The pelvic diaphragm is deeply influenced by what happens above and below it. Misalignments in the arches of the feet or tension in the thoracic diaphragm can place extra strain on the pelvic floor, while restricted movement in the cervical diaphragm or pharyngeal diaphragm can create compensatory patterns that ripple down the chain.

Scar tissue in the pelvic region—whether from cesarean births, episiotomies, or abdominal surgeries—adds another layer of complexity. It can limit the natural rise and fall of the pelvic diaphragm, leading to tightness, weakness, or pain.

Breathing mechanics also play a role. Many people with pelvic floor dysfunction unintentionally breathe in a way that increases intra-abdominal pressure, further straining the pelvic diaphragm.