Pelvic floor exercises are a bit like flossing – you know you should do them, but making them a part of your regular routine seems near-on impossible. You’re not alone. Most women don’t give pelvic floor exercises a second thought until they need to – mostly after childbirth – but as we all know, prevention is better than cure.
There are so many benefits to pelvic floor exercises (better sex, don’t ya know), and we’re not just talking about kegels. Read on for everything you need to know about pelvic floor exercises – from what they are, to how often to do them.
What are pelvic floor exercises?
Pelvic floor exercises are, simply put, moves that strengthen your pelvic floor. Stephanie Taylor, founder of pelvic floor health company Kegel8 and supporter of #pelvicroar, a physiotherapy-led campaign hoping to break taboos surrounding pelvic floor health issues, explains that your pelvic floor is formed of hammock-like muscles and ligaments that stretch from front to back to support your pelvic organs (bladder, vagina and bowel) supported.
‘Think of it as a piece of steak,’ says Taylor. ‘You want yours to be like a fillet: thick and juicy. A weak pelvic floor is the equivalent of a flattened minute steak.’
Helen Keeble, a clinical specialist in pelvic health and co-founder of Umi Health, adds that most ‘lower body exercises' qualify as pelvic floor exercises as they benefit the pelvic floor (more on this to come), but affirms that, ‘If you want your pelvic floor to be stronger, you need to do daily isolated pelvic floor squeezes– i.e. kegels.’
So, pelvic floor exercises and kegel exercises are essentially the same thing. But pelvic floor exercises can also refer to exercises that incorporate other parts of the body, which will dial up the strength of your pelvic floor. Read on for specific examples of general pelvic floor exercises to complement your kegels.
But first: What are kegel exercises?
Kegel exercises involve tensing and relaxing the pelvic floor muscles in isolation, without moving the rest of the body, for a few seconds at a time. Keeble (that's Keeble, not kegel) breaks the process into five easy steps further down.
And how do I perform them?
Do your kegels right with Keeble’s five-step guide.
- Begin lying down comfortably and take deep breaths.
- Imagine you are trying to stop wind, so tighten and lift the anus, then let it go again. Do this activation in between breaths, with the sequence: breathe in, breathe out, squeeze, let go. The movement is subtle.
- Once this feels easy, build up to holding the squeeze for ten seconds at a time.
- When holding, remember to breathe normally, don’t hold it.
- Once you’ve nailed this, progress into doing the move while sitting, then standing.
Can you fix a prolapse with pelvic floor exercises?
First things first, Keeble explains what a prolapse actually is. ‘It’s when the pelvic organs – the bladder, bowels or uterus – is sitting a bit lower and/or for longer than it usually would.
‘For most women with a prolapse, a few simple changes to their daily habits will resolve the symptoms.’ These include:
- Eliminating strain on the toilet
- Not holding tummy muscles in
- Using a pessary
And, case in point, performing pelvic floor exercises ‘correctly and with diaphragmatic breathing’. You should aim to put all of these lifestyle changes into place in conjunction with one another, so, to answer your question, yes, pelvic floor exercises can help to fix a prolapse–if practiced alongside other lifestyle habits.
Do pelvic floor exercises work?
Yes, yes and yes, providing that you practice them consistently. Keeble backs us up, adding, ‘So much so that they are the first line of recommended treatment for pelvic floor dysfunction in the NICE (National Institute of Clinical Excellence) national guidelines.'
Contrary to popular belief, it’s not only your sex life that will rocket, either.
‘If your pelvic floor is weak, it won’t be getting as much blood flow or oxygen,’ Taylor says.
In contrast, a strong pelvic floor can mean:
- Milder menstrual cramps
- Better core strength
- Better posture
- Better sexual function
- Reduce lower back pain
- Heightened self-esteem
- Improvement of urinary incontinence and leaking
‘Kegel exercises have up to a 90% success rate in treating stress incontinence,’ says Taylor. ‘Remember, leaking is never normal.’
How to do pelvic floor exercises
As we’ve mentioned, what we’re talking about when we say 'pelvic floor exercises' here are lower body moves that have big benefits for your pelvic floor. These can complement kegels (isolated pelvic floor squeezes).
Pelvic floor exercises for women
‘It’s really important for your overall pelvic health that your lower body muscles are strong and flexible,’ Keeble tells us. These are the best moves to incorporate into your routine alongside kegels and why, according to her.
Sumo squats
How? Stand with your feet slightly wider than hip-width apart, your toes pointed out at 45 degrees and your torso leaning slightly forward. Bend your knees and sink your hips down, stopping when your thighs are parallel to the floor. Drive through your heels back to starting position. That's one rep.
Why? ‘They’re great for your inner thigh muscles and flexibility, which benefits your pelvic floor.'
Glute bridges
How? Lie on your back on a mat, with your knees bent, and feet flat on the floor. Your feet should be hip-width apart.
On an exhale, squeeze your glutes and push your heels into the floor to lift your hips up towards the ceiling. Pause for a moment at the top before slowly lowering back down (first shoulders, then lower back, then bum) to the mat. That’s one rep.
Why? ‘Strong glutes support the pelvis which in turn, benefits the pelvic floor.’
Add a block in between your knees and squeeze at the top to make your pelvic floor work harder.
Lateral lunges
How? Stand with your feet hip-width apart. Take a big step to the side with your left leg, then bend your left knee, push hips back and lower until your left knee is bent 90 degrees. This should take around two seconds. Push back to start. You can alternate, or complete all reps (10-12 should do it) on your left before moving on to your right.
Exhale to reverse the movement and stand tall. That’s one rep.
Why? ‘For inner thigh strength and flexibility, and working your glute muscles to support your pelvic floor.’
Clamshells
How? Lie on your left side on the floor, with your hips and knees bent 45 degrees. Your right leg should be on top of your left leg, your heels together.
Keeping your feet in contact with each other, raise your right knee as high as you can without moving your pelvis. Pause, then return to the starting position. That's one rep.
Why? 'For hip rotator strength and flexibility, which support your pelvic floor.'
Try to incorporate the movement involved in kegels (i.e. tensing your pelvic floor) as you do all of these moves.
How to do pelvic floor exercises after giving birth
Your pelvic floor needs even more attention after giving birth than it did before, and Keeble has outlined a handy timeline to follow.
1-2 weeks postnatal
‘Regardless of delivery type, the best thing to do is regular deep breathing, kegels and pelvic tilts. The goal here is to reconnect these muscles to the brain – simple activations are key.’
2+ weeks postnatal
'Continue kegels and deep breathing, but add in some bodyweight moves such as squats, bridges, lunges, as well as light, slow walking.’
4+ weeks postnatal
‘Continue kegels and deep breathing, along with low impact cardio such as static cycling or cross training, depending on what kind of birth you had and your energy and comfort levels.’
6+ weeks postnatal
‘Continue kegels and deep breathing, and if all healing has gone to plan, consider introducing light weights. High impact exercise such as running and tennis isn’t usually advisable until you’ve passed the 3-month point.’
She adds: ‘If in doubt, always consult a pelvic health physiotherapist. Acknowledge that each postnatal journey of recovery is different and move at your own pace. There’s no rush.’
How often should you do pelvic floor exercises?
It’s a resounding answer from all experts: daily. ‘If you have symptoms of prolapse, or incontinence, then it’s recommended to do approximately 8-10 squeezes, three times a day,’ Keeble advises.
‘If you have no symptoms and want to try and keep it that way, do five short and five long squeezes while standing, daily.’
Bridie is Fitness Director at Women's Health UK. She spends her days sweating over new workouts, fitness launches and the best home gym kit so you have all that you need to get fit done. Her work has been published in Stylist, Glamour, Cosmopolitan and more. She’s also a part-time yoga teacher with a habit of nodding off mid savasana (not when she’s teaching, promise).
