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Pelvic Floor Strengthening tips

Updated: Dec 14, 2022

Pelvic floor strength is a serious concern for all women, from our childbearing years to post-menopausal years.

Your pelvic floor is a hugely vulnerable muscle, it gets an absolute battering throughout your entire life: Periods, sex, pregnancy, delivery and menopause all playing a part in weakening its structures – this makes the need for strengthening it so important!


The pelvic floor muscles sit like a hammock within your pelvis. They span from your coccyx to your pubic bone: front to back and side to side. There are 3 holes: Urethra, vagina and anus.


· They act to support the pelvic organs (Uterus, bladder and bowel) against gravity and increases in abdominal pressure.

· They wrap around and control the opening of your bladder and rectum. When you increase pressure in your abdomen eg by coughing, sneezing, laughing or jumping, these muscles contract around your urethra and anus to prevent leakage. Equally important, these muscles must relax and lengthen to allow us to urinate or have bowel movements easily.

· They play a huge role in core control and stability through managing intra – abdominal pressure and assisting the other deep abdominal muscles, hip and back muscles in controlling movement of the sacroiliac and hip joints.

· They play an important role in sexual function – a strong pelvic floor is necessary for an orgasm.

Pelvic floor tone:

The pelvic floor muscles should be thick, firm and resemble a muscular trampoline in their ability to move up and down.

They are like any other muscles of the body, they need to be able to contract, relax and go through their full range of movement to function most efficiently.

A Hypertonic pelvic floor tone is one which is too tight and grippy.

A Hypotonic pelvic floor tone is one which is loose and weak.

Pelvic floor dysfunction is a result of pelvic floor muscles either being too weak or too tight.

Pelvic floor muscles often become hypotonic or hypertonic because of the following reasons:

  • Pregnancy and childbirth: Especially women that have had multiple births, instrumental births (use of forceps), or experience tearing from birthing a larger baby are at a greater risk of pelvic floor damage.

  • Chronic coughing: Severe and ongoing bouts of coughing from conditions like asthma, bronchitis, or smoker’s cough can increase pressure bearing downwards on the pelvic floor weakening its fibres.

  • Menopause: We naturally lose muscle mass over age 35 and this is sped up by the decrease in oestrogen associated with menopause.

  • Obesity: Being overweight puts more strain on the pelvic floor muscles

  • Straining on the toilet: Constipation or straining puts pressure downwards on the pelvic floor

  • Heavy lifting: Lifting something heavy with bad posture can cause you to bear down on your pelvic floor

The symptoms of pelvic floor dysfunctions are as follows:

· Incontinence (leaking urine or feces)

· Difficulty urinating or having bowel movements

· Feeling like your bowel movements are not complete

· Frequently feeling the need to use the toilet

· Feeling like you need to force out urine or feces

· Stopping and starting in the middle of urinating

Top tip:

If you’re ever experiencing any of these symptoms, I’d recommend a visit to your local Women’s Health Physiotherapist for a check-up – through examination they’ll be able to assess the tone of your pelvic floor and advise on how to best strengthen it based on your tone.

Remember strengthening the pelvic floor isn’t always a case of doing kegels, if you have a hypertonic tone then this may be making your pelvic floor even more grippy and tense – therefore getting an internal examination by a Women’s Health Physiotherapist is helpful.

Lots of women suffer with symptoms of pelvic floor dysfunction and often laugh them off or just don’t talk about it due to embarrassment.

Leaking even the smallest amount of urine shouldn’t ever happen, so please - start talking and get help with your symptoms.

If left unmanaged, pelvic floor dysfunction can often turn more server and result in pelvic organ prolapse.

Pelvic organ prolapse (POP): This is when one or more of the pelvic organs slip down from their position and bulge in to the vagina or protrude outwards.

There are 3 types of POP:

· Cystocele: The bladder protrudes in to or out of the vagina

· Rectocele: The rectum protrudes in to or out of the vagina

· Uterine prolapse: The uterus protrudes in to or out of the vagina

Symptoms of POP are as follows:

· Heaviness around your lower tummy and genitals

· A dragging sensation inside your vagina

· A feeling like something is coming down into your vagina (like a tampon falling out)

· A bulge or lump in the vagina

1:2 women in the UK experience a prolapse and unfortunately this gets more common as we get older: One of the most common reasons for this is ignoring symptoms and leaving it too long before seeking help and diagnosis.

Other reasons can include:

· Subsequent pregnancies

· A decrease in pelvic floor muscle strength with age

· A decrease in oestrogen levels with menopause

· Bad posture over time

Incorrect exercise techniques and too much impact

· Incorrect day to day movement patterns

· Stress

Living with a prolapse can have a huge impact on your quality of life, ability to freely enjoy exercise and play with your kids – it’s never too late to start strengthening your pelvic floor so why not make it your new year’s resolution…?

My top tips for pelvic floor strengthening are as follows:

  • Visit a Women’s Health Physiotherapist to assess the tone and strength of your pelvic floor

  • If you have a hypotonic pelvic floor, kegels are a great way of strengthening it

  • Breathing techniques, stretching and relaxation are important for a hypertonic pelvic floor

  • Remember your pelvic floor is linked to the rest of your body – quite often jaw pain or plantar fasciitis are symptoms of a hypertonic pelvic floor so a full body awareness is helpful

  • Learn about deep core muscle coordination techniques and apply this to daily life and exercise

  • Make changes to your posture - reducing tightness in the upper body can relieve pressure downwards on the pelvic floor.

  • Daily full body stretching, or yoga will help release a tight pelvic floor

  • Exhale on impact or when heavy lifting to engage the pelvic floor

  • Make changes to your diet to avoid constipation – more fibre and vegetables

  • Improve daily hydration

  • Make changes to your sleep hygiene to reduce stress levels

  • Learn about loading and pressure management strategies to ease the daily pressure on your pelvic floor

All Core Confident programs I teach, from pregnancy to menopause include a large focus on pelvic floor strengthening – remember your pelvic floor is an important part of your core too!

To learn which exercise techniques you can perform to strengthen your pelvic floor please check out any of my pregnancy, postnatal, or peri-menopausal offerings or contact me directly and we can arrange a consultation:

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