Pelvic Floor

Strengthening
Guide
by Lucas Rockwood, ERYT-500

© YOGABODY LLC 1
Table of Contents
The Importance of Pelvic Floor Health....................................................................................................................3

Anatomy of your Pelvic Floor......................................................................................................................................4

Learn Pelvic Floor Contractions..................................................................................................................................5

Reverse Breathing Technique.....................................................................................................................................6

Pelvic Floor Strengthening Exercises.......................................................................................................................7

Seated Practice...........................................................................................................................................................7

Supine Practice...........................................................................................................................................................8

Supported Squat.......................................................................................................................................................8

Modified Bridge Pose...............................................................................................................................................9

Pelvic Floor Squat Walk......................................................................................................................................... 10

Train with Me?............................................................................................................................................................... 11

References....................................................................................................................................................................... 12

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The Importance of Pelvic Floor Health
Strong and coordinated pelvic floor muscles are crucial for your health in the
bathroom, the bedroom, and they can even help contribute to better posture.
Unfortunately, most of us have no idea where these mysterious muscles are, let alone
how to train them if we’re experiencing problems.

Pelvic floor strength matters for Causes of pelvic floor dysfunction

• Bladder and bowel control • Sedentary lifestyles
• Sexual function • Childbirth muscle trauma
• Posture • Obesity
• Age-relaxed muscle loss and laxity

The good news is that just like your bicep muscles or your quads, you can also train
your pelvic floor muscles for strength and coordination. You can’t lift weights the way
you might with your biceps, but by increasing awareness and coordination, your pelvic
floor muscles begin to fire and engage naturally when you get up and down, use the
toilet, and move around in your daily life.

It will take practice and concentration to isolate and coordinate this region and
breathing properly can make it much more accessible. In this guide you’ll learn how
to become more aware of your pelvic floor muscles and the exercises you can do at
home to strengthen, coordinate, and bring awareness back to this area of your body.

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Anatomy of your Pelvic Floor
Eleven different muscles make up your pelvic floor, some large, some tiny. The most
notable are a group of muscles at the base of your pelvis called levator ani, which includes
three primary muscles that make up your pelvic floor – the puborectalis, pubococcygeal,
and iliococcygeal muscles. These key muscles control your urine, bowel, and ejaculation,
and in women they support the uterus. They also affect your posture.

These muscles can become weak and cause problems. The most common causes
are childbirth where they can become strained or torn, age where they can become
atrophied, and also through a lack of use – if you’re sitting down all day, it can lead to
weakened pelvic floor muscles.

A key thing to remember is that your pelvic floor diaphragm and your breathing
diaphragm have a paradoxical relationship – when you exhale you can squeeze your
pelvic floor muscles much easier, when you inhale it’s much harder to squeeze those
muscles. In our exercises we’ll work at the bottom of the exhale, where your breathing
diaphragm is relaxed and there’s more space to squeeze.

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Learn Pelvic Floor Contractions
Most people have never consciously engaged their
pelvic floor muscles, so an important first step is to
learn to engage and relax the various muscles.

Front Muscle Contraction (pubococcygeus)

• Sit in a chair and close your eyes
• Inhale deeply 1-2-3-4, now exhale 4-3-2-1
• Hold your breath at the bottom of the exhale
• Imagine you are urinating and stop the flow
of urine 4-3-2-1
• Release

Back Muscle Contraction (puborectalis)

• Inhale deeply 1-2-3-4, now exhale 4-3-2-1
• Hold your breath at the bottom of the exhale
• Imagine you are defecating and now stop and
squeeze your anus 4-3-2-1
• Release

Middle Muscle Contraction (all 3 levator ani)

• Inhale deeply 1-2-3-4, now exhale 4-3-2-1
• Men: hold your breath at the bottom and
imagine lifting your testicles up into your body
• Women: hold your breath at the bottom and
contract your vagina

Full Pelvic Floor Contraction (4+ muscles)

• Inhale deeply 1-2-3-4, now exhale 4-3-2-1
• Hold your breath at the bottom of the exhale
• Squeeze your front, back, and middle areas
at the same time

NOTE: When attempting to contract your pelvic floor muscles, it’s common to struggle to hold the
contraction. The muscle might contract-relax-contract, meaning you cannot hold it. This is normal.
Keep practicing. It will improve with time.

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Reverse Breathing Technique
In theory, you can engage your pelvic floor at any time,
but in reality, you’ll find it much easier to engage and
Mula Bandha
hold at the bottom of your exhale since your breathing
in Yoga
diaphragm is relaxed up into its dome shape and there
is less downward pressure on the abdominal region. Pelvic floor
engagement,
Your pelvic floor diaphragm and your breathing known as Mula
diaphragm have a paradoxical relationship. When you Bandha (root lock)
inhale, your breathing diaphragm pushes everything in yoga, is a crucial
down so it’s difficult to engage down below. practice for many
poses as it provides
When you exhale, your breathing diaphragm relaxes a flowerpot-like
back up to its dome shape and it’s much easier to stable base for
contract the muscles around your perineum. So, with spinal alignment.
this in mind, we’ll focus on exercises conducted at the
bottom of the exhale with breath retention.

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Pelvic Floor Strengthening Exercises
Aim to practice up to three rounds of each exercise, no more than three times a
day. Don’t overdo it with these practices, otherwise you may trigger short-term
constipation and anxiety.

If you have major pelvic floor dysfunction, please check with a health care provider
before practicing any self-care routine.

Seated Practice
• Sit in a chair with a rolled-up towel
between your legs, touching your
genitals and the base of your pelvis
• Inhale deeply, then exhale
completely and hold
• Engage all your pelvic floor muscles
(front, back, and middle), lift and
squeeze for 1-2-3-4-5
• Release, relax, and breathe normally
• Repeat for two more rounds

NOTE: You can practice this exercise

without a towel, but using one helps to
create greater awareness in this area.

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Supine Practice
• Lie on the floor with your knees bent and a block between your knees
• Inhale deeply, then exhale completely and hold
• Engage all your pelvic floor muscles (front, back and middle), lift and squeeze
for 1-2-3-4-5
• Release, relax and breathe normally
• Repeat for two more rounds

Supported Squat
• Stand in front of stool/chair with your feet a little wider than hip-width apart, inhale
• Exhale and place your fingertips on the chair or steepled together at your chest
• Hold your breath, close your eyes, and lift your pelvic floor
• Engage your pelvic floor muscles as though you are stopping yourself from going
to the bathroom and hold for 4-3-2-1
• Release, stand up, and shake it out
• Repeat for five rounds

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Modified Bridge Pose
Traditional bridge pose focuses on glute strength and backbending: but here, we’ll use
a gentle version of this posture to shift our focus to the pelvic floor.

• Lie on your back, bend your knees, separate your heels hip-width apart
• Inhale 1-2-3-4 through your nose
• Exhale 4-3-2-1 and lift your hips just a little
• Squeeze all three regions of your pelvic floor
• Imagine your tailbone is tucking underneath you
• Hold here for 4-3-2-1
• Release back down onto your back and breathe normally
• Repeat for five rounds

NOTE: If it’s too much to lift your hips, you can practice this pose with your hips on the ground.
Usually the slight lift helps you to engage.

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Pelvic Floor Squat Walk
Imagine yourself stopping the flow of urine and stopping defecation – squeeze it in.
This is a crude way to quickly find and engage your pelvic floor.

• On the exhale, squeeze and lift your pelvic floor muscles, stand, and bend your knees
• Tilt your pelvis backwards by tucking your tailbone under
• Take three steps forward and three steps backwards, keeping your pelvic floor
muscles squeezed throughout
• Sit, relax, and repeat for five rounds

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Train with Me?
If you’d like to improve your strength, flexibility, and cardio-respiratory fitness, I’d love
to invite you to join YOGABODY Daily. We take a science-based approach to wellness,
and Monday through Friday, you’ll receive simple yet powerful at-home practices
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References
Bo, K., & Sherburn, M. (2005). Evaluation of female pelvic-floor muscle function and
strength. Physical Therapy, 85(3), 269-282.

DeLancey, J. O. (2002). Anatomy and biomechanics of genital prolapse. Clinical

Obstetrics and Gynecology, 45(4), 964-979.

Sapsford, R. (2004). Rehabilitation of pelvic floor muscles utilizing trunk stabilization.

Manual Therapy, 9(1), 3-12.

Ashton-Miller, J. A., & DeLancey, J. O. (2007). Functional anatomy of the female

pelvic floor. Annals of the New York Academy of Sciences, 1101(1), 266-296.

Hilde, G., & Staer-Jensen, J. (2013). Age-related changes in pelvic floor muscle strength
among women with urinary incontinence. International Urogynecology Journal, 24(7),
1185-1190.

Bø, K. (2004). Pelvic floor muscle training in treatment of female stress urinary
incontinence, pelvic organ prolapse and sexual dysfunction. World Journal of Urology,
30(4), 437-443.

Sapsford, R. R., & Hodges, P. W. (2001). Contraction of the pelvic floor muscles during
abdominal maneuvers. Archives of Physical Medicine and Rehabilitation, 82(8), 1081-
1088.

Nygaard, I., Barber, M. D., Burgio, K. L., Kenton, K., Meikle, S., Schaffer,
J., Spino, C., Whitehead, W. E., Wu, J., & Brody, D. J. (2008). Prevalence of
symptomatic pelvic floor disorders in US women. JAMA, 300(11), 1311-1316.

Images: YOGABODY LLC / PushprajP/ VectorMine/ shutterstock.com

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