Want to exercise with more confidence? Pelvic health specialist Louise Field explains how to strengthen pelvic floor for better movement
Words: Louise Field | Images: Shutterstock
Bladder leaks and incontinence issues are still some of the biggest taboos in women’s health. Yet, the moment I start a conversation about pelvic floor health, the response is overwhelming – suddenly everyone has something to share. As a pelvic health specialist working with women and fitness professionals every day, I see first-hand how many women quietly put up with symptoms they think are ‘just part of life’.
Whether it’s a little ‘sneeze wee’, leaking slightly during a run, worrying about leaks during strength training or feeling anxious during HIIT workouts, these moments have become so normalised that many women stop questioning them altogether. But here’s the truth: common does not mean normal, and most pelvic floor symptoms can be significantly improved with the right support, awareness and training. So, let’s break the silence and help women feel stronger, more confident and more supported when they move and train.
What I have noticed is that women are incredibly good at adapting. We modify workouts, wear pads ‘just in case’, avoid certain exercises and tell ourselves leaks are simply part of getting older, having children or training hard. But pelvic floor issues shouldn’t be accepted as the price women pay for staying active. Your body should feel supported and confident when you move. And, just like we train our glutes, core or upper body strength, the pelvic floor deserves attention, too.
Why pelvic health matters
Your pelvic floor is a group of muscles that sit at the base of your pelvis, supporting your bladder, bowel and reproductive organs. When these muscles are not functioning as well as they should – whether too weak, too tight or poorly coordinated – symptoms can show up as leaks, urgency, heaviness or discomfort.
What I see time and time again is women ignoring the early signs. Many wait years before seeking help, even though evidence shows pelvic floor training and support can dramatically improve symptoms. Pelvic health isn’t just about prevention; it’s about restoring confidence, supporting the way you move and train, and protecting your body long term.
So, when should you start paying attention? Your body gives you early warning signs – don’t ignore them. Watch out for leaking when coughing, sneezing or exercising; rushing to the toilet or not making it in time; a feeling of heaviness or dragging in the pelvis; difficulty controlling wind or bowel movements; or reduced confidence in workouts and movement. These symptoms are your cue to take action – not to stop moving, but to train smarter and seek the right support.
Train with confidence
If you’ve ever leaked during exercise, you’re definitely not alone. Running, HIIT, CrossFit, heavy lifting and other high-impact activities increase pressure on the abdomen, which the pelvic floor must manage. The repetitive impact from sprinting, jumping and lifting means these muscles need to be responsive, coordinated and strong.
But here’s the good news: you do not have to stop doing the exercise you love. With the right support, training and rehabilitation, many women can confidently return to high-impact exercise.
What are the biggest pelvic floor mistakes women are making? If you’re active, motivated, and already exercising regularly, the answer might surprise you. One of the most common mistakes I see is women focusing only on Kegels exercises while ignoring everything else. The pelvic floor works alongside your core, breath, posture and movement patterns, so they all need to work together.
Another big issue is pushing through symptoms. Leaking during a workout is your body’s way of saying something needs more support. I also regularly see women returning to high-impact exercise too quickly post-birth, ignoring relaxation or constantly ‘gripping’ the pelvic floor muscles, which can be just as problematic as weakness.
Many women also assume symptoms are ‘just ageing’ or ‘just menopause’, but while pelvic floor changes are common, they are not inevitable or unmanageable.
Childbirth and menopause
Two key life stages can have a major impact on pelvic health: pregnancy and menopause.
During pregnancy, the pelvic floor is under increased pressure from the growing baby alongside huge hormonal changes, which can affect support and increase symptoms such as leaks or prolapse. Post-birth, especially after vaginal delivery, the muscles need proper rehabilitation – not guesswork. It’s also important not to overlook scar tissue from both vaginal and caesarean births, as this can affect pelvic floor muscle function, too.
Menopause can also have a significant impact on pelvic floor health. Hormonal changes, particularly declining oestrogen, can affect tissue quality, muscle strength and recovery capacity. This can lead to reduced muscle tone, increased urgency or frequency, leaks during exercise, pelvic organ prolapse, constipation, vaginal dryness and discomfort, as well as reduced confidence during movement and intimacy. This is why pelvic floor health matters throughout every phase of life and not just after having children.
Finding the right balance
Can we overtrain the pelvic floor? Yes, and this is something that’s often overlooked. There’s a common belief that more squeezing (Kegels) equals better results, but just like any muscle group, the pelvic floor needs balance.
Some women actually develop overactive or tight pelvic floor muscles, which can be just as problematic as weakness. If the muscles are constantly ‘switched on’, they lose their ability to fully relax and respond effectively during movement. That’s when symptoms such as urgency, discomfort or even leaking can still happen despite all that effort.
Like every muscle in the body, the pelvic floor needs breath, release, coordination and control. A healthy pelvic floor is one that can switch on and off properly when needed.
How to train your pelvic floor
Master the basics
You don’t need hours of complicated routines, but you do need consistency and good technique. Start by learning how to activate the correct muscles properly. Think about stopping wind and urine at the same time – a lift and squeeze, not a hard clench.
Build strength & endurance
It’s important to build both strength and endurance through slow holds and quick pulses to improve responsiveness, while also focusing on proper breathing. Your pelvic floor and diaphragm work together, so holding your breath increases pressure and can worsen symptoms. Try to breathe normally throughout movement or exhale on effort.
Train it in motion
This is where many women fall short: training in movement. You need to integrate pelvic floor coordination into the mechanics of squats, lunges, lifting and running. Layering breath, activation, release and functional strength together can be incredibly effective.
Can pelvic training devices help?
Pelvic floor training devices can be a useful option for some women, particularly if they need help identifying the correct muscles or staying consistent with their exercises. One example is SomaFlex (available in different sizes from £60, somalives.com), a soft medical-grade silicone device designed to be worn during everyday activities or exercise. Rather than replacing pelvic floor exercises, it aims to support muscle activation as you move. Some women also find it provides an increased sense of support and confidence during higher-impact activities, where minor leaks are more likely to occur.
Louise Field is a pelvic health specialist, educator and director of Adore Your Pelvic Floor, where she supports women and fitness professionals with pelvic floor rehabilitation, education and confidence-building. Visit adoreyourpelvicfloor.co.uk
