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

Most people aren’t told this, but pelvic floor injuries during vaginal birth are common—and often unspoken. These injuries can lead to long-lasting issues like prolapse, incontinence, and pain. The good news? Many of them are preventable, and almost all of them are treatable with the right support.

What the Research Says

A major review published in the American Journal of Obstetrics & Gynecology (AJOG) revealed that:

Up to 19% of first-time moms show signs of levator ani muscle tears on imaging after birth—injuries that are linked to:

Pelvic organ prolapse
Urinary or fecal incontinence
Ongoing pelvic pain
Pain with intimacy
Difficulty returning to exercise

These are life-altering symptoms, yet they’re often dismissed as “normal” after having a baby.

They’re common, but should not be normal.

How Can We Prevent These Injuries?

One of the most effective and underutilized tools in birth recovery and injury prevention is pelvic floor physical therapy—both before and after delivery.

Pelvic floor PT can help:

Prepare your muscles for the physical demands of labor
Optimize pushing strategies and positioning
Minimize excessive strain on pelvic tissues
Support healing postpartum, even years after birth

Our Approach at Archer Physical Therapy

We believe education and prevention are powerful. That’s why our pelvic floor physical therapists work closely with women to:

Identify pre-existing tension, weakness, or imbalances
Create custom plans for pregnancy, labor prep, and postpartum healing
Collaborate with birth professionals to protect your long-term pelvic health

We’re here to break the silence around these injuries and offer real, research-based solutions.

Ready to Learn More?

Pelvic floor therapy isn’t just for postpartum—it’s for prevention, healing, and thriving.

Want to know if it could help you? Book a free phone consult and let’s chat about your birth plan or postpartum concerns! We would love to support you!

Because your body deserves support, and your recovery deserves more than "just give it time."

Sources:
AJOG Study – Pelvic Floor Injury During Vaginal Birth Is Life-Altering and Preventable

Why Pelvic Floor Therapists Look at Your Spine (and Why It Matters for You)