I first noticed that I’d wet myself when I was getting changed after a run. Everything felt normal, but it was definitely more damp down there than usual. At first, I thought it might be sweat – the result of some poor underwear choices and a particularly hard workout. But as the weeks went by, that damp patch kept coming back.

I was pregnant at the time, and like many other women before me, I’d downloaded the Squeezy app the moment I found out in an effort to prepare my pelvic floor. “Are you doing your kegels?” became one of the most common questions I was asked, often accompanied by a knowing smile that suggested the other person suspected my answer would be a resounding ‘no’. The truth was that I had no idea about pelvic floor health. Despite being a health-conscious runner, I didn’t know the first thing about what that part of my body did or why it mattered. And while I squeezed when the app told me to, I didn’t really care too much about the how, when or where.  

And then I had a grade-two prolapse. 

I spent the rest of my pregnancy running with a pessary to ensure I had some support – and, curiously enough, I started to take care of my pelvic floor. Mine is a common tale; most of us don’t think about that all-important pelvic hammock until something goes wrong. “Women present with a wide variety of pelvic floor problems, including urinary and anal incontinence and vaginal prolapse,” says Emily Nellist, a specialist women’s health physiotherapist and the founder of Enphysio. “Other common conditions include pelvic pain (eg pain during sex), an overactive bladder and constipation or bowel evacuation difficulties.”

Whether you’re pregnant, have had a baby or are just trying to live your healthiest life, this is one part of your wellbeing you don’t want to neglect. So, to ensure you don’t make the same mistakes as me, we’ve asked two experts to debunk some of the most common pelvic floor misconceptions and share their top tips for better pelvic health. 

1. Everyone should train their pelvic floor muscles (regardless of age or life stage)

As the NHS makes clear, pelvic floor muscles are just like any other muscle and should be kept strong and active. “Every woman should make training their pelvic floor muscles as part of their regular exercise programme unless they have been advised otherwise by a health professional or they cause pain or symptoms,” says Nellist.

Tina Engelmann, a women’s health expert who specialises in C-section and hysterectomy transformation, agrees on the importance of understanding your pelvic floor from an early age. “I believe pelvic floor education should start in school,” she says. “When pelvic floor muscles are too weak or tight, they don’t just impact our health but also our mental and emotional wellbeing.” Studies have found that women with pelvic floor dysfunction tend to have high levels of depression and anxiety, low mood and emotional distress. 

2. It’s not just pregnancy and birth that increase the risk of developing symptoms

While pregnancy and childbirth are often the most common times to develop an issue, other factors that can weaken your pelvic floor muscles include chronic constipation, chronic coughs and menopause. “Around the time of menopause, oestrogen levels drop and we lose muscle mass, and that can include the pelvic floor as it is a group of muscles too,” Nellist says.

Early symptoms to look out for include leaking when coughing, sneezing or laughing, or having difficulty controlling wind.  

3. Incontinence is not a ‘normal’ part of having a baby

Find a group of women who’ve had babies and someone will inevitably joke about peeing when they jump or no longer having great bladder control. While urinary incontinence is common, Nellist is keen to stress that it’s not normal and not to be expected.

While factors like weight and age can contribute to postpartum issues, performing the right pelvic floor exercises during your pregnancy can reduce the risk of things going wrong later on. If you do have an issue, Nellists says: “The good news is that it is treatable, with most women having successful outcomes with conservative treatment or therapy.” 

4. Pelvic floor health isn’t just about strength

Just as you wouldn’t exclusively do endless bicep curls for a stronger upper body, a healthy pelvic floor doesn’t come from doing endless sets of the same exercise. “Strength is only one component of muscle function,” Nellist says. “Awareness of where the muscles are, how to engage and release them correctly, timing, speed and coordination of the pelvic floor muscles with other muscle groups are also important factors to consider when training them.”

The Squeezy app can help with this as it comes with a pre-set plan that follows NICE guidelines. She recommends performing three sets a day of the following pelvic floor exercises:

• 8–12 endurance repetitions. Draw in your pelvic floor muscles and hold for 10 seconds before releasing fully. Rest for 5 seconds between each one.
• 8–12 quick repetitions (like the endurance ones but drawing in for a second and releasing the next).
• 4 sub-max endurance repetitions. Close and draw in your pelvic floor muscles to approximately 30%t of your maximum contraction strength and hold for 30-60 seconds. Rest for 10 seconds between each one.

5. Kegels don’t work for everyone

It’s clear that pelvic floor weakness can cause issues, but Nellist cautions that the situation can be made worse by pelvic floor exercises: “For many women, that weakness can be caused by overactive or tight pelvic floor muscles.

“If you have tried pelvic floor exercises and they haven’t noticeably helped, you may have an overactive or tense pelvic floor,” she explains. If this is the case, she recommends seeing a professional. 

Engelmann agrees: “The most common misconception I hear from women about their pelvic floor is that kegels are the only solution.” Instead of kegels, she recommends engaging your pelvic floor when doing daily activities and movements. That might be actively engaging every time you get up from seated or when standing on the Tube.  

6. Make sure you can also relax your pelvic floor

“Being able to relax your pelvic floor allows it to respond and engage effectively to changes in abdominal pressure caused by breathing, lifting, jumping or moving your body,” Nellist says. “This provides the necessary support for your pelvic organs, pelvis and spine, and maintains continence.”

So, how can you relax it? Diaphragmatic breathing and pelvic stretches help to lengthen and release your pelvic floor. She recommends spending 10 minutes a day on these.

“Get into a comfortable position lying or sitting,” she says. “Place a hand over your lower ribs on one side and then your other hand on your abdomen or belly. Inhale through your nose, allowing your ribs to open and your belly to rise. As you inhale your pelvic floor relaxes and lengthens. Then exhale – feeling your ribs close and belly lower, and your pelvic floor will return to its original position.” Her favourite stretches include happy baby pose, child’s pose and prayer squat.  

Images: Getty