FSHP Academy
Women’s Health — all lessons

Anatomy and Physiology

Pelvic floor anatomyUnderstanding the menstrual cyclePhysiological changes before and after pregnancy

Life-Stage and Hormonal Conditions

MenopauseOsteoporosisPCOSThyroid disordersHormonal imbalance: what exercise can and cannot doExercise guidelines: step-by-step prescription

Prenatal Exercise

Contraindications and precautions of prenatal exercisePrenatal exercise prescriptionFirst trimester: strengthening and stretchingSecond trimester: strengthening and stretchingThird trimester: strengthening and stretching

Postnatal Exercise

Postnatal evaluation and abdominal rehabilitationBenefits of postnatal exercise for mother and childPostnatal risks and contraindicationsC-section: post-op management and precautionsPostnatal exercise prescription

Pelvic floor anatomy

The pelvic floor muscles — anatomy, functions, their role in the core “canister”, common dysfunctions and how trainers can support pelvic health.

Intermediate Evidence: Strong evidence 3 min read Reviewed 2026-10-31 Status: draft

Learning objectives

  • Describe the anatomy of the pelvic floor
  • Explain pelvic floor functions and the core canister
  • Recognise signs of pelvic floor dysfunction
  • Know when and how to refer

Before this lesson

Why this matters

Pelvic floor problems are common — especially after pregnancy, around menopause and in high-impact sports — and often unspoken.

Anatomy

  • Levator ani: puborectalis, pubococcygeus, iliococcygeus
  • Coccygeus
  • Fascia and connective tissue; perineal muscles

Functions

Support of pelvic organs, continence, sexual function, and pressure management.

The deep “core canister”: diaphragm, pelvic floor, transversus abdominis and multifidus A schematic side view of the trunk as a canister. The diaphragm forms the dome-shaped roof, the pelvic floor forms the floor, transversus abdominis wraps around the front and sides, and multifidus runs along the spine at the back. On inhalation the diaphragm descends and the pelvic floor gently lengthens; on exhalation both recoil upward. Coordinated pressure management supports continence, breathing and trunk stiffness. Inhale: diaphragm andpelvic floor descend Diaphragm — roof Transversus abdominis — front & sides Multifidus — back (along spine) Pelvic floor — base breathing; pressure from above“corset”; tension through fasciasegmental spinal controlcontinence, organ support Schematic, not anatomical scale. Front of body on the left. Exhalation reverses the movement: diaphragm and pelvic floor recoil upward.
Figure 1. The core canister: diaphragm, deep abdominals, multifidus and pelvic floor manage intra-abdominal pressure together. — Original diagram, FSHP Academy (schematic, not to scale).

Deep trunk muscles activate in anticipation of movement [hodges1996].

Dysfunctions

Stress urinary incontinence (leaking with cough, jump, lift), urge incontinence, pelvic organ prolapse, pelvic pain.

Evidence

PFMT is effective for stress urinary incontinence [dumoulin2018], and antenatal PFMT can help prevent incontinence [woodley2020].

Common mistakes and misconceptions

Case study

A CrossFit athlete leaks during double-unders. She sees a pelvic-health physiotherapist, follows a PFMT and progressive impact programme, and returns to double-unders without leaking.

Further learning: video lessons

Video links are only marked “verified” after a human has watched them. Unverified entries open a YouTube search for that channel and topic rather than a guessed link.

Introductory needs verification — opens a YouTube search

Pelvic floor anatomy

pelvic-health physiotherapists and women’s health clinicians (search)

You will understand: pelvic floor anatomy

Why: Clinician-led content; verify the specific video.
Introductory needs verification — opens a YouTube search

Exercise guidelines explained

professional bodies (search, e.g. ACOG, CSEP, RCOG)

You will understand: current guideline recommendations

Why: Clinician-led content; verify the specific video.

Knowledge check

Knowledge check · 0/5

1. The main pelvic floor muscle group is…

Answer B. With coccygeus.

2. A function of the pelvic floor is…

Answer B. Support and continence.

3. The “core canister” includes…

Answer B. Pressure system.

4. Dumoulin et al. (2018) found PFMT for stress urinary incontinence…

Answer B. Cochrane review.

5. A client leaks urine during jumping. You should…

Answer B. Treatable.

Short-answer & application questions

  1. Draw and label the pelvic floor.
  2. Explain the core canister to a client.
  3. Write a referral script for pelvic floor symptoms.

Key takeaways

  • The pelvic floor is a sling of muscles (mainly levator ani and coccygeus) supporting the pelvic organs.
  • It works with the diaphragm, deep abdominals and multifidus to manage pressure.
  • Leaking with exercise is common but not normal and can be treated.
  • Pelvic floor muscle training is effective for stress urinary incontinence.

Connected topics

womens health

Postnatal evaluation and abdominal rehabilitation

pilates

T-zone activation and breathing pattern

womens health

Prenatal exercise prescription

References

  1. Dumoulin C, Cacciari LP, Hay-Smith EJC (2018). Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database of Systematic Reviews, CD005654. Systematic review check pending
  2. Hodges PW, Richardson CA (1996). Inefficient muscular stabilization of the lumbar spine associated with low back pain: a motor control evaluation of transversus abdominis. Spine, 21(22):2640–2650. Classic study check pending
  3. Woodley SJ, Lawrenson P, Boyle R, et al. (2020). Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database of Systematic Reviews, CD007471. Systematic review check pending

Educational content only — not medical advice. Consult a qualified clinician for diagnosis or treatment.