Pelvic Floor Exercises: How and Why
Your pelvic floor is a hammock of muscles across the base of your pelvis, holding your bladder, womb and bowel in place. When those muscles weaken, the first sign is often leaking when you sneeze, cough, laugh or run, and it is far more common than people admit. The good news is that the pelvic floor responds well to exercise. Here is how to do it properly.
What the pelvic floor actually does
The pelvic floor muscles act as a floor for your abdominal organs, a switch for the openings of the bladder and bowel, and a support for the organs above. They relax to let you empty your bladder and bowel, and contract to hold urine and wind in. Like any muscle, they can stretch, weaken or become over-tight, which is why doing the exercises correctly matters more than doing them hard.
Why these muscles matter so much
Weakness is most commonly triggered by pregnancy and childbirth, because the weight of the baby and the effort of birth stretch the muscles. It also happens with age, after the menopause as oestrogen falls, with persistent coughing, heavy lifting and constipation. Strengthening the pelvic floor can prevent stress incontinence, protect against prolapse and make recovery after birth quicker. For many women, it is the single most useful exercise they will ever learn.
How to find the right muscles
The classic trick is to imagine you are trying to stop yourself passing wind, and then to tighten the muscles that stop the flow of urine, and relax them again. Only squeeze gently when testing over a toilet, because regularly stopping urine mid-flow can interfere with emptying. You should feel a lift and squeeze around the front and back passages, without holding your breath or clenching your thighs. If you are unsure, some women find it easier to lie down with knees bent and check with a mirror or fingers.
The two exercises that matter
| Exercise | How to do it | What it trains |
|---|---|---|
| Slow squeeze | Tighten and lift, hold for up to 10 seconds while breathing normally, then rest for the same length | Endurance of the deep, supportive muscles |
| Quick squeeze | Squeeze and release as fast as you can, then rest | Fast-twitch muscles that stop leaks on a sneeze or jump |
Building a routine that sticks
- Aim for three sets of slow and quick squeezes, twice a day
- Start with holds you can manage and build up gradually
- Tie the exercises to a habit such as brushing your teeth
- Do a gentle squeeze before any sneeze, cough or lift
- Keep going for at least three months before expecting lasting change
When exercise is not the answer
For most women the exercises work, but a minority have a pelvic floor that is tight rather than weak, which needs relaxation work rather than more squeezing. If you are not seeing improvement after a few months, or leaking affects daily life, ask your GP for a referral to a women's health physiotherapist, who can design a plan for your specific problem. The urinary infection guide is worth reading too, because a weakened pelvic floor is linked with recurrent UTIs.
Pelvic floor health across your life
The exercises matter at every stage, but especially around pregnancy, the menopause and any time you notice a change. Starting before pregnancy builds a strong foundation, and resuming after birth helps recovery. After the menopause, keeping the routine going helps compensate for the loss of oestrogen's support. The recurrent UTI prevention guide and pregnancy nutrition article cover the other habits that protect this area.
The pelvic floor is the one muscle group most women never think about until something goes wrong, yet it is the easiest to maintain with a few minutes a day. Build the habit now, and your bladder and back will thank you for decades.