How Weak Hips and Glutes Can Create a Hypertonic Pelvic Floor

Have you ever thought of your core as just your abs? Many people do, but the truth is that the core is much more than that. To truly understand how core function impacts movement and stability, it's important to first recognize that the 'core' collectively comprises:

The Pelvic Floor, Transverse Abdominis (a.k.a. the deep core) Multifidi (a.k.a. little muscles along the spine) Diaphragm.  Together, the COORDINATED movements of these muscles create the core ‘canister’ of stability, which can be assessed by observing breath control, postural alignment, and the ability to generate intra-abdominal pressure. Training this coordination involves exercises like diaphragmatic breathing, controlled exhalation with deep core engagement, and progressive loading strategies.

Beyond this foundational core canister, there are other supporting muscles like the obliques, hips, glutes, and other back muscles.

The relationship of the glutes and hips to the pelvic floor is that like any team scenario, when some players aren’t performing their role, others must pick up the slack. In the body, when the core stabilizers—such as the transverse abdominis or diaphragm—aren’t functioning optimally, other muscles like the pelvic floor or hip flexors may compensate, leading to imbalance and dysfunction. The same principle applies to muscle balance in the body.

With the pelvic floor, it's crucial to understand that these muscles are not meant to be the primary movers but rather stabilizing muscles. To understand this let's look at some likely scenarios where the pelvic floor becomes overloaded doing more work than it should:

Weak Hips: A deep hip rotator muscle, the obturator internus, directly connects to the pelvic floor musculature. Due to this close connection, it's essentially considered a muscle of the pelvic floor. Weakness in the hip rotators is common as this strength movement is often neglected. This weakness can lead to the obturator internus failing to perform its job, thus passing the load to the pelvic floor and making it work harder than necessary.

Weak Glutes: The glutes attach at the back of the sacrum (the somewhat triangular-shaped bone between the back and tailbone) and function as a counterbalance to the forward pull on the sacrum from the pelvic floor muscles. Insufficient glute strength allows the sacrum and tailbone to tuck under as the pelvic floor pulls forward overpowering the weak glutes. Over time, this can lead to reduced glute strength and the pelvic floor muscles compensating. Although the pelvic floor is a stabilizing muscle, if it's overworked due to weak glutes, the rest of the core stability dominoes can start to fall.

The gluteus medius, the outer buttock muscle, helps keep the femur aligned in the socket and moves the leg away from the body. In a single-leg stance (i.e., walking), it holds the pelvis level. If the gluteus medius loses strength, several issues can arise:

Pelvic asymmetry in walking (or running) leads to excessive forces directed to the pelvic floor, which performs poorly when the pelvis rocks side to side. The gluteus medius lies atop the deep hip rotators (obturator and the more well-known piriformis). If it's weak, the hip rotators may try to compensate, doing more work than they should. Those muscles can become tense and painful, transferring this tension to the pelvic floor due to the close connection of muscles and fascia.

These scenarios illustrate how weakness in the hip and glute muscles can lead to a hypertonic or overactive pelvic floor. An overactive pelvic floor is one that doesn’t lengthen and contract well with breath or movement. This often results in posterior pelvic floor tension for many women. 

Posterior pelvic floor tension will limit the ability of the hip to find internal rotation which is required for full glute length. If we can't lengthen the glutes, we can't load them effectively for strength changes. Before focusing on strength, we first need to decrease posterior pelvic floor tension through back body breathing and specific movements to improve the ability to find hip internal rotation to lengthen the pelvic floor and glutes. Addressing this restriction allows for better loading of the glutes, optimizing the ability to create strength to help with movement and stability. 

As you can see, weak glutes can contribute to pelvic floor tension developing yet it becomes difficult to strengthen the glutes to absorb some of the workload until we address the role of pelvic floor tension first. 

Found this blog post useful? I'd love to hear from you! Share your thoughts or experiences in the comments—have you noticed how glute activation or hip mobility affects your pelvic floor? Let's start the conversation! Send me a message and spread the word by sharing it with your friends!

Cheering you on ♥️
- Caroline Packard, DPT

Ready to Address Pelvic Floor Tension at the Root?
Weak glutes and hips can contribute to a hypertonic pelvic floor. In my Connect Pelvic Floor Fitness program, you'll learn how to release tension, restore optimal movement, and build strength the right way. With guided workouts, expert coaching, and a supportive community, you'll have everything you need to overcome weak glutes, improve hip stability, and release pelvic floor tension so your body can move and function as it should. Start your 14-day free trial today and take the first step toward lasting relief and strength.