Can Pelvic Floor Dysfunction Cause Hip or Low Back Pain?
Yes—pelvic floor dysfunction can sometimes contribute to hip or low back pain. However, not every case of hip or back pain originates in the pelvic floor.
The pelvic floor works closely with the abdominal muscles, diaphragm, hips, and back to support posture, manage pressure, and provide stability during movement. If part of this system becomes weak, overly tight, painful, or poorly coordinated, other areas may compensate.
This can contribute to discomfort around the low back, hips, pelvis, groin, or tailbone. A pelvic floor physical therapy evaluation can help determine whether the pelvic floor is part of the problem.
How Are the Pelvic Floor, Hips, and Low Back Connected?
The pelvic floor is a group of muscles and connective tissues located at the bottom of the pelvis. These muscles support the bladder, bowel, and reproductive organs while also helping with bladder control, bowel movements, sexual function, and core stability.
The pelvic floor does not work independently. It coordinates with:
The diaphragm during breathing
The abdominal and back muscles
The deep hip muscles
The glutes
The muscles around the pelvis and spine
These muscles continually adjust as you walk, lift, exercise, cough, bend, and change positions.
If the pelvic floor remains tense when it should relax, does not activate effectively when support is needed, or does not coordinate well with breathing and movement, the surrounding muscles may take on additional work. Over time, this may contribute to pain or recurring tightness in the hips and low back.
Research has found an association between pelvic floor dysfunction and lumbopelvic pain. This does not mean the pelvic floor causes every instance of back or hip pain, but it supports evaluating the pelvic floor when pain persists or occurs alongside pelvic health symptoms.
What Does Pelvic-Floor-Related Hip or Back Pain Feel Like?
There is no single pattern that confirms pelvic floor involvement. Symptoms can differ considerably from one person to another.
Possible signs include:
Persistent aching in the low back, hips, pelvis, or tailbone
Deep pain in the buttock, groin, or inner thigh
Pain that increases with prolonged sitting
Discomfort during or after exercise
Pain when lifting, bending, squatting, or carrying a child
A feeling of pelvic tightness or pressure
Pain with intimacy
Urinary leakage, urgency, or frequent urination
Constipation, straining, or incomplete bowel emptying
Symptoms that began during pregnancy or after childbirth
Pain that has not fully responded to treatment focused only on the back or hip
You do not need to experience bladder or bowel symptoms for the pelvic floor to be involved. Likewise, having one of these symptoms does not automatically mean the pelvic floor is causing your pain.
A complete evaluation is the best way to identify the contributing factors.
Can a Tight Pelvic Floor Cause Hip or Low Back Pain?
It can. Pelvic floor muscles may become tight or overactive in response to pain, stress, injury, childbirth, surgery, prolonged sitting, repetitive exercise, or habitual muscle guarding.
An overactive pelvic floor may have difficulty fully relaxing. This can affect the way the pelvis, hips, and spine move and may contribute to discomfort in nearby areas.
Signs of an overactive pelvic floor can include:
Pelvic, hip, groin, or tailbone pain
Pain with sitting
Pain with intimacy
Difficulty beginning urination
A sensation of incomplete bladder or bowel emptying
Constipation or straining
Urinary urgency or frequency
Difficulty taking a relaxed, full breath
Treatment for an overactive pelvic floor generally begins with relaxation and coordination—not more tightening.
Can a Weak Pelvic Floor Contribute to Back Pain?
A pelvic floor that is weak, fatigues quickly, or activates at the wrong time may provide less support during lifting, exercise, coughing, or other activities that increase abdominal pressure.
The body may compensate by bracing the abdominals, holding the breath, gripping the glutes, or placing more strain on the back and hips.
A 2023 systematic review and meta-analysis found that pelvic floor muscle training may be a useful component of some low-back-pain treatment plans. However, the researchers also reported considerable differences among the included studies, so pelvic floor strengthening should not be treated as a universal solution for back pain.
The appropriate treatment depends on whether the muscles need greater strength, improved endurance, better coordination, more relaxation, or a combination.
Why Hip and Back Pain Are Common During Pregnancy and Postpartum Recovery
Pregnancy and childbirth place substantial demands on the pelvis, abdominal wall, hips, and pelvic floor.
During pregnancy, changes in posture, body weight, joint mobility, breathing, and pressure management can alter how the hips and back handle movement. After delivery, the body must recover while also managing lifting, feeding, carrying, disrupted sleep, and repeated bending.
A vaginal delivery may stretch or injure pelvic floor tissues. A Cesarean delivery also affects the abdominal wall, breathing mechanics, scar mobility, and core coordination. Someone can experience pelvic floor dysfunction after either type of delivery.
Postpartum hip or low back pain may be influenced by:
Pelvic floor weakness or tension
Abdominal weakness or diastasis recti
Cesarean or perineal scar restrictions
Reduced hip strength
Changes in breathing and pressure management
Repetitive feeding, lifting, and carrying positions
Difficulty coordinating the core and pelvic floor
Treatment should address the person’s specific findings rather than assuming all postpartum pain comes from one muscle or structure.
Should You Do Kegel Exercises for Hip or Back Pain?
Not automatically.
Kegel exercises involve contracting the pelvic floor muscles. They can help when weakness or reduced endurance is part of the problem, but they may be unhelpful when the muscles are already tight, painful, or unable to relax.
Repeatedly tightening an overactive pelvic floor can potentially increase pain, pressure, urinary symptoms, or difficulty with bowel movements.
Even when strengthening is appropriate, technique matters. Some people hold their breath or tighten their abdominals, inner thighs, and glutes instead of correctly coordinating the pelvic floor.
A pelvic floor physical therapist can determine whether you need strengthening, relaxation, mobility, coordination training, or a combination.
What Happens During a Pelvic Floor Physical Therapy Evaluation?
The evaluation begins with a private conversation about your symptoms, medical history, pregnancies or surgeries, daily activities, exercise routine, and goals.
The physical assessment may examine:
Posture and breathing
Back, pelvis, and hip movement
Abdominal and core function
Hip and glute strength
Areas of muscle tension or tenderness
Balance and movement patterns
Pelvic floor contraction and relaxation
Coordination during lifting or exercise
Bladder and bowel habits
An internal pelvic floor assessment may be discussed if it is clinically appropriate. It is performed only with your consent and after the process has been clearly explained. Your treatment can always be adapted to your comfort level.
The goal is to understand how the pelvic floor, hips, back, breathing, and core are working together.
How Can Pelvic Floor Physical Therapy Help?
Treatment is based on the findings from your evaluation. Depending on what is contributing to your symptoms, it may include:
Pelvic floor relaxation or strengthening
Breathing and pressure-management strategies
Hip, glute, abdominal, and back strengthening
Manual therapy for restricted or tender muscles
Hip and spinal mobility exercises
Scar treatment after abdominal or pelvic surgery
Posture and movement retraining
Guidance for lifting and carrying
Exercise or running modifications
Bladder or bowel retraining
Gradual return to workouts and daily activities
The goal is not simply to treat the location that hurts. It is to identify why the area may be overloaded and help the body move with better coordination, strength, and confidence.
When Should You Seek Medical Care?
Hip and low back pain can have many possible causes. Pelvic floor physical therapy should complement—not replace—appropriate medical evaluation.
Seek prompt medical attention for symptoms such as:
Sudden or severe pain following an injury
New weakness in one or both legs
Numbness around the groin, inner thighs, or buttocks
New loss of bladder or bowel control
Fever accompanied by back or pelvic pain
Unexplained weight loss
Blood in the urine or stool
Pain that becomes rapidly worse or repeatedly wakes you at night
For persistent symptoms without these warning signs, a physical therapy evaluation can help identify musculoskeletal and pelvic floor factors that may be contributing.
In-Home Pelvic Floor Physical Therapy Near Elmhurst
If hip or low back pain keeps returning—or has not fully improved with treatment directed only at the painful area—the pelvic floor may be worth evaluating.
Dr. Melissa Scholl provides personalized, one-on-one pelvic floor physical therapy in the privacy and convenience of your home. The Healthy Pelvis serves women and men in Elmhurst, Oak Brook, Hinsdale, Lombard, Villa Park, Bensenville, Glen Ellyn, Downers Grove, Clarendon Hills, and nearby DuPage County communities.
Treatment is individualized around your symptoms, lifestyle, comfort, and goals. The Healthy Pelvis is also in-network with BCBS PPO plans.
If you are unsure whether pelvic floor physical therapy is appropriate for your hip or low back pain, schedule a free 15-minute telephone consultation. We can discuss your symptoms and help you determine the best next step.