What is low back, SI joint & hip pain?
Think of the trunk as a cylinder: the diaphragm on top, the pelvic floor at the bottom, the deep abdominals and spinal muscles around the sides. Every breath, lift and step depends on those walls tightening and relaxing in the right order to keep pressure balanced and the spine and pelvis steady. When the pelvic floor is weak after childbirth, held rigid from pain or stress, or out of sync with breathing, the low back, SI joints and hips compensate, and they complain.
This is why back pain so often coexists with bladder leaks, constipation, prolapse or diastasis recti, and why treating the back alone gives temporary relief. Pelvic health physiotherapy looks at the whole cylinder: how you breathe, how your pelvic floor and deep core switch on, how your hips move, and what your daily loads look like.
Common signs and symptoms
- Aching or sharp pain in the low back, often worse with prolonged sitting, standing or lifting
- One-sided pain at the back of the pelvis (SI joint), sometimes into the buttock or thigh
- Deep hip or groin pain, pinching with squatting, or clicking
- Pain that began or worsened during pregnancy or after childbirth
- Bladder leaks, urgency, constipation or pelvic heaviness alongside the pain
- A feeling of instability, or a core that “doesn’t switch on”
What causes it?
- A weak or poorly timed pelvic floor and deep core, commonly after pregnancy
- Breath-holding and shallow breathing that overload the back during effort
- An overactive, rigid pelvic floor that restricts hip and pelvic movement
- Diastasis recti or abdominal surgery reducing abdominal wall support
- Hip stiffness or weakness that shifts load to the SI joints and lumbar spine
- Prolonged sitting, repetitive lifting and heavy training without pressure control
How pelvic floor physiotherapy helps
Pelvic health physiotherapy for back, SI joint and hip pain restores the deep support system rather than chasing the sore spot. Your physiotherapist assesses breathing, pelvic floor, core and hip function together, treats what is tight or weak, and rebuilds the coordination that keeps the joints comfortable under load.
A treatment plan typically includes:
- A whole-system assessment: posture, breathing pattern, pelvic floor and deep core activation, hip and SI joint mobility
- Pelvic floor training or down-training, depending on whether yours is weak or rigid
- Breathing and pressure retraining so lifting, coughing and exercise no longer drive load into the back
- Manual therapy and mobility work for the hips, pelvis and lumbar spine
- Progressive strength training that integrates pelvic floor, core, glutes and hips
- Guidance on sitting, lifting, carrying and training habits, and coordination with your doctor or other therapists
What the research says
The studies below are peer-reviewed and linked to their permanent records so you can read them yourself.
In a study of more than 38,000 Australian women, incontinence and breathing disorders were more strongly associated with back pain than obesity or physical activity levels, pointing to the pelvic floor and diaphragm as key contributors.
Smith MD, Russell A, Hodges PW. Disorders of breathing and continence have a stronger association with back pain than obesity and physical activity. Australian Journal of Physiotherapy, 2006. View study
A large majority of women with low back pain in this study also had urinary incontinence, and those with both had reduced pelvic floor function, supporting assessment of the pelvic floor in back pain.
Eliasson K, Elfving B, Nordgren B, Mattsson E. Urinary incontinence in women with low back pain. Manual Therapy, 2008. View study
Adding pelvic floor muscle exercise to routine treatment improved pain and function in patients with chronic low back pain more than routine treatment alone in this randomized trial.
Bi X, Zhao J, Zhao L, et al.. Pelvic floor muscle exercise for chronic low back pain. Journal of International Medical Research, 2013. View study
Treatment at Corelife Wellness in Oakville
Corelife Wellness is a dedicated pelvic health clinic at 3075 Hospital Gate, Unit 312, Oakville, next to Oakville Trafalgar Memorial Hospital. Care starts with a free 15-minute consultation by phone, video or in person, followed by a full assessment with our Registered Physiotherapist. Every pelvis is unique, so your plan is built from that exam rather than a template. No referral is needed, and physiotherapy is often eligible under extended health benefits.
How assessment and treatment work, and how to book, are on our main page: Pelvic floor physiotherapy in Oakville. When a weak core or ab separation is part of the picture, Emsculpt in Oakville (Venus Ab Rehab) is available in the same clinic to complement your physiotherapy.
Helpful reading from our team
When to see a doctor first
Pelvic floor physiotherapy is safe and you do not need a referral, but some symptoms need a medical assessment before or alongside treatment:
- Back pain with new bladder or bowel control problems, or numbness in the saddle area (seek urgent care)
- Progressive leg weakness, or numbness that is spreading
- Back pain with fever, unexplained weight loss or a history of cancer
- Pain after a significant fall or accident
- Severe night pain that is not eased by any position
