Beyond Kegels: How to Really Strengthen Your Pelvic Floor

If you’ve ever been told to “do your pelvic floor exercises” and left to get on with it, you’re not alone. Most women I meet in my St Albans classes were given a sentence of advice at their six-week check, maybe a leaflet, and nothing more. So they squeeze. Hard. Whenever they remember.

After sixteen years teaching women’s health Pilates, I can tell you that squeezing harder is rarely the answer. Your pelvic floor needs to work, yes, but it also needs to let go.

Half of women are doing it wrong

In a 1991 study, researcher Richard Bump gave women brief verbal instructions on how to contract their pelvic floor, then checked them internally. A quarter of the women produced no useful contraction at all. Another quarter were bearing down instead of lifting, which could actually make things worse.

That’s half of women getting it wrong after being “taught”. It isn’t their fault. The pelvic floor is hard to access, it’s surrounded by bigger, louder muscles like your glutes and inner thighs, and nobody shows you what it should feel like.

What your pelvic floor actually does

Your pelvic floor is a hammock of muscle and fascia running from your pubic bone to your tailbone and between your sit bones. It does far more than stop leaks. It:

• keeps you continent when you cough, sneeze, laugh or jump
• supports your bladder, womb and bowel from below
• stabilises your pelvis and lower back
• works with your breathing diaphragm on every single breath
• plays its part in sexual sensation and in birth

Around 70% of pelvic floor fibres are slow-twitch, built for all-day endurance, and 30% are fast-twitch, built for the split-second squeeze when you sneeze. A good programme trains both.

Your breath is your best pelvic floor exercise

This is the part most people have never heard. Your breathing diaphragm and your pelvic floor move together. As you breathe in, both gently drop. As you breathe out, both recoil upwards.

We take around 16 breaths a minute. If your breathing pattern is off, with shallow chest breathing, a held-in tummy or a habit of bracing, that pattern is working against your pelvic floor thousands of times a day. No amount of squeezing in a class can outrun that.

So in my classes we always start with the breath:

1. Breathe in and feel your ribs widen and your pelvic floor soften.
2. Breathe out and let everything settle back to rest first.
3. Only then add a gentle lift, drawing your sit bones together and lifting forwards towards your pubic bone.
4. Breathe in and fully let it go.

That release on the in-breath matters as much as the lift.

Why “just squeeze” can backfire

Pelvic floor problems come from muscles that are too tight as well as too weak. An overactive pelvic floor can cause leaking, urgency, pain with sex, tailbone pain and difficulty emptying your bladder or bowel. Endless Kegels make it worse.

The old advice to stop your wee mid-flow is also one to drop. Done regularly, it can stop your bladder emptying properly.

A healthy pelvic floor is elastic. It can lift, hold, release and respond. That’s why my approach to pelvic floor Pilates in St Albans includes:

• release work: seated work on a soft ball, cat stretches, freeing up tight hips and glutes
• breath-led connection: lifting with the exhale, releasing with the inhale
• movement: rocking, circling and swaying the pelvis, squats and pliés, so the pelvic floor learns to work while you move
• real-life strength: lifting, carrying and getting up off the floor with good pressure control

Train it the way you use it

You don’t need your pelvic floor lying still on a mat. You need it lifting a car seat, chasing a toddler, running for a train or getting back into tennis. So once the basics are there, we progress into standing, balance and loaded strength work. It’s where Pilates and strength training meet, and it’s where women see the biggest change.

You can do my favourite holistic pelvic floor exercises here: 

When to see a specialist

Please see a women’s health physiotherapist if you have leaking, a feeling of heaviness or bulging, pain in your pubic bone, or pain with sex. I work alongside local physios (https://www.katelloydphysio.co.uk) and osteopaths (https://hertsosteopathy.co.uk), and the best results come from both of us.

Frequently asked questions

Are Kegels bad for you? No, but they’re only one tool. Without breath, release and movement they’re often done wrong or too much.

How long until I notice a difference? Many women feel better connection within a few weeks. Real strength takes around three months of consistent practice.

Is it ever too late? Never. I work with women whose babies are six weeks old and women whose babies are thirty.

Ready to find out where you’re starting from?

My pelvic health MOT is a one-to-one session in my St Albans studio where we look at your breathing, posture and pelvic floor connection and build a plan that fits you. Book your pelvic health MOT, or join a Centred Mums class in St Albans or online.

Grace Lillywhite is a women’s health Pilates specialist and the founder of Centred Mums in St Albans. A former professional dancer, she has spent sixteen years helping women rebuild strength and confidence through pregnancy, the postnatal years and menopause. She specialises in pelvic floor health, prolapse, leaking and diastasis recti, and teaches in St Albans and online.