Why you need more than a Strong Pelvic Floor and Why Kegels aren't enough.



Cough, Sneeze, Jump and Leaking Urine… You are in the right place.


Whilst it isn’t uncommon to leak urine, it doesn’t mean it should be. In this blog post we are going to cover this issue and help you avoid Stress Urinary Incontinence or SUI.


Exercise and leaking are a common symptom we hear a lot at Midwife Pip and activities that most frequently lead to this are exercising, more specifically landing movements like, running, sprinting, jumping, skipping etc. Some women may also experience leaking with deadlifts.


Whilst it’s true that childbirth can be one factor contributing to dysfunction of the pelvic floor, not everyone will experience incontinence after childbirth. It is estimated that 4/10 women experience leaking. Though leaking urine is common, it’s usually a sign of a larger issue, one for which doing more Kegels, or having a strong pelvic floor, isn’t always the solution.



Those of you who are training or who have been training may find other women complaining of similar issues/problems, yet most women do not seek treatment because they are either embarrassed or they assume it is normal because other people have the same issue.


Stress Urinary Incontinence can be treated, but it can be a sign that the whole system is breaking down. The pelvic floor is at the bottom of the chain and highlights that there may be an issue/imbalance upstream. The ‘upstream’ being the deep core.


Imbalances: There are a couple of flags that are worth looking out for, that may mean you have a imbalance in your deep core.

  • Lower Back Pain

  • IT Band Syndrome

  • Chronic Groin Strains

  • Hip Bursitis

Why do I Leak Urine?

Many women believe that a ‘weak’ pelvic floor is always the cause of urine leakage… but this is simply not true, there are many factors that can lead to Pelvic Pain and/or Stress Urinary Incontinence.

To best understand why you are leaking we highly recommend seeing a Pelvic Health Physio to get the best advice and direction to help support your issues.


Some of the factors that may be causing issues are:

  • Pelvic Floor may have been damaged and the scar tissue affects the muscles’ ability to contract properly. This damage could have been caused by forceps, vacuum extraction of a baby, episiotomy, or cancer/radiation.

  • Muscles maybe overactive and unable to relax, which decreases the strength of the contraction when they do fire.

  • Pelvic floor muscles may be weak from stretching caused by vaginal delivery or even from the weight of the baby during your pregnancy journey. They may also be weak due to postural habits and lack of exercise.

  • Pelvic floor muscles maybe be overactive but strong. You may also have stronger abdominal, back diaphragm and glottis muscles. Those of you who lift weights maybe in this category. Holding breath whilst lifting weights leads to a rigid thorax, as you can’t contain all the pressure, so you either find yourself grunting/yelling, leak urine, or sustain an abdominal hernia or herniated spinal disc. The pressure will escape through the weakest link.

Will Kegels Help My Pelvic Floor?


The big misconception is that women need to be doing Pelvic Floor training to strengthen them…


Unfortunately, Kegels are not always the answer to Stress Urinary Incontinence and Pelvic Floor Issues. Pillar/Core Stability requires a balance of muscular strength and a neuromuscular (nerves that connect the brain and spinal cord) strategy for engagement to meet physical demands. The diaphragm, deep abdominal muscles, spine, and pelvic floor need to work in harmony together….as you can now probably see that Kegels do not address the system as a whole.


What should I do now?


I highly recommend you have your Stress Urinary Incontinence/Pelvic floor dysfunction checked out by a Pelvic Health Physio. They will do a thorough assessment and will identify what is causing your issue and work with you to treat it.


It is important to work with a physio that can evaluate your specific condition and treat you with appropriate exercises and manual techniques… If you feel embarrassed about seeing someone, I assure you that you have nothing to be embarrassed about. Long Term Health and wellbeing are extremely important and working with the physio will give you an opportunity to learn more about your body and what you can do to help it perform optimally.


How Do I Improve The Function of My Pelvic Floor?


Whilst the Pelvic Health Physio is going to give you a more specific programme, it is also worth thinking about some of the info below:


  • Practice functional movement integrating breathing and relaxation of the pelvic floor muscles.

  • You can start with bodyweight squats, done several times a day.

  • Once you are comfortable in this position, integrate the pattern of being relaxed on the inhale and contracting the pelvic floor on the exhale into your activities – Such as lifting children or heavy object.

  • To fully feel the benefits of this training, it is highly recommended to work with a specialist to help inform correct training and technique. Your Pregnancy Fitness works and focuses on all these elements.

  • Strengthen your glutes – Glutes are at the core of your pillar strength and central stability system. – In modern day society where we are sitting more, our glutes are getting weaker.

  • Stretch and mobilise your hips, groins, hamstrings, calves, quads. When we see a weak pelvic floor, we often see women using glutes and adductors to keep the bladder closes… Crossing legs to stop leaking.. leads to increased tension in the muscles. We need to learn to relax the adductors and fire the pelvic floor muscles.

  • Train without a belt – using a weightlifting belt can increase the intra-abdominal pressure and often the pelvic floor can’t handle the pressure. We actually have our own inbuilt ‘belt’ – deep stability system, therefore practicing using this efficiently and effectively will make you stronger.

  • Don’t let your ego run the show… If you are experiencing issues, get that expert help and alter your training to make sure you aren’t making it worse. Practice lifting with perfect form, develop the true strength and stability you need, then gradually increase load.


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The Author: Midwife Pip

Midwife Pip

Pip is a Mum, Podcaster and practicing Midwife in the UK, currently working as a Delivery Suite Sister she has a wealth of experience supporting parents-to-be through all aspects of pregnancy, birth and the postpartum. Pip has trained and worked in some of the leading maternity units, has completed a master's programme and is passionate about all aspects of women's health and wellness.



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