The Ultimate Guide to Your Pelvic Floor: Exercises, Tools, and Expert Tips

In the ultimate guide to your pelvic floor, we will discuss what it is, exercises to strengthen it, and expert tips.

What Is the Pelvic Floor?

There are nerves, ligaments, and connective tissue that make up your pelvic floor. You can locate your pelvic floor muscles between your pelvic organs and your perineum (the tissue between your bottom and your vaginal opening). This muscle layer stretches from your tailbone to the pubic bone.

The pelvic floor supports the pelvic organs just like a hammock. For example, the pelvic floor muscles support the rectum, bladder, and uterus. However, the muscles can weaken over time, after trauma, following surgery, or after pregnancy and birth.

While a growing baby puts obvious strain on this hammock, chronic straining, high-impact sports, hormonal shifts during menopause, and natural aging also cause it to sag over time.

The more stress on the pelvic floor hammock, the more it moves toward the ground. If the pelvic floor muscles begin to weaken and drop, this is called a pelvic floor disorder.

What Does My Pelvic Floor Do?

Your pelvic floor supports your pelvic organs, particularly when the pelvic floor contracts. The pelvic muscles are so supportive that very little can pass through, even when relaxed. The muscles allow the passage of bodily fluids through the openings of the vagina, the urethra (urine), and the rectum. Having strong pelvic floor muscles gives you control over your bladder and bowel!

Pelvic floor disorders occur when the pelvic floor muscles fail to contract properly. A weakened pelvic floor means that your organs are not fully supported, and left untreated, can cause problems like pelvic organ prolapse and leaking urine. Prolapse occurs when the bladder or uterus drops from inside your body into your vagina.

Even if you don’t experience pelvic organ prolapse, you may have difficulty with incontinence. Pelvic floor weakness may cause you to have problems with bowel movements or to urinate when you sneeze.

Incontinence is not a normal part of aging and should not affect postpartum women for life. Strengthening your pelvic floor can prevent these symptoms.

How Pregnancy Impacts the Pelvic Floor

Pregnancy puts increased pressure on the pelvic floor. The weight of the baby increases, so does the pressure on your pelvic floor.

In preparation for childbirth, your body secretes a hormone called Relaxin. This critical hormone causes the ligaments and pelvic muscles to relax so that your baby’s head can begin to descend. It also softens and opens the cervix, allowing your baby to pass.
Childbirth can stretch and damage the pelvic floor muscles. While this is a win for the childbirth process, this softening leads to decreased pelvic floor tone.

Risk Factors

• Obesity
• Age
• Avoiding lifting heavy weights (particularly over 35 pounds)
• Repetitive high-impact exercise.
• Chronic coughing
• Straining on the toilet.

Risk factors like obesity and age are hard to modify at this stage in the game. However, gaining a healthy amount of weight in pregnancy will help prevent additional stress on your pelvic floor. Maintaining your physical fitness is important, but do not lift heavy weights or engage in repetitive, high-impact exercise routines.

Lifestyle Factors

Increased pressure in the abdominal cavity from coughing or sneezing can affect the pelvic floor. If you are experiencing a persistent cough, seek care from your physician to keep your lungs and pelvic floor healthy.

In pregnancy, there are a few safe ways to resolve a cough. These include cough drops, Robitussin DM cough syrup, and gargling with salt water.

Constipation is a fairly common complaint related to pelvic floor dysfunction. Carry a water bottle with you at all times, sip water constantly, and aim to drink at least two liters each day. Increase your intake of fiber-rich foods, such as vegetables, fruits, legumes, and whole grains.

If you find that you are regularly constipated, try taking psyllium husk powder or Miralax. If constipation is not responding, try Colace (docusate sodium) or Milk of Magnesia. As a last resort, you can always try glycerin suppositories. These are safe for pregnancy and beyond.

It’s important to drink enough water and eat enough fiber every day to keep your pelvic floor healthy!

Reasons to Strengthen Your Pelvic Floor

Individuals with a pelvic floor disorder experience uncomfortable symptoms like the leaking of urine, lower back pain, and inability to control gas. However, strong pelvic floor muscles can adequately support the extra weight of pregnancy, improve healing in the perineum after birth, and contribute to a satisfying sex life.

Studies show that a solid fitness routine decreases the incidence of incontinence, hernia, back pain, and pelvic floor disorders. Intensive programs that target pelvic floor muscles are the most effective. Increasing your core and pelvic strength promotes pelvic floor health.

Six months of supervised pelvic floor physical therapy has benefits for anatomical and symptom improvement during pelvic organ prolapse.

Does Pelvic Floor Training Shorten Pushing Time? (What the Science Says)

There is a persistent myth in the birth community that building a strong pelvic floor makes the tissues too tight, creating a mechanical wall that delays birth and increases pushing time.

The clinical data show the exact opposite.

A landmark randomized controlled trial published in The BMJ evaluated the effects of active pushing during labor. In fact, participating in a pelvic floor muscle training program during pregnancy was associated with a significantly lower rate of prolonged second-stage labor (pushing lasting longer than 60 minutes) compared with those who didn’t train. For every 8 pregnant individuals who do pelvic floor exercises, one case of prolonged pushing is entirely prevented.

Exercises to Strengthen Your Pelvic Floor

Whether you are preparing for childbirth, navigating the postpartum window, or working to maintain bladder control as you age, targeted pelvic floor exercises are essential. You can begin these movements at almost any stage of life, provided you are not experiencing active pelvic pain. Exercises, like tabletops and squats, activate the pelvic floor muscles.

Squats

• Stand upright with your feet somewhat wider than shoulder-width apart, and toes pointed out. If you struggle with proper form, consider using a barbell to improve alignment. It should rest behind your neck on your trapezius muscles.
• Bend your knees and push your hips back as if you’re going to sit in a chair. Tuck your chin and keep your spine neutral.
• Keeping your weight in your heels and your toes pointed slightly outward, drop down until your thighs are parallel to the ground.
• Straighten your legs and stand upright. Complete 15 reps.

Split tabletop

• Lie on the floor with your knees bent so your thighs are perpendicular to the floor and your shins are parallel to it.
• Brace your abs and activate your inner thighs, legs touching.
• Slowly split your legs so each knee falls outward to a comfortable position.
• Slowly rise back to the start.
• Complete 10 to 15 reps and three sets.

Kegel exercises strengthen your pelvic floor muscles. Squeezing your pelvic muscles should feel like you are holding a tampon inside your muscles. You should not lie flat on your back in the second trimester of pregnancy and beyond.

Kegel Exercises

• Sit cross-legged with your knees bent and contract your pelvic muscles from back to front, as if to stop gas.
• Hold the pelvic muscle contraction for at least ten seconds.
• Once you can easily hold for ten seconds, attempt the exercise in various positions multiple times per day (side-lying, standing, kneeling).

If your breathing is properly relaxed and diaphragmatic, your lower hand should expand outward significantly more than the hand on your shoulder. If this is not happening, you are likely “chest breathing.” Try to further relax your body by focusing on taking long, deep breaths in through your nose, allowing your belly to expand fully, and then slowly exhaling out through your mouth.

When you notice this relaxed breathing, pull your pelvic floor up and in as you exhale. Continue focusing on your breath until you can coordinate the exhalation with pelvic floor contraction. Make sure you are not tightening your abdomen where you are touching. If you notice your stomach tightening, refocus on your peaceful breathing.

Eventually, work up to performing 10 at a time, at least 3 times per day. An easy way to remember to do your Kegel exercises is to complete ten every time you are at a red light. It triggers a daily reminder to do them. Stoplights are the perfect location; you are a captive audience while waiting for the light to change, and you can do Kegel exercises anywhere!

Every time you practice deep diaphragmatic breathing, your pelvic floor drops and your uterus gently rocks your baby. This physical movement changes the pressure of the amniotic fluid, providing a primitive form of tactile feedback that anchors early sensory bonding in the womb.

How can I tell that my Kegels are working?

There are ways to check whether your Kegel exercises are working. Perform a Kegel exercise during intercourse and get feedback from your sex partner regarding your vaginal tone during the contraction of the pelvic floor. You can also take a warm bath and put your fingers inside your vaginal opening. Practice a Kegel exercise and see if you can feel a tightening around your fingers.

Pelvic Floor Specialists

In a perfect world, every postpartum mom would receive free pelvic floor physiotherapy. Even though it is costly and not always covered by insurance, most women opt to perform the above exercises at home before calling in the specialists. Studies have shown that physiotherapy is a safe alternative to surgery.

If you perform these exercises for three months without improvement, it’s time to call in the specialists. A pelvic floor physical therapist is specifically trained to evaluate your pelvic floor and develop a treatment plan to address the issues.

A physical therapist will evaluate your pelvic floor using one of two methods. Biofeedback is electronic monitoring that assesses the strength and tone of your exercises to monitor improvement. Physical exams involve a gloved hand in the vagina or rectum to evaluate pelvic floor strength. If you are uncomfortable with the physical exam, you can request an alternative form of evaluation.

What Are Kegel Balls?

Kegel balls, also known as Ben Wa balls, are weights that you put into your vagina to strengthen the pelvic floor.  You may have seen them in Fifty Shades Darker, when Ana wears them out to a formal event. Their primary use isn’t risque or racy, but exercise.

The first time you use these exercise balls may seem intense, but you quickly become used to them. 

These pelvic floor exercisers are round and range in size from marble-sized to 2 inches in diameter. Some Kegel balls even vibrate. The pair of balls is traditionally in a box, and either comes attached or loose.

The connected balls also have a string that remains outside your vagina for easy removal. Ben Wa balls come in different weights, measurements, and materials. Using two separate balls requires more force and coordination to stabilize your pelvic floor.

The balls range in size, texture, and substance. Materials include

• Glass
• Metal
• Body-safe silicone
• Plastic
• Jade
• Latex

Where in the World Did Ben Wa Balls Originate?

Kegel Balls were created more than 1500 years ago in Japan by men.

The reason? Originally, men designed Ben Wa balls for their enjoyment. When inserted, the freely floating balls gave them more pleasure.

But women noticed that the balls strengthened their pelvic muscles and improved their reproductive health. The early Ben Wa balls proved more harmful than helpful because Kegel balls contained mercury.

However, modern Kegel balls have come a long way.

Kegel balls FRMT

Who Should Use Ben Wa Balls?

Everyone has a pelvic floor that supports their pelvic organs. However, for women, those muscles support the uterus, bladder, and rectum. The pelvic floor can become weak with age, pregnancy, childbirth, and other pelvic trauma.

Performing Kegel exercises can strengthen the pelvic floor. Some people can strengthen without any additional weight, while others may need to enhance their pelvic floor workout with weights. Intimate Rose Kegel Exercise System is a tested, evidence-based option for pelvic floor weights.

These balls’ primary purpose is to restore your pelvic floor, but some opt to use them to enhance their reproductive lives. While some women choose to wear them in public, others use them privately.

For the first time, it’s best to practice at home and become familiar with them so you don’t risk the device falling out while running errands.

Are There Risks to Using Kegel Balls?

Yes, using the balls too much can cause muscle fatigue, vaginal tears, or increase your risk of infection. Balls should always be cleaned and used correctly.

How should you insert Ben Wa Balls?

If you are not used to placing anything in your vagina, it can seem overwhelming at first. Lie down on the bed and slowly breathe until you feel relaxed. Some need relaxing music, candles, or a bath before they can relax.

Make sure the balls are clean. If they are a colder material like metal, warm them gently in your clean hands. If you need, you can use a bit of water-based lubricant to insert the balls. Insert them gently one at a time, breathing slowly.

How Do You Use Kegel Balls?

Like Kegel weights, you should start with the lightest weight you can tolerate and insert them one at a time. Any woman can only tolerate one ball at first and build up until both are in their vaginal canal at the same time. Once you can handle both balls’ lightest weight in the vaginal canal, you gradually increase as you can manage.

Use them for 15 minutes twice daily. They bounce around; they provide a unique sensation. Some women use them for short periods during Kegel exercises, while others leave them for hours.

How to Clean Ben Wa Balls

• Start by rinsing both balls under warm water, one at a time.
• Carefully clean them with antibacterial hand soap.
• Wash them in warm, soapy water.
• Run them underwater to wash off any soapy residue.
• Dry them with a clean towel.
• Let them air dry for an hour or two to verify they are clean.

The Bottom Line

There are many ways to improve your pelvic health and other physical symptoms. However, Ben Wa balls and pelvic floor exercises can improve your reproductive health. Challenge yourself to commit to a pelvic health routine for three months. Improving the strength in your pelvic floor will enhance your sex life, your quality of life, and help you to feel your best.

Flexible nursing jobs are still nursing jobs. Download this free guide to explore flexible, rewarding nursing roles that don’t keep you at the bedside: roles you might never have known existed!

Follow us on TikTok or Instagram.