Hey Reader,

Happy Monday!

It’s an extra happy one for me, because we are on spring break: one week off of teaching and headed to the beach!

Before I head out I want to follow up as promised from last week’s email. In that email, I talked about both the red and green flags surrounding pelvic floor function AND how the red flags can be a symptom of a larger force management/production problem (aka. a performance problem).

In this email, I’m going to start walking you through the framework with the first point of my four-point assessment designed to help you determine the primary contributing factors behind your pelvic floor symptoms. I’ll share all 4 points, with one each day now through Thursday this week.

OR you just can get it all in one shot, experiencing, seeing and feeling it in real time. That’s why I’ve also created The Pelvic Floor Audit. It’s a FREE virtual workshop for female runners who want to enjoy running without worrying about their pelvic floor all the time. The visuals, interaction, and live feedback during the workshop make the process much clearer.

The Pelvic Floor Audit will be held live this coming Sunday, March 22 at 12pm EST.

​Click here to learn more now. ​

Still, this email will give you a solid overview of how the pelvic floor integrates with the rest of your body and how pelvic floor health connects with your movement, strength training, and running mechanics. This is not about lying on the floor doing isolated breathing exercises. It’s about understanding how the pelvic floor works as part of a whole-body movement system.

Each of these areas plays a role in how your body absorbs and produces force during running.

1. Stack and Pressure Management

We begin with your core canister.

Instead of thinking about the core as just your abdominal muscles, imagine a cylindrical system made up of:

• The abdominal muscles in the front
• The back muscles behind you
• The thoracic diaphragm (your main breathing muscle) on top
• The pelvic floor at the bottom

These structures work together to create intra-abdominal pressure, which helps protect your spine, stabilize your body, and transfer force as you move.

When this system works well, pressure is distributed evenly. But if the system isn’t coordinated, excessive pressure can get pushed downward into the pelvic floor, contributing to symptoms.

A key piece of this system is finding your stack. This is where the thoracic diaphragm sits neatly above the pelvic diaphragm so they can work together efficiently.

To achieve this alignment, several things need to happen:

• You need access to pelvic neutral, rather than constantly tucking your pelvis under.
• You need the ability to move through anterior and posterior pelvic tilt.
• Your rib cage must stack over your pelvis.
• You must be able to perform long, full exhales without collapsing your posture.
• Your ribs must expand 360 degrees during breathing.

Rib movement is especially important. If your ribs don’t move well, the pressure generated during breathing and movement often gets pushed downward into the pelvic floor.

Assessing Rib Movement Through Shoulder Range of Motion

To evaluate rib cage mobility, we can use shoulder range-of-motion tests as indirect indicators.

Two assessments are particularly useful:

• Overhead Reach
• Apley’s Test

The overhead reach gives insight into how well the back of the rib cage moves, while Apley’s test provides information about the front of the rib cage.

The Overhead Reach Assessment: Assessing the Back of the Rib Cage

For this test, sit with your back against a wall. The wall helps prevent you from cheating the movement.

1. Extend your arms straight in front of you.
2. Turn your thumbs upward so your palms face each other.
3. Keep your arms parallel, like they’re running along railroad tracks.
4. Slowly raise your arms overhead as far as you can.

As you perform the movement, maintain these rules:

• Don’t allow your arms to drift wider apart.
• Don’t let your back leave the wall.
• Don’t let your lower ribs flare upward to compensate.

Ideally, your arms should reach all the way overhead beside your ears without “cheating.”

If your arms stop short of that position or you have to cheat by arching your back, flaring your ribs or widening your arms, it likely means the back of your rib cage is compressed and not moving as well as it should.

Think of your core canister like a balloon. If pressure is applied to the top/back of that balloon—specifically the back ribs—where does the pressure go?

It travels down and forward, often pushing outward into the lower abdomen and downward into the front portion of the pelvic floor. This pressure shift can contribute to symptoms such as pelvic floor heaviness, leakage, or that familiar lower belly “pooch.” I hate the word, but I know you know what I mean when I use it.

The Apley’s Test: Assessing the Front of the Rib Cage

To evaluate how well the front of the rib cage moves, we use a test called Apley’s.

For this assessment:

1. Reach one arm down and behind your back.
2. Try to touch your opposite shoulder blade with that hand.

If you cannot touch the opposite shoulder blade, or if your shoulders roll forward to create the movement, that indicates the front of your rib cage is compressed and not moving well.

Now connect that back to the pelvic floor.

If you exaggerate that forward shoulder position—rolling the shoulders forward and collapsing the chest—you’ll feel how the pressure in your core canister shifts downward. If pressure cannot move upward through the rib cage, it has nowhere else to go except down into the pelvic floor.

A rib cage that doesn’t move well essentially sets the pelvic floor up for failure. Limited rib cage movement also affects something else that runners rely on: rotation. A rib cage that doesn’t move well doesn’t rotate well, and rotation is essential for running. The pelvic floor is intimately connected with the deep hip rotator muscles, which means rib mobility influences the entire rotational chain.

Running, after all, is fundamentally a rotational movement.

So rib cage mobility matters not only for pressure management but also for the rotational mechanics that power your stride.

If these assessments reveal that your rib cage movement is limited, improving rib mobility becomes an important step. We also go deeper into practical strategies during the Pelvic Floor Audit workshop.

Pelvic Position and Finding Neutral

While rib movement matters, the pelvis also needs to be able to position itself well underneath the rib cage.

The goal is to find pelvic neutral so that the pelvic bowl can sit comfortably beneath the rib cage, allowing the core canister to function as a coordinated system.

To understand this, it helps to look at the extremes of pelvic positioning.

An anterior pelvic tilt occurs when the hip bones tip forward. This increases the inward curve of the lower back.

A posterior pelvic tilt happens when you tuck your pelvis under.

But here’s the key point: when most people try to tuck their pelvis under, they simply squeeze their glutes and shove their hips forward. That’s not true pelvic control.

Instead, we want the ability to:

• Access pelvic neutral
• Move smoothly between anterior and posterior pelvic tilt

The primary muscles responsible for helping you control this movement are the hamstrings—especially the proximal hamstrings, which attach high up near the pelvis.

The Toe Touch Assessment

One simple way to evaluate this system is through a toe touch test.

Stand upright with your feet together and legs straight, then bend forward and attempt to touch your toes.

This assessment tells us several different things, but in this context we’re focusing on what it reveals about backside expansion and pelvic positioning.

If you cannot reach your toes, it likely means you struggle to create expansion in the back of your body. This often corresponds with limited rib movement on the back side as well. In this way the overhead reach test and the toe touch test frequently go hand in hand. It also could mean you struggle to find length in the back of the pelvis/pelvic floor. You’ll see why this is important in the second point of the assessment.

On the other hand, if you can bend over and place your palms flat on the floor, it likely means you have a lot of mobility but potentially not enough stability in the pelvis. One issue within this case is the body may compensate by squeezing the glutes and pushing the hips forward to create stability.

That strategy isn’t ideal when we’re trying to find proper length and function in the posterior chain. Again, this will all make more sense in point 2 of the assessment.

Moreover, if you fall into the “super bendy” category—easily placing your palms on the floor—the concept of stacking the rib cage over the pelvis becomes even more important.

Stacking helps create a sense of safety and stability for the body.

When the body doesn’t feel stable, which can often be the case for a body with excess mobility in the connective tissue, it tends to create tension somewhere to compensate. That tension might show up as:

• Clenched glutes (and pelvic floor, the don’t operate separately)
• Tight neck or shoulders
• Tension in the calves
• Over-bracing through the core

And here’s the problem: constant tension is the opposite of a responsive pelvic floor.

A healthy pelvic floor needs the ability to lengthen and relax before it contracts. If everything is constantly clenched, that responsiveness disappears.

For runners who are naturally flexible, developing strength and control through the proximal hamstrings, establishing a good stack, and building functional stability can make a huge difference.

Stay tuned for part 2 tomorrow and/or sign up for the Pelvic Floor Audit now!

Your Coach,
Alison

Alison Marie Helms, PhD Certified Personal Trainer and Running Coach Unlock your full running potential through physics and physiology. ​Work with me.​