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The journal Pain & Movement

The Secret Root Of Sciatica, Low Back + Knee Pain

By Dr. Allison Feldt, PT, DPT 2 min read

In our pursuit of feeling our best, we often overlook the intricate connections within our bodies, particularly in the pelvic floor—a dynamic yet misunderstood component of the core. Beyond its association with incontinence and sexual function, the pelvic floor influences unexpected areas like sciatica, and pain in the neck, back, and knees.

Contrary to common belief, a tight pelvic floor is a weak pelvic floor. Many women have been taught to overtighten their pelvic floors with Kegels to address issues like leaking or pelvic organ prolapse. However, this practice is misguiding. It can lead to problems that compromise pelvic floor dynamics and result in pain throughout the body, as the pelvic floor’s ability to relax, contract, and bulge is compromised.

The pelvic floor is the foundation of core strength. It extends beyond sexual function: it impacts bathroom function, force absorption, and overall body support. 1 in 3 women are affected by pelvic floor dysfunction, which can manifest as excessive or insufficient tension within pelvic floor muscles, presenting symptoms beyond common issues like leaking or discomfort during sex.

Dysfunction in the pelvic floor muscles can result in an imbalance in the core, impacting the stability of the lower spine. This instability can contribute to chronic low back pain, emphasizing the need to consider pelvic health in the assessment and management of lower back issues.

Sciatica, characterized by pain radiating down the sciatic nerve, can also have its roots in pelvic floor dysfunction. The pelvic floor’s role in supporting the pelvis and spine means that imbalances or tension issues can affect the sciatic nerve’s function.

Even knee pain can be influenced by pelvic floor issues. The pelvic floor contributes to overall body stability, and dysfunction in this area can lead to altered biomechanics and over compensation. This can place additional stress on the knees, often resulting in discomfort, pain, or even chronic conditions.

Recognizing the role of the pelvic floor on the entire body is essential for a holistic approach to health and well-being. By addressing pelvic floor dysfunction, people can experience relief from the pain and discomfort that stems from the pelvic floor.

Dr. Allison Feldt, PT, DPT, founder of Body Motion Physical Therapy

About the author

Dr. Allison Feldt, PT, DPT

Allison is a pelvic floor physical therapist and the founder of Body Motion PT in Edmonds. A mom who knows the aftermath of pregnancy and birth firsthand, she's on a mission to help women restore their core and pelvic floor at every stage of life.

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