The Co-contraction Relationship Between Pelvic Floor Contraction and Transversus Abdominis: A Traditional Review

The simultaneous activation of the pelvic floor muscles (PFM) and transversus abdominis (TrA) plays a critical role in maintaining pelvic stability and postural control. Pelvic dysfunctions such as urinary incontinence and chronic pelvic pain can significantly reduce individuals' quality of life, while the coordinated activation of these two muscle groups has emerged as an effective approach to managing such symptoms. This review evaluates the physiological and clinical effects of the combined activity of the PFM and TrA by examining studies on various exercise approaches and methods. Hypopressive exercises (HE) and dynamic neuromuscular stabilization (DNS) techniques have been shown to support pelvic stability, enhance muscle endurance, and improve postural control. The effects of exercises performed in supine and sitting positions on muscle activation may facilitate the development of personalized physical therapy programs. Supported by objective measurement methods such as ultrasound and electromyography, these studies demonstrate that the synchronized activation of the PFM and TrA plays a crucial role in the prevention and treatment of pelvic dysfunctions. By integrating different approaches, this review provides a comprehensive evaluation of the clinical applications of the pelvic floor (PF) and TrA muscles.