When people think about pelvic floor physical therapy, they usually picture exercises or hands-on work focused right at the pelvis. But here’s the thing: your pelvic floor doesn’t work in isolation. It’s deeply connected to your spine—especially the lower back (lumbar spine) and the sacrum (the base of your spine that meets your pelvis).
If we ignore those areas, we might miss the bigger picture of what’s really going on with your pelvic health.
How Your Spine and Pelvic Floor Work Together
Think of your spine and pelvic floor as teammates:
They share connections. The muscles, fascia, and nerves in your low back and sacrum are directly tied to your pelvic floor.
Posture affects pressure. Too much arch in the low back or a tilted pelvis can add extra strain on the pelvic floor or keep it from engaging the way it should.
Nerves matter. The sacral nerves (S2–S4) actually power your pelvic floor. If those nerves are irritated , your muscles may not get the signals they need to work well. Like telephone lines or electrical wires, these communicate to the pelvic floor and if under strain that communication can be interrupted
Why We Always Check the Lumbar and Sacral Spine
Looking at the spine allows us to:
Find hidden contributors. Back pain, stiffness, or posture changes often play a role in pelvic floor problems.
Make treatment more effective. When we address both the spine and the pelvis, the whole system works better together.
Prevent future flare-ups. Keeping your spine and pelvis in balance lowers the risk of recurring leaks, pain, or weakness.
Support pregnancy and postpartum recovery. Addressing how both the spine and the pelvis work together can help with smoother labor, pushing, and healing after birth.
What This Looks Like in Therapy
At Archer PT, we don’t just focus on one area. Your body works as a system, and our approach reflects that. During an evaluation, we might:
Watch how your posture and spine move.
Assess mobility in the low back and sacrum.
See how your core, breath, and pelvic floor work together.
Use hands-on techniques and exercises to restore movement and balance.
The Bottom Line:
Your spine and pelvic floor are partners. By caring for both, we can help with:
Low back or pelvic pain
Bladder and bowel control
Postpartum recovery
Better movement and confidence in your body
At the end of the day, pelvic floor therapy isn’t just about muscles “down there.” It’s about treating you as a whole person—spine, pelvis, and everything in between.
By: Dr. Alexandria Balthrop PT, DPT, PRPC
