Tag Archive for: Pressure Management

Functional Pelvic Floor Training: Why Strength Takes More Than Kegels

When most women hear the words “pelvic floor strengthening,” they usually picture one thing:

Squeeze.

Hold.

Release.

Repeat.

For years, women have been taught that strengthening their pelvic floor means doing more Kegels.

And while pelvic floor contractions can be helpful for some women, your pelvic floor is far more complex than a muscle that simply needs to be tightened.

Your pelvic floor is a dynamic, three-dimensional system that supports your body through movement, pressure, and everyday life.

It helps you:

  • Run
  • Lift
  • Jump
  • Carry your children
  • Maintain balance
  • Control your bladder and bowels
  • Feel confident during exercise and intimacy

Your pelvic floor was designed for movement.

Not just squeezing.

Most women were never taught this.

Your body is not broken.

You may simply need a better understanding of how your pelvic floor actually works.

Your Pelvic Floor Is More Than a Muscle You Contract

The pelvic floor is a group of muscles located at the bottom of your pelvis.

Many women first learn about these muscles when they experience:

  • Pregnancy changes
  • Postpartum leaking
  • Pelvic pressure
  • Pain with intimacy
  • Difficulty returning to exercise

But your pelvic floor is involved in much more than preventing symptoms.

It plays a role in:

  • Supporting your pelvic organs
  • Managing pressure inside your abdomen
  • Stabilizing your pelvis
  • Coordinating with your core
  • Helping you move efficiently

Cleveland Clinic explains that the pelvic floor supports the pelvic organs and plays an important role in bladder, bowel, sexual, and core function.

https://my.clevelandclinic.org/health/articles/22729-pelvic-floor-muscles

Your pelvic floor is part of your entire movement system.

It is not an isolated muscle group.

What Makes the Pelvic Floor a 3D System?

Most muscles are discussed in terms of simple movements.

Your biceps bend your elbow.

Your quadriceps straighten your knee.

But your pelvic floor works in multiple directions and responds as your body moves.

Your body moves through three planes:

Forward and Backward

Like walking, running, or lunging.

Side to Side

Like stepping sideways or balancing.

Rotation

Like turning, twisting, or changing direction.

Your pelvic floor has to respond during all of these movements.

This matters because your life is not lived lying still doing isolated exercises.

Your body is constantly adapting.

Your pelvic floor should be able to adapt too.

Why Kegels Alone May Not Build the Strength You Need

Kegels teach you how to contract your pelvic floor.

That can be valuable.

But functional pelvic floor training requires more.

Think about training for a marathon.

Would you only strengthen your feet?

No.

You would train your:

  • Legs
  • Heart
  • Breathing
  • Endurance
  • Coordination

Your pelvic floor works the same way.

A strong pelvic floor needs:

  • Strength
  • Timing
  • Coordination
  • Relaxation
  • The ability to respond during movement

The question is not only:

“Can I squeeze my pelvic floor?”

The better question is:

“Can my pelvic floor support me during the activities I love?”

Your Pelvic Floor Works With Your Core

Your pelvic floor does not work alone.

It is part of a larger system that includes:

  • Your diaphragm
  • Your deep core muscles
  • Your abdominal muscles
  • Your hips
  • Your glutes
  • Your spine

Together, these muscles help manage pressure and create stability.

Every time you:

  • Pick up your baby
  • Lift weights
  • Cough
  • Laugh
  • Run
  • Squat

your body has to respond and manage pressure.

This is why pelvic floor health is connected to core strength.

Your pelvic floor is not separate from your fitness.

It is part of it.

Your Pelvic Floor and Core Work Differently During Different Movements

Many women are told:

“Just squeeze your pelvic floor and tighten your core.”

But your body is much more intelligent than a simple on-and-off switch.

Your nervous system coordinates your muscles depending on what you are doing.

The way your pelvic floor responds during a squat may not be exactly the same as how it responds while walking or running.

The goal is not to manually control every muscle contraction.

The goal is to improve how your muscles work together.

This is why learning movement patterns matters.

Strength Does Not Mean Constant Tightness

One of the biggest myths about pelvic floor health is that tighter equals stronger.

But a healthy pelvic floor is not one that stays contracted all day.

A healthy pelvic floor can:

Contract

When you need support.

Relax

When your body needs to release.

Lengthen

During changes in pressure.

Respond

During movement.

Think about any other muscle in your body.

You would never walk around flexing your biceps all day and call that strength.

Your pelvic floor works the same way.

Balance creates strength.

Why This Matters After Pregnancy

Pregnancy and childbirth create incredible changes in your body.

Your muscles stretch.

Your posture changes.

Your core and pelvic floor adapt to support your growing baby.

After birth, many women are eager to feel strong again.

They want to:

  • Return to running
  • Lift weights
  • Exercise confidently
  • Feel comfortable in their body again

But postpartum recovery is not about forcing your body back into what it was before.

It is about rebuilding the connection between your muscles.

Your postpartum body is not something to fix.

It is something to understand.

5 Ways to Start Supporting Your Pelvic Floor Today

You do not need complicated exercises to begin improving your pelvic floor function.

Start with these foundational steps:

1. Practice Breathing With Your Whole Body

Your breath influences how your diaphragm, core, and pelvic floor work together.

Avoid constantly holding tension.

Allow your body to move.

2. Pay Attention to Movement Patterns

Notice how your body responds when you:

  • Walk
  • Squat
  • Lift
  • Carry

Movement awareness is the first step toward better coordination.

3. Strengthen Your Whole Body

Your pelvic floor works with the muscles around it.

Include exercises that build:

  • Hip strength
  • Core stability
  • Lower body strength

4. Progress Gradually

Your body becomes stronger through appropriate challenges.

More intensity is not always better.

The right progression is better.

5. Listen to Symptoms

Leaking, pressure, or pain are not things you need to ignore.

They are information.

Your body is communicating with you.

Functional Pelvic Floor Training Helps You Return to Real Life

The goal of pelvic floor strengthening is not simply to perform an exercise correctly.

The goal is to help you live your life confidently.

That might mean:

  • Running without fear
  • Strength training without symptoms
  • Playing with your children
  • Moving without discomfort
  • Feeling confident in your body

A strong pelvic floor is one that supports your goals.

Not one that simply performs a perfect contraction.

You Don’t Need More Random Exercises. You Need a Strategy.

The internet is full of pelvic floor advice.

Some women are told to avoid exercise.

Others are told to do hundreds of Kegels.

Others are told to just push through symptoms.

But your body deserves better than confusing, one-size-fits-all advice.

You deserve a plan that considers:

  • Your history
  • Your symptoms
  • Your goals
  • Your movement patterns

This is about more than symptom management.

Root-cause healing matters.

When you understand how your body works, you can build strength with confidence instead of fear.

Your Pelvic Floor Is Designed for Strength

Your pelvic floor is not weak simply because you have symptoms.

Your body is not failing you.

Your pelvic floor is a powerful, adaptable part of your body that was designed to support you through every stage of life.

When you train it to work with the rest of your body, you create strength that supports real life.

Understanding your body creates confidence.

Your Next Step

If you want to understand how your pelvic floor is functioning and create a plan designed specifically for your body, start with Your Pelvic Floor’s Next Step Form:

https://www.beyondthevbypauli.com/nextstep

If you’re tired of conflicting advice online and want a clear roadmap, explore the No Kegels University® Method and learn how to build lasting strength and confidence.

You don’t need more random exercises.

You need a strategy.

Your pelvic floor was designed for movement, strength, and confidence—and you can learn how to train it that way.

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Postpartum Pelvic Floor Strength: How “Baby Bounces” Can Help

Think about what happens the exact moment your newborn starts crying or acting fussy. You don’t stand there frozen like a statue. And you definitely don’t drop down and start doing intense gym squats.

Instinctively, you pick up that baby, hold them close to your chest, and start swaying. You bend your knees slightly and begin a gentle, rhythmic up-and-down bounce to shush, calm, and soothe them to sleep.

It is one of the most beautiful, natural maternal instincts on the planet. But as a pelvic floor physical therapist, when I look at a mom doing that, I see something else that is absolutely mind-blowing: a built-in way to support postpartum pelvic floor strength that you didn’t even know you were doing.

The Power of Vertical Pressure

Our pelvic floor muscles are highly reactive, and they are specifically designed to activate in response to vertical motion and gravity.

When you stand there performing what I call baby bounces, that gentle vertical pressure automatically signals your pelvic floor to fire and stabilize. You don’t have to squeeze, you don’t have to hold your breath, and you don’t have to forcefully try to activate anything. Your body is automatically doing the physical therapy work for you simply because you are taking care of your baby.

Isn’t that incredible? We are biologically and physiologically designed to need to be with our babies, and the universe literally built your recovery track directly into your everyday bonding habits. To learn more about how the pelvic floor, core, and everyday postpartum movement work together, explore APTA Pelvic Health’s postpartum pelvic health resources.

The Pro Tip: Changing Your Foot Geometry

While your natural baby bounce is an amazing baseline tool, you can challenge your deep core and target different angles of your pelvic floor simply by playing around with your foot positioning. You can do this with your baby in your arms or even while waiting for your coffee to brew:

  • The Wide Stance: Take your feet a little wider than hip-width apart while you sway.
  • Toes In / Toes Out: Pivot your feet slightly inward or outward to change how your hip muscles interact with your core.
  • The Staggered Stance: Place one foot slightly forward and one foot back.

A Note from a Fellow Mama Bear: Because I know you want to keep that baby safe and protected just as much as I do, be smart about your recovery timeline. When I was healing from my C-sections, the staggered stance felt incredibly unstable for my core during the first four weeks. If you want to try staggered baby bounces early on, lean your back or shoulder up against a wall so you feel completely secure and supported.

Action Steps for Daily Bouncing

  • Ditch the Gym Mat: Give yourself permission to stop stressing about finding a quiet 30 minutes to exercise. Use the actual moments your baby needs to be shushed as your movement window.
  • Keep the Breath Moving: Never hold your breath or lock your abdomen while bouncing. Keep your breathing soft and natural so your intra-abdominal pressure stays perfectly balanced.
  • Mix Up Your Stance: Every time you transition to a new room while soothing your baby, consciously pick a new foot position to challenge your muscles.

Restoring the proper function of your pelvic floor doesn’t have to be a massive production. By understanding the simple physiological principles of walking, balloon breathing, and baby bounces, you can support postpartum pelvic floor strength without ever having to step away from your little one.

You are an heiress and a queen, and you deserve a body that works perfectly. If you are ready to stop leaking and finally get the real answers to postpartum recovery, fill out Your Pelvic Floor’s Next Step Form today. Let’s change the conversation together!

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Pelvic Floor After Childbirth: Does Birth Really Wreck It?

Does childbirth wreck your pelvic floor?

This is a question I hear from so many women.

After having a baby, it is common to wonder:

“Will my body ever feel normal again?”

“Did giving birth permanently damage me?”

“Is leaking, pain, or weakness just my new reality?”

And honestly, I understand why women ask these questions.

We live in a culture that often sends confusing messages about postpartum recovery. Some women are told their bodies are “ruined” after birth. Others are told they should be completely back to normal at six weeks.

Neither message tells the full story.

The truth is much more encouraging:

Childbirth can change your pelvic floor, but it does not mean your body is permanently ruined.

Your body went through an incredible process. It adapted, stretched, worked, and began the healing process.

But healing takes time.

And rebuilding strength requires starting with the right foundation.

Your body is not broken.

Your Pelvic Floor Is Not Ruined After Birth

Let’s start by changing the way we think about childbirth.

Birth is not your body failing.

Birth is your body doing something extraordinary.

Your pelvic floor muscles supported your pregnancy, helped stabilize your pelvis, responded to changes in pressure, and played an important role during delivery.

That doesn’t mean there won’t be challenges.

Some women experience:

  • Urinary leaking
  • Pelvic pressure
  • Pain with intimacy
  • Core weakness
  • Difficulty returning to exercise
  • A feeling that their body doesn’t respond the way it used to

These symptoms are common.

But common does not mean permanent.

Most women were never taught this.

Your pelvic floor is a group of muscles and tissues that are designed to adapt. Like any other area of the body, they can recover, rebuild, and become strong again.

Think About Your Body After Birth Like Recovery After Surgery

One of the biggest mistakes we make when thinking about postpartum recovery is forgetting that childbirth is a major physical event.

Imagine someone had shoulder surgery.

Immediately afterward, their shoulder would likely be:

  • Swollen
  • Painful
  • Weak
  • Limited in movement

No one would expect that person to walk out of surgery and immediately start lifting weights.

We understand that healing has to happen first.

The tissues need time.

The muscles need time.

The body needs time.

Childbirth deserves that same understanding.

Whether you had a vaginal birth, C-section, tearing, an episiotomy, or other complications, your body experienced significant changes.

Healing is not a sign that something went wrong.

Healing is the process.

The Difference Between Healing and Strengthening

This is one of the most important concepts I want women to understand.

Healing and strengthening are not the same thing.

Before a muscle can become stronger, the tissues surrounding that muscle need to be ready.

Think about building a house.

You wouldn’t start adding a second story before making sure the foundation was stable.

Your pelvic floor is the same.

Before jumping into intense workouts, heavy lifting, running, or aggressive strengthening exercises, your body needs a solid foundation.

That means asking:

  • Have my tissues healed?
  • Can my pelvic floor relax and contract?
  • Am I able to manage pressure?
  • Does my core work with my pelvic floor?
  • Am I returning to activity at the right pace?

The goal isn’t temporary relief—the goal is long-term strength.

Why Postpartum Recovery Looks Different for Every Woman

One of the most harmful messages women hear is:

“Nine months in, nine months out.”

While this phrase is often meant to be encouraging, it doesn’t account for how different every birth experience is.

Your recovery depends on so many factors, including:

  • Your pregnancy
  • Your delivery
  • Whether you experienced tearing
  • Your baby’s birth position and size
  • Your sleep
  • Your stress levels
  • Your support system
  • Your previous fitness level
  • Your overall health

Your recovery is not supposed to look exactly like your friend’s recovery.

Or your sister’s.

Or the woman you follow online.

The timeline that works for one woman may not work for another.

Your body deserves an individualized approach.

Why the Pelvic Floor Is Different Than Other Muscles

When someone has knee surgery, they often get a period of protected recovery.

They may use crutches.

They may limit activity.

They may rest the joint while healing happens.

But your pelvic floor doesn’t get that same break after childbirth.

Your pelvic floor is working every day.

It supports you when you:

  • Stand up
  • Walk
  • Lift your baby
  • Use the bathroom
  • Cough
  • Sneeze
  • Move through daily activities

And if you are caring for a newborn, sleep deprived, stressed, and constantly moving, your body is healing while also being asked to do a lot.

APTA Pelvic Health explains that pregnancy and childbirth can affect the muscles, joints, tissues, and pelvic floor, and that individualized physical therapy can support recovery when symptoms are present.

https://www.aptapelvichealth.org/info/musculoskeletal-dysfunction-during-pregnancy-and-after-childbirth

This is why patience and support matter.

The Six-Week Appointment Does Not Mean Your Body Is Finished Healing

Many women interpret their six-week postpartum appointment as:

“I’m healed. I’m cleared. I can go back to everything.”

But a checkup is not the same thing as completing the entire recovery process.

A provider may confirm that certain aspects of healing are progressing appropriately, but your body is still adapting.

Your tissues continue to remodel.

Your muscles continue to regain coordination.

Your nervous system continues adjusting.

Your strength continues rebuilding.

You deserve more than a one-size-fits-all timeline.

Childbirth Can Change Your Pelvic Floor—But It Does Not Destroy It

Let’s be clear:

Birth is powerful.

It can create changes.

But change does not automatically mean permanent damage.

Your body is adaptable.

Your muscles can become stronger.

Your tissues can heal.

Your confidence can return.

I have worked with countless women who believed they were permanently changed after childbirth, only to discover that their bodies were capable of so much more than they realized.

The question is not:

“Did childbirth ruin me?”

The better question is:

“What does my body need to heal and become strong again?”

Understanding your body creates confidence.

How to Support Your Postpartum Recovery

A strong postpartum foundation starts with:

1. Give Your Body Time

Healing is not something you can rush.

Your body needs space to recover.

2. Pay Attention to Symptoms

Leaking, pain, pressure, and discomfort are not things you have to ignore.

They are information.

3. Progress Gradually

Strength comes from progression—not from pushing through before your body is ready.

4. Get Personalized Guidance

Your recovery should be based on your birth story, your goals, and your current abilities.

You don’t need more random exercises.

You need a strategy.

Your Pelvic Floor Can Become Strong Again

The most important message I want you to leave with is this:

Childbirth did not ruin your body.

Your pelvic floor is not broken.

Your postpartum journey is not over just because things feel different right now.

With the right support, your body can heal.

It can regain strength.

It can return to activities you love.

Sometimes, women even discover their bodies become stronger and more connected than they were before pregnancy.

Your Next Step

If you’re wondering where to start rebuilding after childbirth, you don’t have to figure it out alone.

Fill out Your Pelvic Floor’s Next Step Form so we can better understand your birth story, your symptoms, and create a personalized plan for your body and your goals.

https://www.beyondthevbypauli.com/nextstep

If you’re ready to stop guessing and start understanding your body, explore the No Kegels University® Method and learn how to build lasting strength and confidence.

Healing isn’t about rushing your body.

It’s about giving it the time, support, and strategy it needs.

Your body brought you through childbirth.

Now it deserves the opportunity to recover, rebuild, and become strong again.

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Why Am I Peeing So Much? What Your Bladder Is Trying to Tell You

Picture this: You wake up in the morning feeling incredibly well-rested. Your head is clear, your energy is high, and you feel ready to take on the day without even reaching for a cup of coffee. For many busy moms and women, this sounds like an absolute fairytale. Often, the reason we aren’t experiencing this level of refreshing rest has everything to do with our bladders.

If you are someone who constantly has to map out where the nearest bathroom is, or if you find yourself peeing every 30 to 60 minutes just to “be safe,” you are not alone. Most women were never taught this, but letting your bladder dictate your schedule can become a long-standing joke among family and friends. It turns into a normal part of your routine, but it is not how your body was designed to function. Understanding your body creates confidence. You don’t have to live in a state where your bladder controls everything you do.

What Is Normal Bladder Capacity?

To reclaim control over your schedule, we first need to establish what a healthy, functioning bladder actually looks like.

On average, a normal bladder capacity is around 16 ounces—which is about two to two and a half cups of fluid. When your bladder fills up to this capacity, the delicate nerves embedded within the bladder wall begin to stretch. This stretching is what triggers a signal up to your brain saying, “Hey, it is time to find a restroom.”

Once you are in the bathroom, your brain sends a signal back down to cause a gentle contraction, allowing you to empty completely. In a healthy system, this entire process should occur roughly every two to two and a half hours during the day. Needing to go every 15, 20, or 30 minutes is a clear indicator that your signaling system is out of sync.

The “Just in Case” Peeing Trap

The biggest myth keeping women stuck in a cycle of frequent urination is the idea that peeing “just in case” before leaving the house protects you from accidents.

The Structural Fact: Emptying your bladder when it is only holding a tiny fraction of its capacity trains the internal nerves to become hypersensitive, effectively shrinking your functional bladder capacity over time.

Another common misconception is that if you have pelvic floor dysfunction, your bladder is simply weak and you have to accept it as part of aging or motherhood. Your bladder is a highly adaptable, muscular organ. Just as it can learn bad habits from frequent, low-volume trips, it can be retrained to hold a normal volume of fluid without triggering panic signals to your brain.

Why Your Bladder Is Tricking You

Why do you feel an overwhelming urge to empty your bladder when it isn’t actually full? It comes down to a root-cause issue of internal signaling errors.

When you get into the habit of running to the bathroom at the very first sign of a minor tickle, your bladder learns to trigger its muscular contractions prematurely. It essentially tricks your brain into believing it is at maximum capacity when it might only be holding 3 or 4 ounces of fluid.

Clinical data shared by the Cleveland Clinic shows that your pelvic floor muscles and bladder must work in a coordinated relaxation and contraction loop. When this loop is disrupted by frequent, anxious voiding, your bladder starts winning the mental game. Root-cause healing matters, and reversing this pattern requires interrupting that false alarm signal before it becomes an automatic reflex.

Action Steps: How to Reclaim Your Bladder Control

You can actively retrain your nervous system and bladder to coexist peacefully. Start with these practical tracking steps:

  1. Track for 24 to 48 Hours: Before you try to change anything, simply write down what you drink, when you drink it, and when you go to the bathroom. Jot down a quick guess of the volume: small, medium, or large.
  2. Look for the Urgency Pattern: Review your notes. If you notice you are peeing every 45 minutes but have only consumed a total of 12 ounces of water over several hours, your bladder is tricking you.
  3. Ask the Capacity Question: The next time you feel a sudden, intense urge to go, pause. Ask yourself: “Have I actually consumed enough fluids in the last hour to fill a 16-ounce cup?”
  4. Delay the Urge: If the answer to the capacity question is no, try to delay your bathroom trip by 5 to 10 minutes. Distract your brain, sit down quietly, or take deep breaths to let the premature bladder contraction pass.

Your body is not broken. Living with constant bathroom anxiety is exhausting, but your bladder capacity can be safely and effectively expanded with the right approach. This is about more than symptom management. It is about regaining the freedom to live your life without checking for a restroom everywhere you go.

You don’t need more random exercises. You need a strategy. Book an appointment and let’s create a plan designed specifically for your body and goals. Start by taking your first intentional step and fill out Your Pelvic Floor’s Next Step Form today to map out your path to long-term strength.

To hear the full story of how resetting my family’s sleep patterns brought these bladder habits to light, listen to Episode 18 of the Beyond the V Podcast with Pauli.

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Core Exercises for Moms: How to Train for Real-Life Strength

If you have ever searched for the “best” ab exercises, you have probably seen the same recommendations over and over again:

Planks.

Crunches.

Sit-ups.

Repeat.

And while there is nothing automatically wrong with those exercises, there is a more important question most women never think to ask:

Why am I doing this exercise in the first place?

As a pelvic floor physical therapist and the founder of No Kegels University®, I don’t believe there is necessarily such a thing as a “bad” exercise.

But there can absolutely be a bad reason for choosing one.

Most women were never taught this: your core workout should actually help you accomplish the things you want your body to do.

If your goal is to keep up with your kids, move through a full schedule, feel strong, and have a body that works efficiently, your core training should reflect those goals.

Stop Choosing Core Exercises Just Because Everyone Else Does Them

Years ago, when I was preparing for a bikini competition, I did a lot of traditional ab exercises.

Crunches.

Weighted mini sit-ups.

Side-to-side exercises we called “penguins.”

And at the time, those exercises made sense.

My goal was aesthetic.

I wanted my abs to be visible when I stepped on stage.

But my goals today are completely different.

Now I want my body to function well.

I want to keep up with my kids.

I want enough strength and endurance to handle a full life.

And yes, if my abs happen to look great too, I’m not going to complain.

The important part is that my exercises changed when my goals changed.

That is something I want every woman to think about when choosing core exercises.

There Is No “Perfect” Ab Exercise

A common question I hear is:

“So does that mean you don’t like planks?”

Or:

“Should I stop doing crunches?”

Not necessarily.

The better question is:

What are you trying to accomplish?

If someone gives you an exercise program, you should be able to ask:

  • Why am I doing this?
  • What is this exercise supposed to improve?
  • How does this help me reach my goals?

You don’t need to blindly follow an exercise simply because you saw someone doing it at the gym, found it on Pinterest, or bought a program that included it.

Understanding your body creates confidence.

The more you understand why you are doing an exercise, the easier it becomes to build a routine that actually serves you.

The Traditional Plank: Good Exercise, Different Goal

Let’s start with the plank.

A traditional plank isn’t automatically a bad exercise.

But if your goal is to develop a core that can respond while your arms and legs are moving, we can make the plank much more dynamic.

Instead of simply holding the same position and staring at the clock, try turning it into what I call a:

Twister Plank.

Think about the classic game Twister.

Right hand here.

Left hand there.

Move your right foot.

Shift your left foot.

Now bring that same idea into your plank.

Try the Twister Plank

Start in a plank position that feels appropriate for your current strength level.

Then begin moving one limb at a time.

For example:

  • Move your right hand slightly forward.
  • Bring it back.
  • Move your left hand to the side.
  • Bring it back.
  • Step your right foot slightly outward.
  • Bring it back.
  • Move your left foot into another position.

You can move your hands and feet in several directions while maintaining the plank.

Now your core has a changing job.

Instead of simply holding one position, your body has to adapt as your base of support changes.

It also becomes an endurance challenge pretty quickly.

If one of your goals is keeping up with your kids and having enough endurance for a full day, this variation can give you a lot more “bang for your buck.”

Why I Like Moving the Arms and Legs

Your core doesn’t spend your entire day working while your arms and legs remain perfectly still.

You’re carrying groceries.

Picking up kids.

Reaching into cabinets.

Moving laundry.

Getting something out of the car.

Your trunk is constantly responding while the rest of your body moves.

That is why I like adding arm and leg movement to core exercises.

Your core has to respond to the changing position of your body while you continue moving.

Mayo Clinic explains that your core includes the muscles around your pelvis, lower back, hips, and abdomen, and that these muscles work together to support balance, stability, and everyday physical activity.

https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/core-exercises/art-20044751

For my goals, that makes the Twister plank much more useful than simply seeing how long I can hold a traditional plank.

What About Crunches?

Crunches are another exercise people often assume I simply don’t like.

Again, that’s not really the point.

I want to know your goal.

If your goal is primarily aesthetic, crunches may have a place in your program.

But if you tell me:

“I want a strong core so I can keep up with my kids and move through my day more easily,”

then I start asking:

How often during your normal day are you repeatedly performing a crunching motion?

Probably not very often.

That’s why I like modifying that movement too.

Try the “Anti-Crunch”

Sit toward the front of a chair.

Cross your arms in front of you.

Keep your rib cage and pelvis comfortably stacked.

Now keep your head, shoulders, and trunk in one long line as you hinge backward from your hips.

Then return upright.

Instead of curling your body into a traditional crunch, you’re asking your abdominal and back muscles to control your trunk while you move as one unit.

I call this the anti-crunch.

I like this exercise because it looks much more like the kinds of challenges we experience throughout real life.

As moms, we are constantly:

  • Holding a child
  • Reaching for something
  • Carrying multiple objects
  • Leaning
  • Shifting
  • Trying to maintain our balance while doing three things at once

Your core needs to support you through those situations.

Train Your Core for Your Actual Life

This is the bigger message.

You don’t need to create an entire list of exercises that are “good” and exercises that are “bad.”

Instead, ask yourself:

What am I trying to accomplish with my body?

Maybe you want to:

  • Keep up with your kids
  • Feel stronger while carrying them
  • Improve your core endurance
  • Move more efficiently
  • Feel confident exercising again
  • Build a strong, capable body

Once you know your goals, you can choose exercises that actually help you reach them.

That might mean keeping some traditional exercises.

It might mean modifying them.

Or it might mean replacing them with something that better matches your goals.

More Bang for Your Buck

As women—and especially as moms—we don’t always have unlimited time to exercise.

That’s why I want the exercises you choose to give you as much benefit as possible.

If you only have a limited amount of time, your workout should have a purpose.

Don’t do an exercise simply because someone online told you that every woman “needs” to do it.

Ask why.

Understand what you’re training.

And choose movements that help your body become stronger for the life you actually live.

The goal isn’t temporary relief—it’s long-term strength.

You don’t need more random ab exercises.

You need a strategy.

If you’re ready to stop guessing and start building a core that supports your actual goals, complete Your Core’s Next Step Form:

https://www.beyondthevbypauli.com/nextstep

Your core training should help you live your life—not just survive another sixty-second plank.

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Leaking During Exercise? How to Jump and Do Jumping Jacks Without Leaking

You are standing in the middle of a group fitness class, enjoying the music and the energy of the room, when the instructor yells, “Alright, thirty seconds of jumping jacks, let’s go!”

Instantly, a wave of anxiety hits you. While the women around you jump without a second thought, you cross your legs, slow down, or slip away to the bathroom. You might even use a few silent “tips and tricks” to hide what is happening, convinced that you are the only one in the room whose body can’t handle the impact.

Let’s clear up a major secret right now: you are absolutely not alone. Bladder leaking during vertical movement is incredibly common, but it is not something you have to accept as your permanent normal.

Many women avoid impact entirely because they are terrified to “poke the bear” and trigger their pelvic floor dysfunction. But avoiding vertical movement completely will never teach your muscles how to get stronger. Your body is not broken, and you don’t have to sit on the sidelines of postpartum fitness forever.

Why Your Pelvic Floor Actually Needs Impact

When it comes to pelvic floor exercises, we are often told to stay flat on our backs, performing isolated contractions in a quiet room. While that style of training has its place in early rehabilitation, it completely misses how our bodies function dynamically.

Your pelvic floor is designed to respond directly to gravity. Anytime your body experiences vertical motion—whether that is walking down the stairs, running for the phone, or jumping on a trampoline with your kids—your pelvic floor muscles naturally react to support your internal organs and keep your urinary sphincter closed.

If you completely eliminate vertical activity from your life out of fear, your pelvic floor never gets the physical conditioning it needs to handle sudden forces. To build real-world, long-term strength, you have to train the muscle within the exact environment it is failing.

The Threshold Misconception

The Myth: If you leak during an exercise, you should just push through it or use a heavier pad until your core eventually gets stronger.

Pushing through leakage is a recipe for chronic muscle fatigue. On the other hand, avoiding the movement entirely causes the muscle to weaken from disuse.

The secret lies in identifying your personal physical threshold. Your threshold is the exact point of intensity, speed, or repetition where your pelvic floor can no longer manage pressure, resulting in a leak. The goal of a smart postpartum fitness routine is to work right below that threshold line, giving the muscles a safe challenge without overloading them.

The Root Cause: Muscle Fatigue and Scar Tissue Limits

Root-cause healing matters because your pelvic floor cannot function optimally if it is structurally restricted. Your pelvic floor is a dynamic muscular sling. If you have had an episiotomy or experienced a perineal tear during childbirth, you have scar tissue in that region.

Think of scar tissue like super glue inside your muscle layers. While it is wonderful for closing up a wound, it can cause the surrounding muscle fibers to stick together, severely restricting their ability to fully lengthen and contract. When those muscle fibers are glued down by an old scar, they cannot move fast enough or stretch fully to protect you against a sudden jump.

Clinical evidence supported by the Cleveland Clinic emphasizes that scar tissue mobilization and progressive impact loading are crucial components in restoring normal tissue elasticity and muscular power to the pelvic floor. When your brain triggers movement, your dynamic core and pelvic floor must be uninhibited to naturally regulate internal pressure.

Action Steps: The “Grandma Method” for Progressive Jumping

If you want to return to jumping jacks or running without leaking, you need to alter the variables of the movement to stay below your leaking threshold. Try this progressive strategy used by my top coaching clients:

  • Lower the Amplitude and Speed: Don’t start by jumping as high or as fast as you can. Slow the movement down significantly.
  • Channel Your Sweet Grandma: When initiating a jumping jack, imagine how your grandmother might do it. Keep your feet close to the ground, step or gently hop your feet out only an inch or two, and slow your tempo down to a crawl.
  • Build Volume First: Perform 5 to 10 of these low-intensity, “Grandma-style” jumping jacks. If you experience zero leakage, you have successfully found a safe working zone below your threshold.
  • Isolate and Change One Variable: Work at this level for a week or two. Once your body feels secure, increase only the speed while keeping your feet close together. If that stays dry for a week, keep the speed but try jumping your feet a tiny bit wider. Never increase speed and size at the exact same time.

Healing isn’t about perfection; it’s about understanding, consistency, and smart progression. You do not have to live your life in fear of a jumping jack or a trampoline. Your body is fully capable of adapting and building dynamic strength when given the right strategic input.

You don’t need more random exercises. You need a strategy. If you are ready to stop managing symptoms and start building real, lifelong resilience, take a moment to complete our Your Pelvic Floor’s Next Step Form. Let’s work together to create an actionable plan designed specifically for your body, your scar tissue, and your fitness goals.

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Posture and Leakage: The Jenga Tower Guide

When someone tells you to “fix your posture,” what do you automatically do? You probably roll your shoulders back, lift your chest toward the ceiling, and try to stand as rigidly upright as possible.

But if you are managing pelvic floor dysfunction or noticing that you leak every time you experience a bad cough or a sudden laugh, traditional posture advice might be making things harder for your core.

Most women were never taught how their alignment directly dictates how hard their pelvic floor muscles have to work. If your body’s posture is misaligned, even the most consistent pelvic floor exercises won’t give you the lasting dry days you are looking for. True women’s wellness isn’t about looking like a rigid soldier; it’s about setting up your skeletal foundation so your muscles can do their job effortlessly.

The Jenga Principle of Body Alignment

To understand how your alignment influences your bladder control, think about the classic game of Jenga. You start the game with three blocks stacked neatly in one direction, three blocks stacked the other way, building a perfectly vertical, stable tower.

As the game progresses, players pull blocks out from the bottom and stack them precariously on top. The tower begins to lean, shift, and wobble because it is no longer stacked directly on top of its original foundation. The higher and more crooked it gets, the harder the remaining blocks have to work to keep the entire structure from crashing down.

Your body operates on the exact same structural law. When your bones are stacked efficiently, your muscles and joints share the weight of gravity optimally. But when pregnancy or daily habits shift your alignment out of place, your pelvic floor becomes the overtaxed block at the bottom of the tower, desperately trying to hold everything up.

The Shoulder Correction Myth

The Myth: Good posture means squeezing your shoulder blades together and puffing out your chest.

When you try to correct your posture entirely from your upper body, you miss the actual core foundation. Squeezing your shoulders back does nothing to align your midsection. In fact, many women correct their posture by hyper-extending their mid-back, which thrusts the bottom of the rib cage up and forward. This upper-body rigidity doesn’t fix the underlying pressure problem; it simply hides it while continuing to place mechanical stress on your lower abdomen.

The Root Cause: The Forward-Tipped Rib Cage

During pregnancy, your growing belly and your sweet baby naturally pull your weight forward, tipping the bottom of your rib cage out and open. If you look at yourself in a mirror from the side, you might notice that instead of pointing straight down, your ribs are angled out toward the front of the room.

When your rib cage is constantly tipped forward, your body’s internal line of gravity changes. Instead of your breath’s pressure distributing evenly across your entire pelvic canister, it gets directed straight over the top of your urethra and vaginal opening.

According to professional rehabilitation guidelines from Herman & Wallace Pelvic Rehab Institute, structural alignment and skeletal positioning directly dictate the mechanical efficiency of the pelvic floor muscles. When you stay in an exaggerated, unstacked position, your pelvic floor has to work double-time just to keep you dry against everyday abdominal pressure.

Action Steps: Find Your “Click” in the Mirror

Improving your posture takes time, and the goal isn’t to walk around like a robotic statue all day. Our bodies are beautifully designed to move in and out of different shapes. However, you want to spend the majority of your day in an optimal position. Use this physical visualization to find your stack:

  • Stand in Profile: Look at yourself from the side in a mirror. Locate the very bottom, rounded edge of your rib cage and the top bones of your pelvis.
  • Visualize the Crane: Imagine a crane gently grabbing the very top of your rib cage, lifting it up slightly to decompress your spine, and shifting it back and down until it sits directly over your hips.
  • Look for the Straight Line: If you dropped a plumb line straight down from the center of your ribs, it should land directly into the center of your pelvis, not several feet in front of you.
  • Listen for the “Click”: Many of my patients find success by picturing their ribs lifting up, tipping back, and “clicking” into place directly over their pelvis. Once you feel that click, take an inhale. You should find it significantly easier to take a deep, clear breath in this position.

This is about more than symptom management—it’s about restructuring how your body interacts with gravity. When you master the rib-to-pelvis stack, you give your deep core its fighting chance to heal.

You don’t need more random exercises. You need a strategy. If you are tired of conflicting advice online and want a clear roadmap, explore the No Kegels University® Method. Take a moment to fill out our Your Pelvic Floor’s Next Step Form so we can look at your unique alignment and get you moving with absolute confidence.

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Postpartum Pelvic Floor Recovery: What to Do in the First 6 Weeks

When you have a baby, everyone has advice.

Rest.

Drink water.

Take care of yourself.

Wait until your six-week appointment.

But when it comes to your pelvic floor, many women are left wondering:

“What am I actually supposed to do after birth?”

Should you start exercising?

Should you avoid movement?

Should you wait six weeks before doing anything?

Should you start doing Kegels immediately?

These questions are so common because postpartum care often leaves out one important piece:

Your pelvic floor needs support from the beginning—not just after you are “cleared.”

Your body is not broken.

Your postpartum recovery is not about waiting around until some magical finish line where your body suddenly feels normal again.

It’s about learning how to reconnect with your body, rebuild strength gradually, and understand what your pelvic floor needs during each stage of healing.

Most women were never taught this.

You Don’t Have to Wait Six Weeks to Start Supporting Your Pelvic Floor

One of the biggest misconceptions about postpartum recovery is that you cannot do anything for your pelvic floor until your six-week checkup.

This idea often leaves women feeling disconnected from their bodies during a time when they are already experiencing so many changes.

The truth?

There are gentle ways to begin supporting your pelvic floor before six weeks.

That doesn’t mean jumping into intense workouts.

It doesn’t mean pushing through pain.

It doesn’t mean doing hundreds of Kegels.

And what is appropriate will depend on your birth experience, symptoms, and how your body is healing.

It means helping your body reconnect with movement gradually.

Early postpartum recovery is about creating a foundation.

And that foundation can start with simple things like comfortable movement, breathing, and reconnecting with your muscles.

For additional guidance on gradually returning to movement after pregnancy, Mayo Clinic has a helpful overview:

https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/in-depth/exercise-after-pregnancy/art-20044596

Your Pelvic Floor Is Designed to Respond to Movement

Many women think strengthening their pelvic floor only means one thing:

Kegels.

But your pelvic floor is not an isolated muscle that works independently.

It works together with:

  • Your hips
  • Your core
  • Your diaphragm
  • Your breathing patterns
  • Your posture
  • Your movement

Your pelvic floor responds to the demands you place on your body.

That means everyday movements can become opportunities to gradually rebuild strength.

The goal isn’t temporary relief—the goal is long-term strength.

Start With Walking: The First Step Toward Recovery

One of the first movements I often recommend postpartum is walking when it feels comfortable for your body.

It sounds simple.

And that’s the point.

Recovery does not have to begin with complicated exercises.

Walking can help your body reconnect after pregnancy and birth.

But there is one small adjustment that can make a difference:

Pay attention to how you walk.

During pregnancy, many women develop a waddle.

As your belly grows, your posture and movement patterns naturally change. Your hips adjust, and some muscles may become less active.

After birth, we want to gradually encourage those muscles to work together again.

As walking becomes comfortable, try focusing on:

  • Heel-to-toe walking
  • Standing tall
  • Moving with intention
  • Eventually adding a little backward walking if it feels good

Backward walking can be an optional progression because it encourages your hips to engage differently and challenges your body in a new way.

Small changes create big awareness.

Why Your Hips Matter for Your Pelvic Floor

Your pelvic floor does not work alone.

The muscles around your pelvis influence how your pelvic floor functions.

During pregnancy, your body makes incredible adaptations to carry and deliver your baby.

Those adaptations are necessary.

But after birth, your body needs opportunities to reconnect.

Your hips, glutes, core, and pelvic floor all communicate with each other.

When one area isn’t working efficiently, other areas may compensate.

This is why postpartum recovery should focus on the whole system—not just one muscle.

Understanding your body creates confidence.

Baby Bounces: Functional Movement as You Recover

One movement many moms naturally do postpartum is something I call:

Baby bounces.

You know the movement.

You’re holding your baby.

They’re fussy.

You start gently bouncing up and down to soothe them.

You’re not jumping.

You’re not doing deep squats.

You’re simply creating gentle movement.

As this movement becomes comfortable during your recovery, your pelvic floor has to respond to those small changes in pressure and movement.

That is part of what the pelvic floor does throughout everyday life.

You don’t need to turn baby bounces into an intense exercise routine. Think of them as an example of how normal, functional movement can become part of rebuilding connection with your body.

Pay Attention to Symptoms

One important thing to remember:

Your movement should not consistently create new or worsening symptoms.

The goal is not:

“How much can I push through?”

The goal is:

“How can I challenge my body while still supporting recovery?”

If a movement causes new or worsening leaking, pressure, heaviness, or pain, that is information.

It doesn’t mean you failed.

It may mean your body needs:

  • Less intensity
  • A different position
  • More foundational work
  • More time
  • Individualized support

Symptoms are communication.

They are not something to ignore or feel embarrassed about.

Why You Don’t Need to Overthink Every Exercise

Many women become overwhelmed postpartum because they think recovery has to be complicated.

They worry about:

  • Perfect breathing
  • Perfect timing
  • Perfect technique

But sometimes the best place to start is simply reconnecting with your body.

Talk to your baby.

Sing.

Walk when it feels comfortable.

Bounce gently as your body is ready.

Move naturally.

Your pelvic floor was designed to respond to life—not just exercises.

Progressing After the Early Postpartum Stage

As your body becomes stronger and movement feels easier, you can begin progressing.

This may eventually include:

  • Squats
  • Lunges
  • Different foot positions
  • More challenging strength movements

But progression should be based on how your body responds.

Just because you can do something does not always mean your body is ready for it.

A good measure is what happens afterward.

Ask yourself:

  • Did I feel good during the movement?
  • Did I have symptoms afterward?
  • Do I feel stronger over time?
  • Am I progressing gradually?

Your body gives you feedback.

Listen to it.

Postpartum Recovery Doesn’t Have an Expiration Date

Maybe you’re reading this and thinking:

“My baby isn’t a newborn anymore.”

Good news:

These principles still apply.

Whether you are:

  • In the very early days of healing
  • Six months postpartum
  • Seven years postpartum

your body is still capable of change.

In those first days after birth, your priority is healing, rest, and comfortable everyday movement—not rushing into strength training.

But your postpartum journey doesn’t end at six weeks.

Many women spend years believing they missed their opportunity to recover.

You didn’t.

Your body is adaptable.

Your pelvic floor can become stronger.

Postpartum Recovery Is About Confidence, Not Fear

The women I work with often tell me the biggest change isn’t just physical.

It’s emotional.

They feel more confident because they understand:

  • Why symptoms happen
  • What their body needs
  • How to progress safely
  • How to rebuild strength

That knowledge changes everything.

You deserve better than fear-based advice that tells you to avoid all movement or accept symptoms as your new normal.

Your body carried you through pregnancy and birth.

Now it deserves the support to recover.

Your Next Step

If you are unsure where to begin rebuilding your pelvic floor after birth, you don’t have to figure it out alone.

Fill out Your Pelvic Floor’s Next Step Form so we can better understand your birth experience, your symptoms, and what kind of support may be right for you.

Pelvic Floor Next Step

If you’re ready to stop guessing and start understanding your body, explore the No Kegels University® Method and learn how to build lasting strength and confidence.

Postpartum recovery isn’t about doing more.

It’s about doing what your body needs, when it needs it.

Your body is capable of healing.

And your strongest chapter may still be ahead.

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Constipation and Pelvic Floor: Why Going Every Day Doesn’t Mean You’re Not Constipated

One of the most common conversations I have with patients starts the same way.

I’ll ask, “Tell me about your bowel movements.”

Almost immediately, they’ll answer, “They’re fine.”

Then I’ll ask a few more questions.

Do you strain?

Does it feel like you completely empty your bowels?

Does it ever feel like you’re working really hard just to have a bowel movement?

How often do you go?

That’s when the conversation usually changes.

Many women suddenly realize that what they’ve considered “normal” for years may actually be signs of constipation or pelvic floor dysfunction.

Some tell me they only have a bowel movement every two or three days but assumed that was normal.

Others tell me they go every single day—but every bowel movement involves straining, pushing, or feeling like they never completely emptied.

That’s why I want to challenge one of the biggest misconceptions I hear:

Just because you go every day doesn’t automatically mean your bowels are healthy.

If you’d like to hear me teach this concept in more detail, you can watch Episode 34: Constipation & Your Pelvic Floor on YouTube.

We Don’t Talk About Bowel Health Enough

One reason this misunderstanding is so common is because most of us simply don’t talk about bowel movements.

It can feel embarrassing.

Too personal.

Maybe even “not ladylike.”

But here’s what I tell my patients:

Your bowel habits are one of the clearest indicators of your overall health.

As a pelvic floor physical therapist, I also believe they’re one of the best indicators of how well your pelvic floor is functioning.

Ignoring bowel habits because they feel uncomfortable to discuss doesn’t make the problem go away.

It simply delays finding answers.

That’s one of the reasons I started talking openly about pelvic floor health. Women deserve to understand their bodies without shame or embarrassment.

Frequency Isn’t the Whole Story

Many people judge bowel health using only one question:

“How often do you go?”

While frequency matters, it doesn’t tell the whole story.

I care just as much about how you’re having your bowel movements.

For example:

  • Are you holding your breath?
  • Are you pushing and straining?
  • Do you feel like you’re fighting your body?
  • Do you leave the bathroom feeling completely empty?

Those answers often tell me much more than simply hearing, “I go every day.”

A healthy bowel movement should feel comfortable.

It shouldn’t feel like a workout.

The Connection Between Constipation and Your Pelvic Floor

Many women don’t realize that constipation and the pelvic floor influence each other.

Sometimes constipation contributes to pelvic floor problems.

Other times, the pelvic floor itself is contributing to constipation.

That’s why I ask every patient about bowel habits—even if they came to see me for leaking, prolapse, or pain.

Everything is connected.

Once my patients understand that relationship, something interesting happens.

Their perspective changes.

Instead of thinking:

“Why is my physical therapist asking about poop?”

They begin asking:

“How can improving my bowel habits also improve my pelvic floor?”

That shift in understanding is incredibly powerful.

Understanding your body creates confidence.

Stop Fighting an Uphill Battle

At the beginning of this episode, I shared a story about becoming a mom.

Before my children were born, I had all kinds of rules about technology.

I was convinced my kids wouldn’t be interested in screens.

Then reality happened.

No matter how hard I tried to fight it, technology was part of the world they were growing up in.

Eventually I realized something important:

I could keep fighting an uphill battle…

Or I could adjust my approach and create healthy habits that actually worked for our family.

That same lesson applies to constipation.

So many women spend years fighting their bodies.

They strain.

They push harder.

They assume discomfort is simply part of life.

But once they understand how the pelvic floor works and how healthy bowel habits support that system, everything becomes less of a struggle.

The goal isn’t to fight your body.

The goal is to work with it.

Better Bowel Habits Protect Your Pelvic Floor

One of the biggest reasons I care about constipation is because repeated straining doesn’t just affect your bowels.

It affects your pelvic floor too.

Every time we bear down excessively, we place additional pressure on the muscles and connective tissues that support our bladder, uterus, and rectum.

Over time, that repeated stress can contribute to pelvic floor dysfunction.

That’s why I don’t look at constipation as an isolated digestive problem.

I see it as part of your pelvic health.

Addressing bowel habits isn’t just about becoming more comfortable.

It’s about protecting the strength you’ve worked so hard to build.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), healthy bowel habits involve more than frequency. Persistent straining or difficulty passing stool can signal constipation even if bowel movements occur regularly.

Small Changes Can Make a Big Difference

One thing I love about pelvic floor therapy is that meaningful progress often starts with simple changes.

You don’t always need a complicated plan.

Sometimes it’s learning to pay attention to your bowel habits.

Sometimes it’s changing your toilet posture.

Sometimes it’s improving your breathing.

Those small adjustments work together to make bowel movements feel easier and place less stress on your pelvic floor.

As I often tell my patients, once your bowels and your pelvic floor begin working together instead of against each other, that uphill battle starts to disappear.

Your Next Step

If you’ve always assumed your bowel habits were “normal,” I encourage you to get curious.

Instead of only asking, “How often do I go?”

Start asking:

  • Do I strain?
  • Do I feel completely empty afterward?
  • Does my body feel relaxed, or am I forcing the process?

Those questions can tell you far more about your pelvic floor than you might expect.

If you’re ready to understand what’s contributing to your symptoms and want a personalized plan for improving your pelvic floor health, I’d love to help.

Complete Your Pelvic Floor’s Next Step Form to discover the next best step for your body.

👉 https://www.beyondthevbypauli.com/nextstep

Remember, your body is constantly giving you information. Learning how to listen to it is one of the greatest gifts you can give yourself.

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Pelvic Floor Physical Therapy: The Powerful Whole-Body Approach to Healing

Pelvic floor physical therapy is about much more than squeezing or doing isolated Kegels.

If you have been struggling with pelvic floor dysfunction—whether that looks like leaking every time you cough, a heavy sensation of pelvic pressure, or persistent core weakness—you may have been searching for one straightforward solution.

You might try isolated pelvic floor exercises, brace your stomach during daily chores, or use products that temporarily manage leaking. You focus all your attention on one small area of your pelvis, expecting that if you strengthen those muscles enough, everything will improve.

But after weeks of trying to manage symptoms in isolation, you may notice that progress feels temporary.

The leaking returns.

The pressure remains.

Your core still feels disconnected.

As a physical therapist for women and founder of No Kegels University®, I see this cycle constantly.

Most women were never taught this: your pelvic floor is not a standalone structure. It is part of an interconnected system involving your breathing, core, spine, movement, pressure management, and nervous system.

That is why effective pelvic floor physical therapy often needs to look beyond the pelvic floor itself.

Your body is not broken.

The goal isn’t temporary relief—it’s long-term strength.

The Core as an Interlocking System

To understand why localized squeezing doesn’t always create lasting pelvic health, we have to look at how your deep core manages pressure.

Think of your torso like a cylinder.

The system includes:

  • The Roof — Diaphragm: Your primary breathing muscle beneath your lungs.
  • The Front and Sides — Deep Abdominal Muscles: Including the transversus abdominis, which wraps around your midsection.
  • The Back — Deep Spinal Stabilizers: Including muscles such as the multifidus.
  • The Floor — Pelvic Floor: The muscles supporting the bottom of the system.

These structures work together every time you breathe, lift, cough, exercise, or carry your child.

As you inhale, your diaphragm descends and your abdominal contents shift slightly. Your pelvic floor generally lengthens and lowers in response.

As you exhale, the diaphragm rises and the pelvic floor naturally recoils.

When this coordination becomes inefficient, pressure may not be distributed as effectively throughout the system.

For example, constantly holding your breath while lifting or sucking your stomach in all day can change how your core and pelvic floor manage pressure.

This is why pelvic floor physical therapy often addresses breathing, movement, core coordination, and daily habits—not just Kegels.

APTA Pelvic Health provides education and resources on pelvic health physical therapy and the many factors that influence pelvic floor function.

Myth: Structural Healing Means Ignoring the Nervous System

Let’s dismantle a common misconception:

Pelvic floor recovery is purely mechanical.

Muscles absolutely matter.

But muscles are also influenced by your nervous system.

Think about what your body does when you’re stressed.

You may:

  • Clench your jaw
  • Raise your shoulders
  • Hold your breath
  • Tighten your abdomen
  • Grip your glutes

Your pelvic floor can also hold tension.

When stress, previous pain, or anxiety keeps your nervous system on high alert, your pelvic muscles may become more guarded.

For some women, that means the muscles have difficulty fully relaxing.

That can contribute to symptoms such as:

  • Pelvic pain
  • Urinary urgency
  • Pain with intimacy
  • Difficulty with bowel movements
  • A constant feeling of tightness

This doesn’t mean every pelvic floor symptom is caused by stress.

It means nervous system regulation may be one important piece of a bigger picture.

Root-cause healing matters.

Effective pelvic floor physical therapy looks at the whole person—not just one muscle.

The Pillars of a Whole-Body Approach

A whole-body approach considers the different systems that influence how your pelvic floor functions.

1. Pressure Regulation and Alignment

How you breathe, stand, sit, lift, and move can influence how pressure travels through your abdomen and pelvis.

For example, you may notice that you:

  • Hold your breath while lifting
  • Constantly grip your stomach
  • Push your hips forward while holding a baby
  • Brace your core all day

These patterns aren’t automatically “bad,” but they may make your system less efficient if they become your default.

Pelvic floor physical therapy can help you develop better awareness and coordination during everyday movement.

2. Nutrition, Hydration, and Bowel Health

Your pelvic floor does not exist separately from your bowel and bladder habits.

Constipation and frequent straining can place repeated pressure on the pelvic floor.

Adequate hydration, balanced nutrition, and healthy bowel habits can support overall pelvic health.

The goal isn’t to follow a perfect diet.

It’s to recognize that pelvic floor recovery involves more than exercises alone.

3. Neurological Awareness

You cannot easily coordinate a muscle you don’t understand.

Education matters.

When you understand:

  • Where your pelvic floor is
  • How it responds to breathing
  • What relaxation feels like
  • What contraction feels like
  • How it responds during lifting or exercise

you gain greater control over how your body moves.

Understanding your body creates confidence.

That education is a major part of high-quality pelvic floor physical therapy.

Why Whole-Body Pelvic Floor Physical Therapy Matters

Pelvic floor symptoms can come from different underlying problems.

Two women may both experience leaking but need completely different treatment plans.

One may need more strength.

Another may need relaxation.

Another may need help with breathing and pressure management.

Another may need support returning gradually to impact exercise.

This is why generic advice like “just do Kegels” often feels incomplete.

Pelvic floor physical therapy may address:

  • Muscle strength
  • Muscle relaxation
  • Coordination
  • Breathing
  • Core function
  • Hip strength
  • Pressure management
  • Scar tissue
  • Movement patterns
  • Nervous system sensitivity

This is about more than symptom management.

The goal is to understand why the symptom is happening.

Step Onto the Path of True Healing

You do not need to overhaul your entire life tomorrow.

Start small.

Practice Exhaling During Effort

When you lift your child, groceries, or something heavy, notice whether you hold your breath.

Try gently exhaling through the hardest part of the movement.

Let Your Abdomen Move When You Breathe

You do not need to suck your stomach in all day.

Allow your ribs and abdomen to expand naturally with your inhale.

Notice Your Tension Patterns

Ask yourself:

  • Am I clenching my jaw?
  • Gripping my glutes?
  • Holding my breath?
  • Constantly tightening my stomach?

Awareness is the first step toward changing a pattern.

Get Individualized Guidance

If you’re dealing with leaking, pressure, pain, urgency, painful intimacy, or difficulty returning to exercise, consider working with a pelvic floor physical therapist.

A personalized assessment can help identify whether your symptoms involve:

  • Weakness
  • Tightness
  • Poor coordination
  • Pressure management
  • Scar tissue
  • Nervous system guarding
  • Another pelvic health issue

The Path Forward

The goal of recovery isn’t simply to stop a symptom for a few hours.

It’s to build a body that feels strong, capable, and supported during real life.

Pelvic floor physical therapy works best when it recognizes that your pelvic floor is part of a larger system.

Your breathing matters.

Your movement matters.

Your core matters.

Your nervous system matters.

Your daily habits matter.

And your individual symptoms matter.

Your body is not broken.

You don’t need to navigate pelvic floor recovery through guesswork or isolated exercises.

You deserve a clear, evidence-informed roadmap designed around your body and your goals.

If you’re ready to stop guessing and start understanding your body, complete Your Pelvic Floor’s Next Step Form to receive guidance based on your symptoms and goals.

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