A healthy pelvic floor is something most of us take for granted. Not only does your pelvic floor hold your organs in place, it also helps control your bladder, preventing leaks and accidents. And just like any other muscle in your body, regular exercise can keep it strong. Here, experts share the best pelvic floor physical therapy exercises to help block problems like urinary incontinence, fecal incontinence and more. The best part? You can do them from the privacy of your own home.
What is your pelvic floor?
Before we get into the nitty-gritty, let’s start with the basics – like what, exactly, your pelvic floor is.
“Your pelvic floor is a group of muscles and tissues at the bottom of your pelvis that acts like a hammock to hold up your bladder, bowel and uterus,” says Raj Dasgupta, MD, Chief Medical Advisor for Fortune Recommends Health. “It helps control when you go to the bathroom, supports core stability and plays a role in sexual function.”
Many factors can contribute to a changing or weakening pelvic floor, including age and childbirth.
“Your pelvic floor can become weaker as you age due to several reasons, including hormonal changes during menopause, pregnancy, childbirth, chronic coughing or frequently lifting heavy objects,” says Dr. Dasgupta. “These factors can stretch or strain the muscles, making them less effective.”
Signs of weak pelvic floor muscles
Not sure if you have a weak pelvic floor? Symptoms include bladder leaks, fecal incontinence, pain during intercourse or discomfort in your lower back or pelvic region. If you notice these signs, you might benefit from pelvic floor physical therapy exercises. But don’t jump right into exercise without seeing a specialist first, cautions Heather Jeffcoat, doctor of physical therapy and CEO of Femina Physical Therapy.
“The first thing that has to be addressed is the cause of the weakness,” Jeffcoat explains. “Not every person should start with strengthening the pelvic floor right away. For example, somebody that has a hypertonic pelvic floor would need to perform pelvic floor muscle down training or relaxation exercises prior to beginning a strengthening routine.”
But if you aren’t experiencing pelvic floor dysfunction and simply want to keep your muscles strong, feel free to give physical therapy exercises a try.
Pelvic floor physical therapy exercises
Doctor of physical therapy and board-certified Women’s Health Specialist Melissa McElroy often asks patients to begin with simple breathwork.
“More often than not, belly breathing is the first exercise I will give to my patients,” McElroy says. She explains that pregnancy, trauma and the societal pressure to “suck in” means that most women aren’t breathing all the way into their diaphragms, which must be fixed before moving onto more intensive exercises.
“Proper control starts with proper breathing,” McElroy explains. “Your pelvic floor and your diaphragm should sync and work in the same rhythm. Once this proper function and coordination is restored, then and only then will other exercises to target the pelvic floor really work.”
To practice belly breathing, place one hand on your chest and the other on your abdomen. Breathe in through your nose, focusing on expanding out through your diaphragm and upper belly rather than through your chest.
Check out this YouTube video for a tutorial: Diaphragmatic breathing
Once you’ve mastered your breathing, you can progress to other pelvic floor physical therapy exercises like the ones below.
1. ‘Fog the mirror’ pelvic floor physical therapy exercise
Similar to kegel exercises, this technique gently contracts and relaxes the muscles of your pelvic floor.
- Lie on your back with knees bent and feet flat on the floor.
- Inhale through your nose and breathe into your belly.
- Then, exhale as if you were “fogging a mirror” and gently contract the pelvic floor muscles, “like you were cutting off the flow of urine,” instructs McElroy.
- She recommends 30 reps, contracting your pelvic muscles for five seconds at a time to strengthen these muscles.
2. ‘Elevator’ pelvic floor physical therapy exercise
“This pelvic floor muscle exercise helps activate both superficial and deeper muscles of the pelvic floor,” McElroy says. To perform this exercise, picture your pelvic floor muscles as an elevator in a three-story building.
- Sit on a therapy ball or chair and inhale through your belly.
- Then, exhale, slowly lifting your pelvic muscles, one “floor” at a time.
- As you exhale, slowly lift and activate the pelvic floor slightly, to the “first floor”, McElroy says.
- As you continue to exhale, engage a little more to get to the “second floor,” again to the “third floor,” and then release,” explains McElroy.
- Repeat for three minutes.
3. ‘Quadruped hover’ pelvic floor physical therapy exercise
- Start on your hands and knees, with your hands directly under your shoulders and knees directly under your hips, says McElroy.
- Keep your back flat as if you were making a box shape with your body.
- Curl your toes under, then inhale, exhale and engage the pelvic floor as you raise your knees 1 inch off the ground.
- Hold the position for five seconds. Repeat 10-20 times.
Watch a YouTube tutorial here: Quadruped Knee Hovers
4. ‘Clamshell’ pelvic floor physical therapy exercise
- Lie on your side with your knees bent and head supported, advises McElroy.
- Breathe into your belly and exhale.
- As you exhale, engage the pelvic floor and lift your upper knee without moving your pelvis or lifting the foot.
- Hold 5 seconds, then lower your knee. Repeat 20 times on each side.
Watch a YouTube tutorial here: Core Exercise: Clam Shells
This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.
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