The Muscle Group Nobody Talks About

A conversation with Dr. Rachel Chirichella, DPT, CSCS on pelvic floor health, athletic performance, and why this part of the body deserves a seat at the table.

This is part of Performance Rewritten, conversations with the people and communities changing what it means to move. Each installment looks at the same questions from a different angle: What is performance? What keeps people consistent? And what does it mean to build something that lasts? 

Most athletes have never thought much about their pelvic floor. It is not a topic that comes up in training plans, strength programs, or pre-race briefings. If it comes up at all, it is usually in the context of an obvious problem, something that has already gone wrong.

Dr. Rachel Chirichella thinks that is too late.

Rachel is a Doctor of Physical Therapy who works at the intersection of performance and pelvic health. Through The Performance Shift and Pilates Plus Cherry Hills, she works with athletes across disciplines, helping them understand a part of their body that has been quietly doing a lot of the work all along.

We talked with Rachel about why the pelvic floor matters for performance, what signs athletes tend to miss, and what it actually takes to support it over a long training career.

 

Why Every Athlete Should Care

The pelvic floor does not show up on most training plans, but Rachel makes the case that it should.

“Your pelvic floor supports very important organ systems, aids in breathing, and stabilizes your pelvis. All important aspects of longevity and performance.”

That framing matters. The pelvic floor is not just a women’s health issue or a postpartum concern. It is a foundational structure that every athlete, regardless of gender, relies on for stability, power transfer, and long-term function. When it is working well, you do not notice it. When it is not, the effects show up in places that seem completely unrelated.

Rachel sees athletes who have been dealing with lingering hip issues, adductor strains, and even jaw tension, without realizing the pelvic floor may be part of the picture. The system is more interconnected than most people expect.

What the Signs Actually Look Like

Pelvic floor dysfunction does not always announce itself. Rachel has learned to look for patterns that athletes often dismiss or work around.

“Common things I see that can directly impact performance are urinary incontinence with high impact activities, poor glute activation that impact core and pelvic floor coordination, pudendal nerve irritation, and even adductor injuries.”

On the performance side, those signs are meaningful. Poor glute activation is often traced back to a pelvic floor that is not coordinating properly with the surrounding musculature. Longstanding adductor strains or injuries that do not resolve effectively can have a pelvic floor component. Pudendal Neuralgia or commonly called Saddle Anesthesia directly impacts sports like biking, running, and even in the gym.

In daily life, the signals are different but equally worth paying attention to. Jaw tension. Reduced rib cage and thoracic spine mobility. Disruptions in bowel, bladder, or sexual function. None of those feel like athletic problems on the surface, but Rachel sees them as part of the same picture.

Endurance, Reactivity, and Pressure Management

One of the more useful reframes Rachel offers is about what the pelvic floor is actually designed to do.

“The pelvic floor is designed to be endurant and reactive rather than being the strongest muscle in the body.”

That distinction matters for how athletes think about training it. During a long ride or trail run, the pelvic floor is working continuously to support the trunk, pelvis, and organs. It is not producing explosive force. It is holding up under sustained demand, which requires a different kind of conditioning than most athletes focus on.

During lifting, the demand shifts. The pelvic floor needs to react quickly to load, moving from a lengthened to a shortened position without conscious thought. When that coordination is off, athletes often feel it as instability, discomfort, or leaking under heavy effort.

Pressure management ties it all together. What that means in practice is how the abdominal cavity, pelvis, and pelvic floor are absorbing and distributing force, which looks different depending on the load and duration of activity. The abdominal cavity and pelvic floor are a true powerhouse in the body, Rachel says, and coordinating them together is essential for both performance and everyday health.

On Leaking: Common Is Not the Same as Normal

Leaking during high-intensity activity is widespread enough that many athletes have come to accept it. Rachel does not.

“I don’t like to consider leaking with activity ever normal and always say to seek help as soon as you are aware, and especially if it’s getting worse.”

She does offer one nuanced exception. In heavyweight Olympic lifting, leaking can occasionally occur at the bottom of a movement where the pelvic floor is fully lengthened under a maximal load with proper breathing mechanics. In that specific context, she says, it may indicate the pelvic floor is functioning relatively normally given the demand.

But for the vast majority of situations, including running, jumping, and general lifting, leaking is a signal worth addressing. The good news, she says, is that there are tools and techniques that can reduce or eliminate it. Athletes do not have to accept it as part of the cost of training hard.

The Easiest Thing You Can Do

When it comes to recovery habits that support pelvic floor health, Rachel keeps the starting point simple.

“The easiest thing you can do to support your pelvic floor is learn how to properly diaphragmatically breathe and relax your pelvic floor.”

Diaphragmatic breathing is something most athletes can add directly into an existing stretching or mobility routine. It does not require extra time or equipment. It allows the pelvic floor to decompress and recover after the sustained demands of high-volume training.

For athletes who are putting in significant mileage or heavy training blocks, this kind of intentional relaxation work can be just as important as the effort that preceded it. The pelvic floor needs recovery time the same way any other muscle group does.

Nutrition, Hormones, and the Full Picture

Rachel approaches supplementation and nutrition the same way she approaches everything else: start with the individual.

“Generally, sleep, proper fueling, and checking your bloodwork to determine your specific supplementation needs are imperative to performance.”

She is also direct about one area that does not get enough attention in athletic contexts: hormone health. Estrogen and testosterone both play a role in maintaining the health and function of pelvic floor tissue. Addressing any hormonal imbalances is not just a quality-of-life consideration. It has real implications for how well the tissue holds up under training stress and how well it recovers.

The through line is familiar by now. Sleep, fueling, and the right information about what your body specifically needs. Get those right, and everything else is working from a stronger foundation.

About Rachel

Dr. Rachel Chirichella, DPT, CSCS is a physical therapist specializing in pelvic health and performance. She works with athletes through The Performance Shift, offering physical therapy services, and through Pilates Plus Cherry Hills, offering group and private Pilates. You can follow her work on Instagram at @rachel.chirichella.dpt.