What are the best and worst pelvic floor exercises?

So, the short answer is, it depends! Let me explain, but first, you will need to answer some questions…

1)What is your goal for exercise? Strength? Mobility? Flexibility? Stopping leaking? Supporting a prolapse? Managing pelvic pain? Some combination of these?

2)What is the current state of your pelvic floor? Is it tight? Lax? Tight and weak? Lax and weak? Painful?

So let’s start with the first question. If you are looking to strengthen your pelvic floor, kegels may be helpful. But because kegels aren’t particularly functional, the best pelvic floor strengthening exercises involve the pelvic floor moving through its entire range of motion as part of a system. Some examples include squats, bridges, lunges, hip hinging/deadlifts--why yes, they are staples of any lower body strengthening program, and for good reason! They are functional, and they build strength!

To maximize the contribution of your pelvic floor, be sure to maintain good diaphragmatic breathing throughout, and be sure to relax between sets. Exercises targeting your abdominal muscles also help tap into the function of your pelvic floor as the floor of your core--again, coordinating with diaphragmatic breathing!

For flexibility and mobility, you would want to focus on exercises that lengthen the core, hips, and pelvic floor: some of my favorites are child’s pose, butterfly stretch, happy baby, and cobra.

For managing pelvic pain, often working on relaxing and lengthening the pelvic floor and supporting muscles of the hips, core and back, followed by strengthening, is often necessary. Kegels would NOT be the exercise of choice here!

2) If your pelvic floor is tight, you need to find ways to help it let go. Diaphragmatic breathing and the stretches listed above can be a great place to start. If it is lax, strengthening the hips, core and pelvic floor is often indicated. Again, kegels are NOT tops on this list!

If your pelvic floor is lax, kegels may be appropriate as part of a more comprehensive strengthening and activation program, but again, it depends.

So here are the takeaways:

1. Everyone is unique, and responds to exercise differently. What is helpful for one person can be harmful to another. This is why it is so important to listen to your body. If you try some strengthening exercises and have increased pelvic pain, your body is telling you that something is not right, and that you may need to focus on relaxing and lengthening your pelvic floor. If strengthening exercises reduce your symptoms, you are most likely on the right track! This is where pelvic floor therapy can be so helpful, to assess the current state and function of your pelvic floor, and the way it communicates with the rest of your body.

2. Often, it is not the exercise itself that is good or bad, it is the way that it is performed. Make sure to not restrict your breathing, and be sure to finish with stretching and some form of relaxation to help your muscles let go.

This post is meant for educational and informational purposes only; it is not to be used as a substitute for medical advice. If you have questions about any of the exercises I mentioned, or about your pelvic floor and exercise, ask a pelvic floor therapist! I would be happy to help you!