How Your Hips Impact Your Pelvic Floor (and Why It Matters More Than You Think)

You know that feeling when your hips are tight, your back feels off, or your core just isn’t doing its job? It might all come back to your pelvic floor. The pelvic floor is a group of muscles that does far more for you than you may realize (like a silent partner).

Your pelvic floor isn't just about bladder control. It's part of a full system that stabilizes your spine and body, supports your organs, and coordinates with your hips and core every single time you move. When one part of that system goes offline, something else steps up to fill the gap — and that’s where the trouble starts. That may mean your hips contribute to pelvic issues or could mean your hip issues are contributed to by the pelvic floor (yay human body complexity).

Let's dive in below.

The Hip–Pelvic Floor Connection

The pelvic floor and hips are friends. They share muscles, fascia, nerves, and movement patterns. And what we often find is that when one’s out of sync, the other has to compensate. Remember group projects in high school? Same vibes.

How they’re linked:

• The obturator internus (a deep hip rotator) literally forms part of the pelvic wall and connects directly to the pelvic floor fascia.

• Glute max and med help stabilize the pelvis, influencing how pressure is distributed to the pelvic floor during movement.

• Shared nerve supply (like the pudendal nerve) means tension or weakness in one area can affect the other.

So if the hip is tight, weak, or overworked, your pelvic floor will feel it. Even if you don’t realize that’s where it’s coming from.

When Things Get Out of Sync

1. Tight hips may mean a tense pelvic floor

When hip rotators or adductors stay tight, they limit motion through the pelvis. Your pelvic floor responds by staying on high-alert. It's trying to create stability, but it's overworked, tired, and maybe a bit burned out. Honestly, same. Sorry, I digress. Anyways, this can lead to tension, tailbone pain, or that “can’t fully relax” feeling. Heck it can also cause prolapse, incontinence, constipation, sexual dysfunction, should I continue?

2. Weak hips may mean an overworked pelvic floor

If your glutes or deep rotators aren’t pulling their weight, your pelvic floor often picks up the slack. Over time, that leads to fatigue, heaviness, or even leaking with activity. Kind of like you when your group left you with all the work (the tension/fatigue part).

3. Limited mobility = changed mechanics

When hip mobility is restricted, whether from pregnancy, prolonged sitting, or old injuries, then everything from your gait to your squat mechanics changes. That alters the load on your pelvic floor and can show up as pain, pressure, or instability.

What This Means for You

If you’ve been told to “just do Kegels” or if you stretch your hip flexors daily without real relief, you’re missing half the picture.

Your hip flexor probably doesn’t need another stretch. In fact, please stop just stretching you hip flexors before I climb on a soap box about bad info on the internet. Your system needs better coordination (and probably a good bit more strength). The pelvic floor doesn’t work alone; it relies on support from the hips, glutes, and deep core. And honestly, the same could be said for the hips, glutes, and core in regards to needing help from the pelvic floor.

Research shows that improving hip strength and mobility not only enhances pelvic floor function but also helps reduce low back and tailbone pain (Arab et al., 2010; Sapsford & Hodges, 2012).

How to Start Reconnecting

Release: Gentle hip mobility work (think figure-4 stretch or open books). We want blood flow and length, not to yank your muscles all over the place.

Reconnect: Add deep breathing and pelvic floor relaxation. Let the hips and pelvic floor move together, not against each other.

Rebuild: Strengthen your glutes, rotators, core, and everything in between with functional movements like squats, lunges, deadlifts, or bridges.

Forget perfection, the goal is to help your body move as one, not in pieces.

When to Get Support

If your hips feel locked, your pelvic floor never seems to “turn off,” or symptoms like leaking, heaviness, or tailbone pain pop up with movement, your body’s asking for backup.

Pelvic floor physical therapy bridges that gap. An in-depth evaluation looks at your movement patterns, strength, and breath mechanics to find the real source of your symptoms...not just chase the pain.

You deserve to move, lift, laugh, and live without worrying what your body will (or won't) do next.

Healing is about connecting to and with your body, not some unattainable level of perfection. When your hips and pelvic floor finally start working together again, everything else follows. If something here clicked for you, take it as your sign to start listening. Your body’s been trying to tell you what it needs all along. And when you give it the right support? Life gets a whole lot easier… and a lot less leaky or painful.

⚠️ Disclaimer: This post is for educational purposes only and not intended as medical advice. Always check with your provider before starting a new exercise program.

References

1. Arab AM, Chehrehrazi M, Amiri M, Rahimi A. The relationship between hip muscle strength and pelvic floor muscle function in women with and without stress urinary incontinence. Int Urogynecol J. 2010;21(10):1249-1253. doi:10.1007/s00192-010-1175-9

2. Sapsford RR, Hodges PW. The role of the pelvic floor in breathing and abdominal muscle function. Neurourol Urodyn. 2001;20(1):97-108. doi:10.1002/1520-6777(2001)20:1<97::AID-NAU11>3.0.CO;2-A