:
This helps reconnect breath, core, and pelvic floor.
You can also add gentle expansion work like
Simple Tools That Help
Sometimes small tools can support better coordination.
Using a Pilates ball between the knees can help activate inner thigh support and improve pelvic stability.
This reduces the need for the pelvic floor to overwork.
How This Connects to Other Symptoms
Pelvic floor dysfunction rarely exists alone.
You may also be experiencing:
or even:
Sciatica in Pregnancy: Why the Zingers Down Your Leg Aren’t Random
These are often different expressions of the same underlying issue:
pressure not moving well through the body.
The Bottom Line
Pelvic floor symptoms during pregnancy are not always about weakness.
Often, they are about coordination — how the pelvis, ribs, breath, and core work together.
When those systems are supported and moving well, the pelvic floor no longer has to overwork.
And that’s when symptoms start to change.