All individuals have a pelvic floor, no matter the sex. Despite this fact, the pelvic floor has largely been left out of orthopedic, fitness, and sports education and assessment. Therefore, the pelvic floor is frequently thought of as a “taboo” region of concern that is discussed only during and after pregnancy.


Why is the pelvic floor important? The transversus abdominis (TrA) (Figure 1), diaphragm, pelvic floor muscles (PFM), and multifidus function together to provide spinal support by managing IAP (16). This system has been described by a variety of visual models including a cylinder, a soda can, and a piston (17). As described by Richardson et al. (18), the TrA serves as the wall of the system, with the pelvic floor as the base and the diaphragm as the top. The pelvic floor is the missing link in previous core discussions that ignore the bottom of the soda can. One study even concluded that the pelvic floor has a greater influence on low back pain compared with abdominal muscles (19).

Figure 1: 

The TrA originates from the lateral one-third of the inguinal ligament, the anterior two-thirds of the inner lip of the iliac crest, lateral tensor fascia latae, and internal aspects of the lower six costal cartilages, where it also connects to the diaphragm. There are also fascial and muscular connections connecting the TrA to the internal oblique and rectus abdominis muscles. The TrA assists with stability and helps manage IAP with the PFM, diaphragm, and multifidus.