The Integral Role of Pelvic Health in Mobility and Cardiometabolic Function

Pelvic health is increasingly recognized in contemporary research as a foundational determinant of whole-body function rather than a narrow or specialty-specific concern. The pelvic floor is a coordinated group of muscles, ligaments, and connective tissues that supports the bladder, bowel, and reproductive organs while contributing to postural stabilization and load transfer through the trunk and hips. It works synergistically with the diaphragm, abdominal wall, and deep spinal musculature to form a dynamic core stabilization system essential for gait, balance, lifting, and everyday movement (Woodley et al., 2017; Hagen et al., 2020)

When pelvic floor function is weakened, overactive, or poorly coordinated, the body often compensates by altering movement mechanics elsewhere in the kinetic chain. These compensations may contribute to lumbar spine loading, hip and pelvic pain, gait asymmetry, and functional mobility limitations across the lifespan, particularly in postpartum and aging populations (Curillo-Aguirre et al., 2023; Chen et al., 2025). Pelvic floor dysfunction frequently presents as urinary incontinence, pelvic organ prolapse, or pelvic pain, but its impact extends into daily activity, exercise tolerance, and participation in meaningful roles (Dumoulin et al., 2015).

Pelvic Health and Cardiometabolic Intersections

Emerging research also indicates meaningful associations between pelvic floor dysfunction and cardiometabolic risk profiles. Higher rates of stress urinary incontinence have been observed among individuals with obesity, central adiposity, and metabolic dysregulation, suggesting shared pathways involving inflammation, intra-abdominal pressure, connective-tissue loading, and neuromuscular fatigue (Ayeleke et al., 2021; Chen et al., 2025). These findings imply that metabolic risk factors may not simply coexist with pelvic floor disorders but may worsen symptom progression and functional burden over time.

At the same time, pelvic floor symptoms can limit engagement in physical activity due to fear of leakage, discomfort, or exertional strain, reducing movement exposure that would otherwise support cardiometabolic resilience. Interventions that improve pelvic floor strength, coordination, and endurance — particularly pelvic floor muscle training (PFMT) — have been shown to improve quality of life, physical confidence, and participation in exercise and daily activity (Curillo-Aguirre et al., 2023; Dumoulin et al., 2015). In this way, pelvic health can act as both a mediator and an enabler of cardiometabolic health behaviors.

Mobility, Function, and Long-Term Outcomes

Pelvic floor disorders are prevalent and often under-recognized, with substantial impact on mobility, vitality, and psychosocial well-being across midlife and older adulthood (Chen et al., 2025). Untreated symptoms are associated with lower physical functioning and activity tolerance, and with avoidance of movement contexts that might otherwise support musculoskeletal strength and metabolic regulation (Ayeleke et al., 2021).

Evidence across randomized trials and systematic reviews demonstrates that PFMT — with or without adjunctive biofeedback — improves continence outcomes, pelvic muscle performance, and functional quality-of-life measures (Dumoulin et al., 2015; Hagen et al., 2020; Alouini et al., 2022). During pregnancy and postpartum, PFMT is also associated with reduced pelvic floor complications and improved recovery trajectories, further reinforcing its role in movement capacity and long-term function (Zhang et al., 2024).

These improvements are clinically meaningful because they reduce barriers to activities such as walking, resistance training, and lifestyle movement — behaviors that form the foundation of cardiometabolic prevention and disease management.

Clinical Implications and Integrated Care

Taken together, the literature supports a more integrated view of pelvic health within mobility, rehabilitation, and cardiometabolic care. Screening for pelvic floor symptoms within primary care, metabolic care, and physical therapy settings can help identify dysfunction early and connect individuals with conservative, evidence-based interventions such as PFMT, neuromuscular re-education, behavioral strategies, and weight-and-load management approaches (Dumoulin et al., 2015; Curillo-Aguirre et al., 2023).

Addressing metabolic risk factors such as obesity, inactivity, and systemic inflammation may confer dual benefits — improving both cardiometabolic status and pelvic floor symptom burden — while optimizing pelvic function can reduce participation barriers and enable sustained engagement in physical activity across life stages (Ayeleke et al., 2021; Chen et al., 2025).

Conclusion

Pelvic health is a structural, neuromuscular, and behavioral foundation for movement, stability, and participation, with downstream implications for cardiometabolic resilience and quality of life. Reframing pelvic health as a core component of whole-body function allows clinicians, researchers, and patients to pursue more comprehensive and preventive strategies that support mobility, metabolic wellness, and long-term functional independence across the lifespan.