Table 2.

Potential contributing factors

Altered biomechanics (gait, posture, core, respiration, prolapse)

Muscular response to stress

Maladaptive guarding to pain (especially abdominals and intra-/extra-pelvic muscles)

Poor sports training techniques/overtraining

History of overactivation (eg, elite sports, intense childhood regimes such as ballet/gym)

Constant abdominal activation to appear slimmer

Injury or dysfunction (current or previous): spinal, hip, pelvic, lower limbs, obstetric

Surgical: repeated sensitizing events, persistent postoperation muscle guarding

Attempting core exercises when overactivity is already present