How Weak Hips and Glutes Can Create a Hypertonic Pelvic Floor

The best way to wrap your head around this is to first understand 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.

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

In any team scenario, when some players aren’t performing their role, others must pick up the slack. 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. This underscores another reason why strength training should be a routine priority—'use it or lose it' is certainly true for muscle strength.

 Found this blog post useful? I'd love to hear from you! Send me a message and spread the word by sharing it with your friends!

Cheering you on ♥️
- Caroline Packard, DPT