Recovery Insights Blog | Foundational Rehab

What Is the Pelvic Floor?

The pelvic floor is a group of muscles spanning the bottom of your pelvis—like a hammock supporting your bladder, bowel, and reproductive organs.

These muscles:

Control urination and bowel movements

Support pelvic organs

Contribute to sexual function

Stabilize the spine and pelvis

Work with your core and breathing

Everyone has a pelvic floor. While often discussed for women, pelvic floor health matters for all genders.

Signs of Pelvic Floor Problems

Weakness (Hypotonic)

Urinary leakage (coughing, sneezing, jumping)

Difficulty holding urine or stool

Pelvic organ prolapse (heaviness, bulging)

Reduced sexual sensation

Tightness (Hypertonic)

Pelvic pain

Painful intercourse

Difficulty emptying bladder or bowels

Constipation

Pain with sitting

Important: Not all pelvic floor problems need strengthening. Tight pelvic floors need relaxation, not Kegels.

Finding Your Pelvic Floor

For Everyone

Imagine you're:

Stopping the flow of urine midstream (don't actually do this regularly)

Holding back gas

Lifting your pelvic floor up and in

You should feel a gentle squeeze and lift deep in your pelvis—not your abs, buttocks, or thighs.

Check Your Technique

Place a hand on your abdomen—it should stay relaxed

Your buttocks should not clench

You should not hold your breath

The movement is internal, not visible

Basic Kegel Exercise

The Foundation:

1. Find the muscles (as described above)

2. Contract and lift the pelvic floor

3. Hold for 3-5 seconds

4. Relax completely for 3-5 seconds

5. Repeat 10 times

Progress over time:

Increase hold time (up to 10 seconds)

Add more repetitions (up to 3 sets of 10)

Practice daily

Beyond Basic Kegels

Quick Flicks

For quick muscle response (stopping a sneeze leak):

1. Contract pelvic floor quickly

2. Release immediately

3. Repeat 10-15 times quickly

4. Rest, then repeat

Elevator Exercise

For strength and control through range:

1. Imagine your pelvic floor as an elevator

2. Contract to "first floor"

3. Lift higher to "second floor"

4. Go to "third floor" (maximum)

5. Slowly lower back down, floor by floor

6. Repeat 5-10 times

The Knack

For preventing leaks during activities:

1. Before coughing, sneezing, or lifting

2. Contract pelvic floor firmly

3. Hold during the activity

4. Release after

Practice until it becomes automatic.

Pelvic Floor Relaxation

For tight/overactive pelvic floor:

Diaphragmatic Breathing

1. Lie on back, knees bent

2. Place hand on belly

3. Inhale—belly rises, pelvic floor naturally descends

4. Exhale—belly falls gently

5. Focus on complete relaxation on inhale

6. 5-10 minutes daily

Happy Baby Pose

1. Lie on back

2. Bring knees toward armpits

3. Hold feet or ankles

4. Gently rock side to side

5. Focus on relaxing pelvic floor

6. Hold 1-2 minutes

Child's Pose with Breathing

1. Kneel, sit back on heels

2. Fold forward, arms extended

3. Breathe deeply into belly and back

4. Feel pelvic floor release with each inhale

5. Hold 2-3 minutes

Butterfly Stretch

1. Sit, soles of feet together

2. Let knees fall open

3. Gentle forward fold

4. Breathe and release

5. Hold 1-2 minutes

Pelvic Floor + Core Integration

The pelvic floor works with your deep core. Train them together:

Breathing Coordination

1. Inhale: pelvic floor and belly relax

2. Exhale: pelvic floor gently lifts, deep core engages

Bridge with Pelvic Floor

1. Lie on back, knees bent

2. Exhale, engage pelvic floor

3. Lift hips into bridge

4. Hold 5 seconds

5. Lower, relax completely

6. 10 repetitions

Dead Bug with Pelvic Floor

1. Lie on back, knees at 90°

2. Exhale, engage pelvic floor

3. Lower opposite arm and leg

4. Return, relax

5. Repeat other side

6. 10 each side

For Specific Populations

Postpartum

Wait for provider clearance (usually 6 weeks)

Start gently—muscles are stretched and weakened

Focus on connection before strength

See a pelvic floor PT if problems persist

Prostate Issues (Prostatitis, Post-Surgery)

Kegels help before and after prostate surgery

Can improve urinary control

May help with erectile function

Relaxation important for chronic prostatitis

Pregnancy

Safe throughout pregnancy

Helps prepare for delivery

May reduce incontinence risk

Balance strengthening with relaxation

Menopause

Hormonal changes affect pelvic floor

Continued exercise maintains function

May need more focus on relaxation

Discuss options with provider

Common Mistakes

1. Bearing down instead of lifting — Wrong direction!

2. Clenching buttocks or thighs — Isolate the pelvic floor

3. Holding breath — Breathe normally

4. Only doing quick contractions — Need sustained holds too

5. Doing Kegels with tight pelvic floor — Relax first

6. Forgetting to fully relax — Relaxation is half the exercise

When to See a Specialist

A pelvic floor physical therapist can help if:

You can't find your pelvic floor muscles

Symptoms aren't improving after 8-12 weeks

You have pelvic pain

You're unsure if you need strengthening or relaxation

You've had pelvic surgery

You have prolapse symptoms

Problems are significantly affecting your life

Sample Daily Routine

Morning (5 minutes):

Diaphragmatic breathing (2 minutes)

Kegels: 10 holds (5 seconds each)

Quick flicks: 15 reps

Midday (2 minutes):

10 Kegels while sitting at desk

Practice "the knack" before sneezing/coughing

Evening (5 minutes):

Happy baby pose (1 minute)

Bridges with pelvic floor (10 reps)