The pelvic floor consists of muscles, ligaments, and connective tissues that support the pelvic organs against gravity and intraabdominal pressure. This musculoskeletal structure has been vastly under diagnosed and treated as a primary and secondary source of pelvic floor dysfunction. The complex mechanics of the pelvic floor’s bimodal function and frequent insults to the integrity of the pelvic diaphragm from altered biomechanics, pregnancy, athletics, menopause, sexual trauma, prior surgery and obesity contribute to the pelvic musculature’s vulnerability to damage and injury. Frequently muscles respond to stress and injury by tightening and spasming or developing scar tissue within the muscle. These reactions often cause surrounding musculature to overreact as well. These spasms may decrease the ability of the muscle to generate adequate force and they may actually become weak while at the same time remaining tight.