“Leaking when you laugh”? Pelvic floor. “Feeling heavy down there”? Pelvic floor. “Struggling to control the urge to pee when running”? Pelvic floor… or at least that’s what we’re always told, right?
For years, women have been told that pelvic floor exercises are the answer to almost every post-baby issue. And whilst strengthening the pelvic floor is important, it’s only part of the story. As a postnatal exercise specialist, I’ve worked for over 15 years to help women rehabilitate their pelvic floor and feel confident and connected to their bodies again. If you’ve been squeezing away without seeing the results you expected, here are three things you might be missing.
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1. Work from the bottom up
This might sound odd, but your feet might be letting down your pelvic floor.
During pregnancy, as your bump grows, the increased weight can cause the arches of your feet to flatten. Many women even notice that they permanently go up a shoe size.
Flattened arches reduce your body’s natural shock absorption, leaving your pelvic floor to bear the brunt of impact, which can lead to issues with incontinence and core function. It’s similar to the way bumps in the road are much more noticeable when your car’s suspension isn’t working properly.
The thing is, no amount of kegels will help your feet. By focusing on the small muscles in the foot along with our core rehabilitation exercises, we can rebuild the arch and improve balance and core stability. Fortunately, you can use everyday, around-the-home objects to help.
One great exercise for the feet is placing a piece of kitchen roll or a small dishcloth on the floor, stepping onto it with one foot, and curling the edges up with your toes. Then, using just your toes, pull the whole paper inwards to strengthen the foot muscles.
2. Back to basics
Have you noticed a dull ache in your lower back during or after pregnancy? It could be due to a shift in the pelvis during pregnancy. As the baby grows, the pelvis is shifted forward, which can create an arch in the lower back.
This can cause back pain and affect the pelvic floor, as the forward tilt means the weight of the organs, baby, placenta, and amniotic fluid rests on the pelvic floor rather than the bony structure of the pelvis. Postpartum, the pelvis will largely return to proper alignment on its own, but glute exercises can help speed up the process and correct any bad posture habits before they start to stick.
The fix is not endless squats – although they can be a useful part of your workouts. Instead, I recommend prioritising exercises which activate the deep glutes and promote stability across the core, building up intensity over time. Here’s an example of a great workout to target the glutes.
3. The missing piece – and the hardest exercise
There’s one more thing about pelvic floor rehab which is so often misunderstood or missed out completely. If you notice symptoms such as leaking, increased pressure, or pain in the lower back, it may not be due to muscle weakness at all.
Sometimes, the opposite is true.
Just like any other muscle, to effectively contract, the pelvic floor first needs to relax. For some women, this is the part which causes problems.
If your pelvic floor is constantly tight, your muscles can’t work properly. After enough strain, they become unable to generate force. It would be like holding a dumbbell out in front of you all day and then trying to do a bicep curl.
Symptoms of a tight and overactive pelvic floor, other than the ones already mentioned, can include: difficulty emptying your bladder, pain during intercourse, and pain when inserting a tampon.
In this case, more squeezes aren’t what you need. What you really need is to work on pelvic floor relaxation exercises. If you feel this resonates with you, here’s a short pelvic floor release workout that you can easily fit into a busy day:
The bottom line
To be honest… this isn’t even the bottom line. Despite the pelvic floor being a relatively small muscle group, its connection to the rest of the body runs deep. This also means the reasons for dysfunction can come from many sources, like a clenched jaw, tense shoulders, or poor breathing patterns. To learn how to take a ‘proper’ breath, follow this tutorial:
It can be overwhelming to learn how many factors go into building a stronger core post-pregnancy. But the good news is, once you start addressing the whole system, rather than focusing on one small part, things quickly begin to click into place.
For more evidence-based postnatal recovery advice, pelvic floor education and realistic fitness guidance for women navigating motherhood and midlife, subscribe to Strong Like Mum on YouTube.
