There is a critical blind spot in women's healthcare: the intricate connection between the pelvic floor, the deep core, and systemic nerve pain.
What does this mean?
It means that your sciatica might be caused by the condition of your pelvic floor. There's a ton of research on the deep core, of which the pelvic floor is a part. And we encourage you to check it out. But sometimes this stuff hits home when we read about someone's experience.
One of those stories belongs to Femme Flexor founder Wanda Cotie. It was actually a personal, multi-year struggle with chronic sciatica pain rather than just a simple quest to fix common bladder leaks that resulted in the Femme Flexor.
The Sciatica and Pelvic Floor Connection
For three and a half years, Wanda suffered from debilitating sciatica pain. Like many women, she moved through a medical landscape that frequently misdiagnoses or compartmentalizes pelvic symptoms. It was only when she discovered that her pelvic floor was likely involved that the pieces of the puzzle clicked together. She learned about:
The Shared Deep Core: The pelvic floor muscles do not act in isolation; they form the base of the deep core, working in tandem with the diaphragm, deep abdominal muscles, and the multifidus muscles stabilizing the spine.
The Piriformis and Nerve Entrapment: When the pelvic floor becomes hypertonic (chronically tight), imbalanced, or weak, surrounding stabilizing muscles—like the piriformis muscle in the glutes—overcompensate. This chronic gripping places direct, agonizing pressure on the sciatic nerve.
The Silent Symptom Cycle: Because her bladder leaks were only occasional, standard diagnostic protocols completely missed the pelvic connection, leaving her to also manage a loss of interest in intimacy due to persistent, ambiguous pelvic pain.
Here's the anatomy behind it.
To understand how pelvic floor dysfunction can cause sciatica, you first have to abandon the idea that the pelvic floor is a single, isolated set of muscles responsible for bladder control. It isn't. It is one wall of a pressure chamber.
The abdominal cavity is bounded superiorly by the diaphragm, inferiorly by the pelvic floor, and circumferentially by the abdominal wall and spine. Together with the deep spinal stabilizers — particularly the multifidus — these muscles form a three-dimensional support system around the lower back and pelvis, functioning as an integrated unit rather than a collection of independent parts.
Sciatica, then, is not always a spine problem originating in a disc. Sometimes it begins much lower and much closer to the centre of the body.
The Piriformis: When the Deep Core Stops Working
When the pressure-chamber system breaks down — when the pelvic floor is weak, chronically tight, or unable to function as part of the team — the body finds workarounds. One of the most consequential involves the piriformis muscle.
What the standard clinical description often omits is why the piriformis becomes problematic in the first place. The piriformis is a secondary stabilizer of the pelvis: one of the muscles that compensates when the primary deep core system is not doing its job. When the pelvic floor is hypertonic or weak, these secondary muscles take on loads they were not designed to carry continuously.
A chronically overworked piriformis becomes inflamed, and the sciatic nerve pays the price. The most common features are buttock pain, external tenderness over the greater sciatic notch, and aggravation of pain through sitting. This is a pattern that can persist for years while clinicians focus on the lumbar spine.
Hypertonia: A Different Challenge
A hypertonic pelvic floor means that the muscles of the pelvic floor are in a constant state of tension, like a closed fist. The muscles become tired, sore, and struggle to return to their natural state. This constant muscle tension locally decreases blood circulation and exchange of oxygen and metabolites, which can lead to the formation of myofascial trigger points — hypersensitive areas within the muscle tissue itself. These trigger points refer pain outward into the pelvis, the hips, and down the sciatic nerve pathway.
Releasing that tension is always the first priority. First therapies are often:
Diaphragmatic breathing. Typically the first intervention, and the most immediately accessible. When you inhale, the diaphragm moves down — causing the pelvic floor to lower slightly and receive a gentle stretch. When you exhale, the diaphragm rises, and the pelvic floor moves upward with a gentle contraction. Because the diaphragm and pelvic floor are functionally coupled on every breath, learning to breathe deeply and slowly re-establishes the rhythmic release cycle that a hypertonic pelvic floor has lost. It helps the pelvic floor relax, letting go of persistent tension.
Myofascial trigger point release. This technique addresses the hypersensitive knots that form in chronically contracted muscle tissue. By targeting areas of tightness, myofascial release helps restore flexibility and mobility to the pelvic area, easing tightness and improving blood flow to the region. It can be performed both internally by a trained pelvic physiotherapist and externally on the surrounding gluteal, hip, and abdominal tissue.
Where the Femme Flexor Can Help
Wanda's personal breakthrough led her to design a tool that completely redefines pelvic floor exercise. The traditional "squeeze and hold" approach (squeezing against empty air) is insufficient and can actually worsen pain for women with hypertonic or uncoordinated muscles.
Her methodology focuses entirely on balance, awareness, and awakening, promoting relaxation and gentle, genuine, strength building:
Traditional Kegels vs. The Femme Flexor Approach
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Squeezing blind air → Tactile proprioception
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Strength-only focus → Balance & coordination
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Can worsen tightness → Awakens tissue layers
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Isolation approach → Restores blood flow
Awakening the Tissues via Proprioception: The design is engineered to fit gently just past the vaginal entrance, providing structural, physical feedback to the surrounding tissues. The moment it is inserted, the brain receives a map of where the muscles actually are.
Practising Without the Pressure of Intercourse: For women suffering from chronic pelvic pain or low libido due to discomfort, forcing intercourse can cause the brain to associate intimacy with trauma, leading the muscles to reflexively guard and tighten further. Training with a non-invasive, body-safe silicone tool allows women to reclaim their anatomy in a safe, non-sexual, stress-free context.
Restoring Blood Flow and Vitality: Using gentle resistance training causes a natural pumping mechanism in the muscles. This draws oxygenated, nutrient-rich blood flow directly into the three layers of vaginal tissue. This increased circulation revitalizes atrophied or traumatized tissue, awakening nerve pathways and restoring natural elasticity and lubrication.
Wrapping Up
If this article helped you make connections about your pelvic floor, we're so happy to have helped. If you suspect that a hypertonic pelvic floor may be part of your chronic pain experience, we encourage you to see a pelvic floor physiotherapist.
And know that you don't have to figure it out alone. The Femme Flexor may be an important part of your healing journey.
