Your Pelvic Floor Was Made to Move With Your Body
When you think about strengthening your pelvic floor, Kegels or pelvic floor contractions may be the first thing that comes to mind — and for good reason. Specific pelvic floor muscle training is well supported by research and can be an important part of rehabilitation, but it’s only one piece of the puzzle.
Your pelvic floor isn’t only working when you intentionally contract and relax it. It supports, stabilizes and responds with you throughout the day — when you walk, climb stairs, carry groceries, lift weights, exercise, cough, sneeze and simply move through life.
Your pelvic floor is part of a much bigger system — and we can train it that way too!
That means helping it work alongside your core, hips and breathing, so the strength you build can carry over into the way you actually move.
Your Core Is More Than Your Abs!
When most of us picture our “core,” we think about our abdominal muscles. But fun fact — your core is a whole team! Your pelvic floor works closely with your diaphragm, abdominal muscles and deep back muscles to help support your body and manage pressure as you breathe and move. This is why we often combine pelvic floor work with breathing and core exercises. Practising these muscles together helps build coordination as we add resistance, change positions and progress to more challenging movements.
Different activities also need different responses. A cough needs a quick reaction, while lifting or carrying may require more sustained support and pressure management. Strength matters in rehabilitation, but so do coordination, endurance and relaxation!
What Do Your Hips Have to Do With It?
Quite a lot!
The hips and pelvic floor sit incredibly close together and are closely connected anatomically. One of the deep hip muscles, the obturator internus, shares connective tissue with the pelvic floor, and research has also shown potential benefits of combining pelvic floor muscle training with hip and glute strengthening for some women with urinary incontinence.
It also makes sense when we look at movement. When you squat, climb stairs, carry something or balance on one leg, your feet, hips, trunk, breathing and pelvic floor are all contributing. So seeing bridges, squats, lunges or hip strengthening in pelvic floor physio might not be as random as it first seems!
What Can Pelvic Floor Rehab Look Like in Real Life?
Pelvic floor rehab isn’t just about one exercise or one type of strengthening. It can be about helping the pelvic floor work more effectively with the rest of your body — through different movements, different demands and different stages of life.
Pelvic floor function can be influenced by many changes over time, including pregnancy, postpartum recovery, shifts in activity and strength, midlife, perimenopause, menopause and aging. That’s why pelvic health support can be valuable at so many different points in life. For one person, the goal might be returning to running or lifting weights. For someone else, it could be gardening, playing pickleball, carrying a grandchild or simply feeling stronger in everyday life.
What matters is building the strength, coordination and capacity for what you need — and want — your body to do.
How Can We Help?
At Makewell Health, pelvic floor physiotherapy looks at more than one muscle or one exercise. We look at you as a whole person — including your pelvic floor, core, hips, breathing, movement, symptoms and the activities and goals that matter most to you. From there, we help you figure out where to start and how to progress. That might mean improving relaxation and coordination, building strength, working on balance or gradually returning to more demanding activity.
Our goal is to help your pelvic floor work well as part of the rest of your body, so you can keep doing the things that matter most to you.
References
Hay-Smith EJC, Starzec-Proserpio M, Moller B, et al. Comparisons of approaches to pelvic floor muscle training for urinary incontinence in women. Cochrane Database of Systematic Reviews. 2024.
Marques SAA, Silveira SRBD, Pássaro AC, et al. Effect of pelvic floor and hip muscle strengthening in the treatment of stress urinary incontinence: a randomized clinical trial. Journal of Manipulative and Physiological Therapeutics. 2020.
Muro S, Nimura A, Ibara T, et al. Anatomical basis for contribution of hip joint motion by the obturator internus to defaecation/urinary functions by the levator ani via the obturator fascia. Journal of Anatomy. 2023.
These resources are provided for educational purposes and are not a substitute for individualized assessment by a qualified pelvic health physiotherapist.