Pelvic floor strength

When you sneeze, cough or jump the last thing you want to do is experience bladder or bowel leakage (incontinence). Pelvic floor exercises are important for all women to practise to maintain strong muscles and reduce the risk of incontinence. The steps and best way to do pelvic floor exercises are discussed along with how to retrain your bladder to hold more urine.

Pelvic floor exercises

In this video, physiotherapist Anne Patterson gives lots of tips on how to maintain pelvic floor fitness.

Like other muscles in the body, the pelvic floor muscles, the 'sling' of muscles that support the bladder, bowel and uterus, can be strengthened by exercise. Ideally, all women should do daily pelvic floor exercises throughout adulthood to maintain strong muscles and reduce the risk of incontinence. These exercises are particularly good for stress incontinence. When combined with a bladder training program, they help to increase the bladder's capacity. Women with strong pelvic floor muscles may also have an improved sexual response.

Pregnant woman on exercise ball

You can do the exercises anywhere: waiting in the car at traffic lights, in a queue, watching television, sitting at a table, cooking – basically any time you have a moment to focus your attention on strengthening your pelvic floor.

Pelvic floor exercises are not necessarily easy to do correctly. The pelvic floor muscles are complicated muscles that can be difficult to isolate. When done correctly they are very effective, but practising the wrong technique will not help the situation and can make the problem worse.

If doing the exercises yourself doesn't help, then you can seek help from a physiotherapist who specialises in pelvic floor muscles or a continence nurse. 

How to strengthen your pelvic floor

female pelvic floor

Start practising this exercise either sitting or lying down. Once you have mastered level 1 over the course of a week or so, move to level 2 and then level 3.

The aim is to exercise your pelvic floor muscles every day.

Steps What to do

Tighten the muscles around the anus, vagina and urethra all at once and try to lift them up inside.

  • Try to do this without bearing down, holding your breath or squeezing your buttocks or legs together
  • Nothing should be tense or tight above the belly button when exercising
Level 1
  • Slowly count to 5
  • Let your muscles go
  • Rest and relax your pelvic floor muscles while you count to five
  • Repeat
  • Do as many as you can up to 10
Level 2
  • Instead of counting to five, slowly count to 10
  • Let your muscles go
  • Rest and relax your pelvic floor muscles while you count to 10
  • Repeat
  • Do as many as you can up to 10
Level 3 After you have done 10 of the level 2 exercise, do some really strong squeezes – as strong as you can, then let go.
Do as many of these as you can, up to about 10.

Once you have practised, you should be able to do the pelvic floor exercise standing and walking, so it is easier to include the exercise in your day.

As well as making it a regular routine, it helps to squeeze your pelvic floor hard and fast when you cough, sneeze, or pick anything up.

Listen to the podcast

Bladder retraining

Bladder retraining improves your bladder capacity and enables it to hold more urine. It is useful for women who frequently pass urine or have urge incontinence.

  • Drink 6-8 (1.5-2 litres) glasses of fluid daily (avoid caffeine, fizzy drinks and alcohol)
  • Delay going to the toilet by one minute, then gradually, over weeks, increase this time to five minutes or more
  • Avoid going to the toilet 'just in case'; go only when you have the urge to go

Last updated 20 July 2017 — Last reviewed 15 January 2014

** Currently under review **

This web page is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your health practitioner. The information above is based on current medical knowledge, evidence and practice as at January 2014.

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