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What’s it all about Pelvic Floor?

pelvic floor exercises and advice annabel karmel

Pelvic floor is rarely discussed prior to pregnancy and childbirth – unless you practise Pilates, where you definitely can’t get through a class without it being mentioned at least 10 times! But considering its importance, this silence surrounding such a vital collection of muscles needed to help support the pelvic organs is frankly, bonkers!

I’m sure we have all been asked by our GP or midwife whether we perform pelvic floor exercises, but do we really understand their relevance or how in fact to do them? We know they are important, but what are they actually for?

What is the Pelvic Floor

Your pelvic floor is a powerful layer of muscles that sit underneath your pelvic organs, like a hammock, between your tailbone and pubic bone. These muscles act like a buoyancy aid to support your pelvic organs, which include the bladder, the bowel and the uterus. The ligaments also act as an anchor for the uterus. Without this support a variety of conditions can arise which I’ll touch on shortly.

Deep pelvic floor muscles

The pelvic floor muscles can be seen to be running vertically from the sacrum bone at the bottom of the spine to the pelvic bone at the bottom of the image.

This doesn’t affect me?!

Or does it? It’s worth noting, that regardless of age or whether you are pregnant or not, all women, particularly over the age of 30 should be protecting and working their pelvic floor muscles. As with most things, prevention is better than cure and this is definitely true with your pelvic floor. If these muscles aren’t exercised, you could risk ending up with incontinence issues or a pelvic prolapse, which is where your uterus, rectum, urethra, or bladder starts to collapse into your vagina. Pregnancies, improper exercise technique (including common fitness regimes such as running, spinning, weight training, HIIT, boxing etc) as well as living a sedentary life all affect our pelvic floor muscles.

Why is the pelvic floor so important?

Both men and women have a pelvic floor – a fact that is often news to men! But unlike men, women often find out how much we need to care for this area, during or after childbirth. Pregnancy and childbirth can weaken and lengthen the pelvic floor muscles and ligaments, thus allowing the pelvic organs to move down into the vaginal wall.  The pelvic floor works with the abdominal and back muscles to stabilise and support the spine.  By maintaining a connected and strong pelvic floor it can help with the following:

  • Stop stress incontinence – when you leak some urine when you cough, sneeze, laugh or run
  • Prevent pelvic organ prolapse
  • Support your back and pelvis, reducing lower back pain
  • Increase sensation during sex! And for men, can increase the hardness of their erection and help with erectile disfunction
  • Strengthen an unstable pelvis (where there is little control of the pelvic area creating excess movement which can cause lower back pain) which can affect postural alignment

One misconception and one worth noting is that regardless of whether you have a vaginal or caesarean birth, it is not necessarily the birthing process that puts strain on the pelvic floor but the gradual increase in weight bearing and stretching that occurs over the pregnancy. So, do not be fooled, we all need to focus on these muscles as much as possible.

Working the Pelvic Floor

Like any muscle, the more you use it the stronger it gets and luckily these exercises can be done anywhere, at any time and with no one else knowing!  So, there is actually no excuse not to do some of these on a daily basis.

The following exercises will not only help you recognise what these muscles feel like to connect but also strengthen and tone from the inside out.

Identifying the correct muscles is the first challenge. There are several ways which may help you to correctly identify the different parts of your pelvic floor muscles – here are a few to try!


This exercise is great to do at any point in the day when sitting or standing. Taking a breath in to prepare, on your exhale zip up from the back to the front in between your legs. Essentially this is the feeling of stopping wind followed by stopping the flow of urine. As you come from front to back begin to feel your abdominals beginning to connect and hollow.  Hold this connection for a breath or two.  Slowly release and relax. To increase the difficulty and focus of your connection the next step is to add the Pelvic Elevator.


This time as you exhale and connect, imagine your pelvic floor is an elevator.  Close the doors (connect from back to front), now go slowly up the 1st, 2nd and to the 3rd floor. At each floor your connection is getting stronger as you lift in and upwards with your pelvic floor. At the top (3rd floor) hold and on the next breath slowly release going down one floor to the next, stopping and holding at each floor. Avoid rushing and releasing everything in one go! Once at the bottom, open the doors by releasing completely. You can do this exercise when sitting watching the TV, washing up or sitting in the car. There is no excuse – they can be so invaluable to strengthen and tone these deep, hidden muscles.


Lie on your back, with your knees bent. Breathe in to prepare and on the exhale, connect your pelvic floor (zipping up back to front) and then your abdominals (as mentioned above). Gently tilt your pelvis drawing your navel to spine and imprint the pelvis and lower back onto the mat. Hold for the breath and on the inhale return to the start position. Look to avoid using your glutes to make the movement.

A good test of your pelvic floor muscles is to stop the flow of urine for a second or two, then relax and finish emptying without straining. This ‘stop-test’ may help you identify the muscles around the front passage which control the flow of urine. Although this is a good test, this should not be practised as a regular exercise.

Things don’t seem right

If you feel things are not quite right, it is important to seek professional help. Problems such as the following may not necessarily be linked to a weak pelvic floor and should be properly assessed:

  • Accidental leakage of urine, bowel motions or wind
  • Difficulty emptying your bladder or bowel
  • Needing to urgently or frequently go to the toilet to pass urine or bowel motions
  • Vaginal heaviness or a bulge
  • Pain in the bladder, bowel or in your back near the pelvic floor area when exercising the pelvic floor or during intercourse.

Don’t forget – if we look to regularly exercise and maintain the pelvic floor muscles the benefits are endless. AND the best thing is it’s never too late to start building strength and connection in this area.

The niix.fit fitness app which combines Pilates and HIIT allows anyone to follow her methods no matter where they are in their fitness or how much time they have.

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