If I told you that the majority of women will, at some point in their lives, experience some form of urinary incontinence when jumping, coughing, or sneezing — what would you think?
Would you be interested in learning more? Would you wonder why women seem to suffer more often than men? Or would you consider it a natural part of life that you’ll eventually face?
But what if you were given the right information and the proper ways to prevent or even manage the issue — would you be interested then?
If yes, keep reading…
What is the pelvic floor?
The term is somewhat misleading, because “floor” makes us think of something flat — but in reality, it has a dome-like shape. It consists of muscles that stretch from the coccyx to the back of the pubic symphysis, forming a “dome” of support across the pelvis.
You can feel your pubic symphysis by tracing your fingers downward from your navel until the soft tissue stops at a bony edge; the coccyx is at the end of your spine. This gives you an idea of where the pelvic floor muscles lie between those two points.
These muscles are multiple and interconnected, arranged at different angles and planes as they attach to various points on the pelvis. You can sense them when you “hold in” to stop urinating or passing gas — the sensation is similar in both men and women.
The pelvic floor is also considered an “erotic” muscle, as it can be gently engaged during sexual activity. It is elastic and mobile, and its strength/stability varies depending on how it attaches to the bony structure of the pelvis.
Its importance lies in the organs it supports.
Women: bladder, uterus, intestines (urethra, vagina, anus).
Men: bladder, intestines (penis, anus).
The pelvic floor supports these organs and contributes to their proper function. Good muscle tone is crucial for the integrity and function of the bladder, vagina/penis, and rectum, and helps prevent tissue laxity that can lead to prolapse (e.g. of the uterus or rectum). When the muscles no longer respond effectively to exercise, surgical correction may be required — another reason to start strengthening as early as possible.
What weakens the pelvic floor?
- Pregnancy and childbirth: the weight of the growing baby, hormonal changes, prolonged labor, multiple births, or large babies.
Many women experience incontinence after childbirth because the pelvic floor has been stretched or injured (tear or episiotomy). - Perineum: the area between the vagina and anus (women) or between the testicles and anus (men). Many pelvic floor muscles join here; its weakness is often considered the “Achilles’ heel.”
- Overstrain/pressure factors: obesity, constipation, chronic smoker’s cough, intense aerobic exercise, repeated heavy lifting, allergic sneezing, persistent or improper abdominal workouts.
- Modern lifestyle: prolonged sitting, driving, reduced physical activity. (In prehistoric or traditional societies, frequent deep squatting, outdoor work, and climbing naturally strengthened the pelvic floor.)
Men, this applies to you too!
Good pelvic floor tone has been shown to help prevent prostate cancer and improve sexual function in men. It also aids in preventing incontinence later in life.
Pelvic Floor Exercise
Most muscles contain both slow-twitch and fast-twitch fibers.
- Standing or deep-squat positions → mainly slow fibers.
- Holding urine or quick reactions (e.g. running for a bus) → mainly fast fibers.
For a strong, balanced pelvic floor, train both.
How to locate the muscles
Sit on a soft surface with your legs slightly apart, bring your fist gently to your mouth and cough — you’ll feel the muscles between your legs press down into the chair. Then “lift” the muscles upward (the opposite direction).
Alternatively, imagine holding yourself to avoid urinating, defecating, or passing gas.
If your glutes, inner thighs, or hamstrings tighten, you’re probably not activating the pelvic floor correctly. Try to relax those muscles to feel the difference.
Note: The “stop–start urination” exercise has shown mixed results and may lead to urinary difficulty and/or infections. Today, mental visualization or mindful activation is preferred and more effective.
Much of Yoga and Pilates already engages the pelvic floor, but below are simpler home exercises.
Exercise 1 (basic contraction – slow fibers)
- Imagine you’re holding yourself to avoid going to the bathroom.
- Draw the muscles up and in.
- Hold for 5 counts.
- Release completely.
- Repeat until you feel fatigue.
- Breathe normally.
Exercise 2 (double intensity – slow fibers)
- Draw the muscles up and in as before.
- Then draw them a bit further in, so the second contraction is stronger than the first.
- Relax and repeat.
- Breathe normally.
Exercise 3 (pulsing contractions – fast fibers)
- Make small, quick contractions without rest pauses in between (like a pulse).
- Breathe normally.
Practice positions
Try the exercises in 5 positions:
- Lying down with knees bent
- Lying on your back
- Lying face down
- Standing
- Sitting
Χρόνος/συχνότητα: Κάθε άσκηση για 2–3 λεπτά ή μέχρι κόπωσης, με διάλειμμα ανάμεσα. Μπορείτε να εντάξετε 1–2 θέσεις την ημέρα (π.χ. στο γραφείο ή όσο βράζει το νερό).
Ένα διακριτικό αυτοκόλλητο στην κουζίνα, στον καθρέφτη ή στο τραπεζάκι μπορεί να λειτουργεί ως υπενθύμιση.
Program length: Continue for at least 6 weeks to 3 months.
P.S. There are some situations in which pelvic floor exercise is not beneficial. If your symptoms persist, consult your gynecologist, who will guide you further.