Pelvic Floor Exercises for Women: Strengthening Guide

Published by Lizzie Thornton

Pelvic floor health is crucial for women's wellbeing at every life stage. This comprehensive guide explains pelvic floor function, provides effective exercises, and offers practical advice for maintaining pelvic health throughout life.

Understanding the pelvic floor

What is the pelvic floor?

  • Layer of muscles at base of pelvis
  • Stretches like hammock
  • Supports bladder, bowel, uterus
  • Controls continence
  • Important for sexual function
  • Works with core muscles

Why it matters

  • Prevents incontinence
  • Supports pelvic organs
  • Enhances sexual function
  • Supports pregnancy and birth
  • Aids recovery after childbirth
  • Prevents prolapse
  • Improves core stability

Common pelvic floor problems

Stress incontinence

  • Leaking with cough, sneeze, laugh
  • Leaking with exercise
  • Most common type
  • Weak pelvic floor muscles
  • Very treatable

Urge incontinence

  • Sudden strong urge to urinate
  • May not reach toilet in time
  • Overactive bladder
  • Can be improved with exercises

Pelvic organ prolapse

  • Organs descend into vagina
  • Feeling of heaviness
  • Bulge in vagina
  • Common after childbirth
  • Increases with age
  • Exercises can help

Risk factors

Who's at risk?

  • Pregnancy and childbirth
  • Menopause
  • Aging
  • Chronic coughing
  • Constipation and straining
  • Heavy lifting
  • High-impact exercise
  • Obesity
  • Previous pelvic surgery

Finding your pelvic floor muscles

How to locate them

  1. Sit or lie comfortably
  2. Imagine stopping urine mid-flow
  3. Squeeze and lift internally
  4. Should feel tightening
  5. Don't hold breath
  6. Don't squeeze buttocks or thighs

Common mistakes

  • Bearing down instead of lifting
  • Holding breath
  • Squeezing buttocks
  • Tensing thighs
  • Pulling in tummy too much
  • Doing exercises during urination

Basic pelvic floor exercises

Slow exercises (endurance)

  1. Squeeze and lift pelvic floor
  2. Hold for up to 10 seconds
  3. Relax completely
  4. Rest for 10 seconds
  5. Repeat 10 times
  6. 3 times daily

Quick exercises (power)

  1. Squeeze and lift quickly
  2. Hold for 1 second
  3. Relax completely
  4. Repeat 10 times
  5. 3 times daily

Progression

  • Start with 3-5 second holds
  • Build to 10 seconds
  • Increase repetitions gradually
  • Takes 3-6 months for full benefit
  • Be patient and consistent

Advanced exercises

The Knack

  • Pre-contract before cough/sneeze
  • Squeeze just before impact
  • Prevents leaking
  • Practice regularly
  • Becomes automatic

Functional exercises

  • Squeeze while standing
  • Squeeze while walking
  • Squeeze during daily activities
  • Integrate into life

Exercises in different positions

Lying down

  • Easiest position to start
  • Knees bent, feet flat
  • Relaxed position
  • Good for beginners

Sitting

  • On chair or exercise ball
  • Feet flat on floor
  • Good posture
  • Convenient during day

Standing

  • More challenging
  • Functional position
  • Progress to this
  • Most relevant to daily life

Pelvic floor and exercise

Safe exercises

  • Walking
  • Swimming
  • Cycling
  • Pilates
  • Yoga
  • Low-impact aerobics

Exercises to modify

  • High-impact aerobics
  • Running (if symptoms)
  • Jumping
  • Heavy weights
  • Intense core work
  • Trampolining

Exercise tips

  • Empty bladder before exercise
  • Use The Knack
  • Build up gradually
  • Wear supportive clothing
  • Stop if symptoms worsen
  • Seek advice if problems

Lifestyle factors

Bladder habits

  • Don't go "just in case"
  • Wait for normal urge
  • Take time to empty fully
  • Don't strain
  • Limit bladder irritants

Bowel health

  • Avoid constipation
  • High-fiber diet
  • Adequate fluids
  • Don't strain
  • Good toilet posture
  • Feet on stool

Weight management

  • Maintain healthy weight
  • Reduces pelvic floor stress
  • Improves symptoms
  • Prevents problems

Pregnancy and postnatal

During pregnancy

  • Continue pelvic floor exercises
  • Daily practice
  • Prepares for birth
  • Aids recovery
  • Safe throughout pregnancy

After childbirth

  • Start exercises soon after birth
  • Gentle initially
  • Build up gradually
  • Essential for recovery
  • Seek help if problems
  • 6-week check important

Menopause and beyond

Changes at menopause

  • Reduced estrogen
  • Tissues less elastic
  • Increased risk of problems
  • Exercises still effective
  • Never too late to start

Older women

  • Exercises benefit all ages
  • Improves symptoms
  • Prevents worsening
  • Maintains continence
  • Supports active lifestyle

When to seek help

See specialist physiotherapist if

  • Any leaking of urine
  • Urgency problems
  • Feeling of heaviness or bulge
  • Pain during sex
  • Not sure if doing exercises correctly
  • No improvement after 3 months
  • Symptoms worsening

What to expect

  • Confidential assessment
  • Internal examination (if appropriate)
  • Personalized exercise programme
  • Lifestyle advice
  • Follow-up support
  • High success rate

Additional treatments

Biofeedback

  • Visual feedback of muscle activity
  • Helps learn correct technique
  • Motivating
  • Improves results

Electrical stimulation

  • For very weak muscles
  • Helps activate muscles
  • Combined with exercises
  • Temporary aid

Vaginal weights

  • Progressive resistance
  • Hold weight in place
  • Strengthens muscles
  • Use with guidance

The role of physiotherapy

Elderly Rehabilitation & Exercise provides specialist women's health physiotherapy including:

  • Comprehensive pelvic floor assessment
  • Personalized exercise programmes
  • Correct technique instruction
  • Biofeedback training
  • Lifestyle advice
  • Treatment for all pelvic floor problems
  • Pre and postnatal care
  • Confidential, sensitive support

The bottom line

Maintaining pelvic floor health requires:

  • Regular pelvic floor exercises
  • Correct technique
  • Daily practice
  • Patience (3-6 months for results)
  • Healthy lifestyle habits
  • Early help-seeking if problems
  • Lifelong commitment
  • Never too late to start

Pelvic floor problems are common but not inevitable. With regular exercises and good habits, you can prevent problems, treat existing symptoms, and maintain pelvic health throughout life. Don't suffer in silence—help is available and very effective.

Need pelvic floor help?

Our specialist physiotherapy service provides expert, confidential assessment and treatment for all pelvic floor problems. We help you strengthen your pelvic floor and regain confidence.

Get in touch Learn about Elderly Rehabilitation & Exercise

Lizzie Thornton, Specialist Community Physiotherapist

About the author

Lizzie Thornton is a specialist community physiotherapist with over 15 years of experience in women's health and pelvic floor rehabilitation. She is HCPC registered and a member of the Chartered Society of Physiotherapy. Lizzie provides physiotherapy across Staffordshire Moorlands and Cheshire East.

View Lizzie's profile