There are several ways to strengthen your pelvic floor; ideally, you’ll work with a practitioner who can design a comprehensive, holistic approach to rehabilitation. Here are some of the components of successful pelvic floor strengthening.

Disclaimer: 

The information provided on this website is for educational and informational purposes only and is not intended as medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

1. Pelvic Floor Exercises (Kegels, Non-kegel exercises) 

Pelvic floor exercises can be broken into different types. Your pelvic floor requires different kinds of input to build strength. Many people have a pelvic floor that is overactive (hypertonic, “too tight”).  In those cases, the pelvic floor muscles are constantly engaged, which means that they’re not responsive to load. If the pelvic floor muscles cannot relax, they cannot engage when you sneeze, jump, etc. Just like keeping your arm bent in a perpetual bicep curl will not strengthen your whole arm, keeping your pelvic floor muscles constantly engaged will not strengthen your pelvic floor.

Kegel exercises are widely prescribed but are not appropriate when the pelvic floor is already overactive. Instead, exercises that help relax, retrain, and lengthen the pelvic floor muscles to be responsive are more appropriate. These kinds of exercises may include stretches involving the hips, spine, and upper body. 

When performed correctly, Kegel exercises effectively teach proper contraction and engagement of your pelvic floor muscles; it’s important to include a relaxation phase, not just a contraction. Here’s a video with an exercise that is a great alternative to Kegels–even if your pelvic floor is hypertonic, you can try this exercise. Strengthening and lengthening the pelvic floor muscles helps you achieve  better control and responsiveness during movement..

2. Incorporating Pilates and Yoga

Pilates and yoga can be useful modalities for helping strengthen your pelvic floor. As they help to coordinate your core and pelvic floor in response to whole body movements. The breath plays a large role in pelvic floor function, and yoga classes or Pilates classes that help you learn how to coordinate your core and breath can be helpful. These modalities focus on helping you connect to the muscles of your body and how they feel as you move through space, and will help you make a mental map of your body–including your pelvic floor.

3. Using Equipment to Enhance Training

Some equipment can enhance your pelvic floor training–internal devices/vaginal trainers like the Perifit or Elvie or other biofeedback mechanisms can be useful for helping you feel and connect to your pelvic floor. I would recommend seeking the advice of a pelvic health physical therapist before using one of these devices, since it may not be useful if your pelvic floor muscles are hypertonic.

4. Diet and Lifestyle Changes

Your pelvic floor muscles are essential to digestion and elimination so staying hydrated and consuming an appropriate amount of fiber are recommended. You may need to talk to your doctor about what your particular body needs–for some people, urinary incontinence can be a matter of drinking too many caffeinated beverages. It’s out of the scope of my work as a movement teacher to give you dietary or nutritional advice. but do check in with your medical providers and see if there’s anything that you could be tweaking to improve your pelvic floor function.  

I do not advocate intentional weight loss as a blanket solution for pelvic floor weakness. There is evidence that increases in weight can add load to your pelvic floor, and there is evidence that surgical weight loss interventions have a positive effect on pelvic organ prolapse in people with a high body weight. However, you do not need to make your body smaller in order to function better; you can help your pelvic floor muscles respond better at any size.

5. Building a Consistent Routine

Building a consistent routine is helpful in any sort of healing process. The best routine is the routine that you actually stick to. If that means you only work out intentionally to support your pelvic floor twice a week, great! Start slowly and expect that there will be setbacks along the way. Build accountability by connecting with a friend or working with a coach. Learn when practicing works best for you: first thing in the morning? Last thing before bed? At work? Make a plan, stick to it, if you’re not noticing improvements in a months time, you might consider working with a movement professional specializing in pelvic health.

If you would like a program that is designed to support your pelvic floor health and healing, my Restore Your Core® program is broken down into steps that help you make progress and build a consistent routine that fits into your life.

6. Monitoring Progress and Adjusting Your Routine

How do you know you’re making progress? Take that “grape-lifting” video from before. Write down how it went for you the first time. Come back to it after 6 to 8 weeks of consistent work, and reassess. How are your symptoms? What feels better? What’s still difficult? Get curious about what else you need to change–the frequency or intensity of exercise? Do you have a practitioner who’s following your progress and can give you feedback? These are ways to monitor your progress and help you see how much you’ve grown.