Core Resilience

Your pelvic floor is part of your core — and sometimes it’s the part that’s been missed.

If your lower back pain keeps returning, your core work doesn’t seem to translate into feeling stronger, or you leak, feel heaviness or struggle with pressure during exercise, it may be worth looking beyond your back alone.

Your diaphragm, abdominal wall, deep spinal muscles and pelvic floor work together to support movement and manage pressure.

At CoreGood, we assess how that whole system is working — then identify what actually needs improving.

Why Does My Back Pain Keep Coming Back?

Perhaps you’ve already done the rehabilitation.

Your back settled, you returned to normal life, and then weeks or months later it started again after a lift, a long drive, a hard training week — or for no obvious reason at all.

Or perhaps your back isn’t particularly painful, but your “core” simply doesn’t feel as strong or coordinated as it used to.

Women also commonly describe:

Core exercises that don’t seem to translate into function

Being told to “engage your core” without knowing whether they’re actually doing it

Leaking during running, lifting or exercise classes

Heaviness or pelvic pressure after training

Back ache that builds through the day

Feeling constantly braced or gripped

Difficulty coordinating breathing with lifting or exercise

There are many possible reasons for recurrent back pain.

Pelvic floor dysfunction isn’t the explanation for every woman’s back pain.

But when back or core problems occur alongside bladder, bowel, pelvic floor or pressure-management symptoms, it makes sense to assess the system together rather than repeatedly looking at the back in isolation.

What Actually Is Your Core?

Your core is much more than your abdominal muscles.

Four important components work together around your trunk:

These structures don’t work independently.

When you breathe, cough, lift, run or change direction, your trunk needs to generate and manage pressure while also remaining mobile enough to move.

A well-functioning system can create tension when it’s needed and let go when it isn’t.

That last part matters.

A good core isn’t one that is permanently braced.

How Does the Pelvic Floor Fit In?

The pelvic floor forms the base of this system.

It needs to respond appropriately when pressure and load increase — during a cough, lift, jump or landing — while also being able to relax when that activity is over.

Different women can have very different problems.

One woman may have a pelvic floor that doesn’t generate enough force or endurance.

Another may generate plenty of activity but struggle to coordinate it at the right time.

Another may be constantly gripping and unable to relax.

Those situations can feel surprisingly similar:

poor control, fatigue, heaviness, leakage, discomfort or a core that simply doesn’t feel right.

But the rehabilitation can be very different.

That’s why “do more pelvic floor exercises” isn’t always the answer.

Can Pelvic Floor Dysfunction Cause Lower Back Pain?

The relationship is more nuanced than saying one causes the other.

Women with lower back pain are more likely to have altered pelvic floor function, and pelvic floor dysfunction and lower back pain can coexist.

Both also share relationships with breathing, abdominal function, movement, load and pressure management.

That doesn’t mean your pelvic floor is responsible for your back pain.

It means that for some women, leaving the pelvic floor out of the assessment means leaving out part of the system.

This becomes particularly relevant when recurrent back pain occurs alongside:

Bladder leakage

Urinary urgency

Pelvic heaviness

Pelvic pain

Difficulty relaxing the pelvic floor

Symptoms with running or lifting

Pregnancy or childbirth-related changes

In those situations, assessing the back and pelvic floor together can give us a more complete picture.

Weak Isn’t the Only Problem

Pelvic floor rehabilitation is often associated with strengthening.

But strength is only one part of function.

A pelvic floor that is constantly active can become fatigued, tender and poorly coordinated.

If you’re already gripping, repeatedly adding more squeezing may be exactly the wrong strategy.

We want to know:

Can you contract?

Can you generate enough force?

Can you sustain it?

Can you coordinate it with your breathing?

Can you respond when load arrives?

And importantly — can you fully let go afterwards?

The goal isn’t the strongest possible pelvic floor.

It’s a pelvic floor that responds appropriately to what you’re asking your body to do.

Breathing, Bracing & Pressure

Every time you lift, cough, run or jump, pressure changes inside your abdomen.

Your diaphragm, abdominal wall and pelvic floor need to coordinate with those changes.

Breath-holding and very rigid bracing can sometimes increase the pressure the pelvic floor has to manage.

That doesn’t mean you should never brace or hold your breath during exercise.

The right strategy depends on what you’re lifting, how heavily you’re working, your goals and your current capacity.

For someone returning to exercise or experiencing leakage, heaviness or pain with load, improving breathing and pressure-management strategies can make a meaningful difference.

We can assess how you currently manage those demands rather than simply giving everyone the same breathing instruction.

What Does Running and Training Ask of Your Pelvic Floor?

Running, jumping, skipping, CrossFit, weight training, netball, gymnastics, tennis and other high-load activities repeatedly challenge the pelvic floor.

That isn’t a reason to avoid them.

It’s a reason to make sure your body has the capacity to meet the demand.

If you leak during a run, feel heaviness after training or develop symptoms as you fatigue, the useful question isn’t:

It’s:

“What part of the system isn’t keeping up with the demand?”

That may involve pelvic floor strength or endurance.

It may involve timing.

It may involve breathing and pressure management.

Or it may simply mean the load has progressed faster than your current capacity.

Once we understand the limiting factor, we can work on it.

The goal is to build capacity — not remove the activities you enjoy.

What About Pregnancy and Childbirth?

Pregnancy changes the whole core system.

Your abdominal wall lengthens, your breathing mechanics adapt and your pelvic floor manages increasing load for months.

Birth can create further changes to pelvic floor muscle, connective tissue and coordination.

A caesarean birth also involves abdominal surgery and recovery.

If your back or core has felt different since pregnancy — particularly if you also experience leakage, heaviness, abdominal separation or pelvic floor symptoms — assessing these systems together can be useful.

How We Assess It

We don’t begin by handing you another core programme.

We begin by understanding what your system is actually doing.

Understanding Your Situation

We’ll talk about:

When your symptoms started

What aggravates or settles them

What rehabilitation you’ve already tried

Your work and training

Pregnancy and birth history where relevant

Bladder and bowel function

Any pelvic floor symptoms

What you’ve stopped doing

What you’d like to get back to

Then we assess the things most relevant to that story.

Objective, Non-Invasive Assessment

Whenever appropriate, we begin with objective, non-invasive assessment.

Real-time ultrasound can allow us to observe pelvic floor movement through the lower abdomen.

Rather than assuming you are performing a pelvic floor contraction correctly, we can see whether the bladder base lifts, whether you can sustain that movement and whether you can relax afterwards.

It can also help identify when someone is inadvertently bearing down when they believe they are lifting.

At the same time, we can observe how the deep abdominal wall is behaving and how the two systems coordinate with breathing.

Biofeedback can provide additional information about pelvic floor activation, endurance and control.

But we don’t only assess you lying down.

We also want to see how your body moves and manages the actual loads that provoke your symptoms.

Will I Need an Internal Examination?

For most women attending primarily for back pain or core function, no.

Real-time ultrasound, biofeedback and movement assessment can provide a great deal of useful information without an internal examination.

If we think an internal assessment could provide additional information that would genuinely change your rehabilitation, we’ll explain what we’re looking for and why.

It remains your choice.

You can consent, decline or defer it.

Your Personalised Pathway

Once we understand what’s limiting you, rehabilitation may include:

Pelvic Floor Rehabilitation

Improving strength, endurance, timing, relaxation or coordination according to what your pelvic floor actually needs.

Core & Movement Rehabilitation

Improving how your abdominal wall, spine, hips and pelvic floor work together, then progressing that into the movements relevant to your life.

Breathing & Pressure Management

Improving coordination between your breathing, abdominal wall and pelvic floor during lifting, exercise and everyday activity.

Downtraining

Where the problem is excessive pelvic floor activity rather than weakness, rehabilitation may focus first on learning to reduce unnecessary tension and restore normal relaxation.

Hands-On Treatment & Acupuncture

Where pain, muscle tone or other musculoskeletal contributors are relevant, hands-on treatment or acupuncture may form part of the broader rehabilitation pathway.

Return to Running, Lifting & Sport

Progressively building the strength, control and load tolerance required for the activities you actually want to do.

Collaborative Care

If your symptoms suggest something requiring medical investigation or another healthcare provider, we’ll tell you.

You don’t need to know which approach is right for you before booking. That’s our job.

What Improvement Can I Expect?

The goal isn’t simply to make you better at core exercises.

It’s for the improvement to show up in your life.

That might mean:

Your back doesn’t flare as often

You feel stronger lifting

You can run without leaking

Training doesn’t leave you with pelvic heaviness

You can increase load without constantly worrying about your back

You understand when to brace and when to relax

Your core finally feels connected rather than something you’re constantly trying to “switch on”

How much improvement you can expect depends on what’s contributing, how long it has been present and what you’re asking your body to do.

After your assessment, we’ll explain what we think is realistic.

If your presentation suggests your back pain needs medical investigation rather than — or alongside — rehabilitation, we’ll tell you.

What About ACC?

ACC may contribute where back pain follows an accepted accidental injury, such as a specific lifting, sporting or other injury.

Back pain that has developed gradually without an eligible injury is generally treated privately.

If ACC applies to your treatment at CoreGood, ACC contributes towards rather than necessarily covering the full appointment fee.

If you’re unsure whether your situation may qualify, ask us when booking.

Frequently Asked Questions

I Already Do Pilates and Core Work. Why Would This Be Different?

Pilates and other core training can be excellent.

The difference is assessment.

It is possible to perform many core exercises without knowing whether your pelvic floor and deep abdominal system are contributing in the way you think they are.

We use objective assessment to identify whether something is actually missing before deciding what needs more training.

Why Do I Leak When I Run or Lift?

Running and lifting increase the demand on your continence and pressure-management systems.

Leakage can occur when the pelvic floor doesn’t generate enough support, isn’t responding at the right time, fatigues as the session progresses or isn’t coordinating effectively with the rest of the system.

The answer isn’t automatically to stop training.

It is to understand why your current capacity isn’t meeting the demand.

Should I Stop Running or Lifting Until My Back Settles?

Usually, complete avoidance isn’t necessary.

We may temporarily modify load, volume or particular activities while building the capacity required to tolerate them.

The aim is generally to keep you moving while progressively preparing you for more.

Should I Be Doing More Pelvic Floor Exercises?

Only if the assessment shows that strengthening is what you need.

If your pelvic floor is already overactive or poorly coordinated, more squeezing may be unhelpful.

That’s one of the reasons we assess before prescribing.

Is My Back Pain Coming From a Disc?

It may be, or there may be other musculoskeletal contributors.

We assess your back, hips, movement and neurological signs alongside your core and pelvic floor function.

If your symptoms suggest something requiring further medical investigation, we’ll tell you and can communicate with your GP with your permission.

Do I Need a GP Referral?

No.

You can book directly.

Ready to Take the First Step?

If your back pain keeps returning, your core doesn’t feel as strong or coordinated as it should, or exercise is accompanied by leakage, heaviness or pelvic floor symptoms, it may be worth looking at the whole system.

Your first appointment is about understanding what’s limiting you and working out what can realistically improve.