Why Pelvic Floor Exercises are not Enough

I have had many women say to me, “I do my pelvic floor exercises, why don’t I feel any better down below?”

Pelvic floor exercises have been discussed for decades. Often, women are told to stop the flow of urine when they go to the toilet, to know which muscles to exercise when focusing on their pelvic floor. You are then told to do these exercises daily, and often without any other instruction. But are you doing them correctly? Are you correctly using other muscles to assist your pelvic floor, and are you practicing all of this when carrying out your daily tasks?

What am I doing wrong?

Have you ever thought about engaging your pelvic floor when you pick up your child? This repetitive pattern puts a massive amount of pressure through the muscles in your tummy and pelvis, and if you have not trained the muscles to work for you, over time they may become unable to hold the pelvic organs in their right place, or allow for efficient emptying of your bladder and bowel. Do you find that your tummy and/or pelvic floor pushes out or down when you get up from a chair, pick up your child, or put the buggy into the car, blow up balloons for your child’s party, or when you laugh, cough or sneeze? These signs demonstrate that far more is going on that just weakness in your core, your pelvic floor also has something to do with the appearance of your ‘mummy tummy’ and how it functions too

The Brain and muscle connection

Do you know if you are activating your muscles correctly? If those muscles in your pelvis are not working as well as they could be, other muscles take over to compensate for a dysfunctional core. You may find that it’s hard to activate your pelvic floor without squeezing the muscles in your bottom, holding your breath or pushing out your tummy. You cannot strengthen a muscle your brain cannot activate. You need exercises help you ‘find the muscle’ and activate it properly.
Any muscle that has become less active due to changes in body posture, or trauma needs to be focused on individually, to strengthen it. You need to learn to isolate the pelvic floor, to train it to contract. The brain needs to consciously ‘find the muscle’ it wants to use and activate it properly. The body can then re wire’ itself to make that muscle become active.

What about the machine recommended by Physiotherapists?

If your pelvic floor muscles are weak, or ‘hypotonic’ you may benefit from using a feedback device known as electrical stimulation to help ‘wake up’ your pelvic floor. As your ability to control your pelvic floor improves then you would move on to teach it how to become part of the team and work alongside your ‘core’ muscles. There is no evidence to say that using electrical stimulation alone is a more effective way of strengthening your muscles than exercise. You need to put in the work too by concentrating and joining in to encourage more muscles fibres to contract. Stimulation treatment is not recommended for ladies who have a hypertonic pelvic floor.

What is a hypertonic Pelvic floor?

Vicky Keates – Clinical Specialist Physiotherapist in Women’s Health explains that a hypertonic pelvic floor symptoms develop “when your pelvic floor muscles spasm. The associated pain can make sitting down very difficult and sex extremely painful”. She goes on to say that the symptoms of a hypertonic pelvic floor include “vaginal pain or soreness, pain on and/or difficulty having sexual intercourse, pelvic floor muscle spasm and inability to release the pelvic floor muscles fully.” Women can also experience difficulty passing urine as the muscles are too tight or can in fact leak urine as the muscles have become too tired to work properly as a as they have been working overtime when they should have been at a normal resting tone.

Vicky explains that women may suffer from hypertonic pelvic floor due to hypersensitivity from scar tissue for example if a woman has torn badly during childbirth or had a traumatic delivery,
women who have been the victims of sexual abuse can subconsciously tense up – some women who feel threatened clench their pelvic muscles, some women who are anxious or stressed can have hypertonic pelvic floor muscles. In the same way that some people carry muscular tension between their shoulder blades, other women carry it in their pelvic floor eg some women clench their pelvic floor muscles when they feel stressed. Some post-menopausal women’s skin becomes thin and dry due to lack of the hormone oestrogen, and they can tense up their pelvic floor muscles without realising if sex has become painful. Having a prolapse can sometimes make sex uncomfortable, which can make women anxious about having sex, and might increase hypertonicity.

Women with hypertonic pelvic floor muscles should not be encouraged to practice pelvic floor exercises until they have ‘down trained’ their pelvic floor.

The pelvic floor is part of your core

Pelvic floor muscles don’t work alone. They interact with some ‘core’ muscles in your body: your deep lower stomach muscle (transversus abdominus); your deep back muscle (multifidus) and your ‘breathing band of muscle’ (diaphragm). You need to pay individual attention to all four ‘walls’ of your core, before activating them in the right sequence, to work in together effectively. Restoring the order in which different muscles of the core contract is the first step in rehabilitation of the core and from here, you can then integrate the pelvic floor and core into more complex functional activities

Connect your core to the rest of your body

The next stage after training the brain to ‘fire up’ and strengthen the core muscles correctly, is to adopt a whole-body approach with your exercises, and combine your core exercises with movement that replicates your daily life activities. It makes sense to move a structure (your body) how it was designed to, so the exercises you do need to be purposeful.

purposeful movements for mamas

shoulder press

Lunge and reach



rotate and press

The muscles of the pelvis are attached to the bones and muscles in your back, legs, abdomen and bottom. They support movements in these areas and shift higher to your diaphragm, your breathing muscle under your ribs. Any movement we do, whether it’s a lunge, squat, rotation, push, pull or bend, your pelvic floor and core is challenged to assist those movements and support the organs and structures within the pelvis. With the right coaching, you will improve the look of your tummy, and be reducing symptoms such as leaking urine, or passing wind, plus the occurence of your bladder, bowel or uterus falling into your vagina. Your body is designed to move, so you need to make your workouts efficient, for what you need to manage in your daily life.

In summary

So, you can see, that pelvic floor exercises alone, don’t help in recovery of your body. The right coaching and activation of each individual muscle group of your core, is essential to the restoration of this unit. This should always be focused on BEFORE moving onto exercises that incorporate the whole body. Whole body movements should be functional for the tasks you need to accomplish in your daily routine, and you should ALWAYS activate your core with every exercise.

Nina’s core and pelvic floor workshops are the ideal way to safely and effectively recover your core. It doesn’t matter if your baby was born 2 months, two years, or two decades ago. What you will learn about the condition of your inner muscle unit, and how to incorporate exercises to activate and strengthen it, will be a powerful step to achieving to optimal performance of your entire body.

If you are suffering from back or pelvic problems, leaking of bladder or bowel with activity or when you laugh or sneeze and/or just don’t feel ‘connected’ to your body, then these are great workshops for you. Bookings for 2018 are now open. BOOK NOW