Weak Pelvic Floor: Do You Trust Your Cough Or Sneeze?

Pelvic Floor (PF) weakness can affect women and men of all ages.

It is not just something that is experienced by post-natal or post-menopausal women. 

What Is Your Pelvic Floor?

Your pelvic floor is made up of layers of muscles and other tissues such as ligaments and fascia. 

For women, these layers help support the bladder, the uterus and the bowel and also help with sexual function.

For men, the pelvic floor helps support the bladder and bowel. 

For both men and women, the urethra (your front passage) and your back passage both pass through the pelvic floor muscles and fascia, allowing you to have some control over your bladder and bowel movements. 

As shown in the diagram, the pelvic floor muscles extend from the pubic bone at the front, all the way to the tailbone (coccyx) at the back. 

What Is It Responsible For?

Your pelvic floor is responsible for controlling bowel and bladder function particularly when you cough, sneeze, laugh, jump or run. 

If your pelvic floor is weak, you may experience bladder leakage and leakage of flatulence or bowel movements. 

If it is weak you may find it difficult to stop or slow the flow of urine of faecal matter. 


What Can Cause A Weak Pelvic Floor? Are You At Risk?

There are many reasons as to why your pelvic floor may be weak or you have noticed it is getting weaker.

Those who are at a higher risk of pelvic floor weakness include;

  • Women who are Pregnant
  • Women who have given birth (particularly with a vaginal delivery or an emergency c-section)
  • Those that are overweight
  • Those who undertake continuous amounts of heavy lifting
  • Those who suffer from chronic coughing (such as those with Asthma, Bronchitis or Smoker’s cough)
  • Those who have had pelvic surgery (for example a hysterectomy)

But know that it is not just limited to the above conditions. 

Why It Is Important To Have A Strong Pelvic Floor?

It is important for your pelvic floor to be strong so that you have confidence and trust in it that you won’t wet yourself when you laugh, cough or sneeze. 

In the long term, if you do not seek the appropriate medial advice, you are at risk of prolapse (bladder, bowel or uterine (if female)). 

What Is A Prolapse?

In short, a prolapse can occur if the fascia or the ligaments supporting your pelvic floor and pelvic organs have been torn or stretched for any reason. 

If your pelvic floor muscles are weak then those organs might not be held in the right place and may migrate down. 

A prolapse can be internal or external. It can occur in the bowel, bladder or uterus.  

Below is an example of a uterine prolapse, which can occur in women. 

Can You Prevent Pelvic Floor Weakness And Prolapse?

In some instances, it cannot be prevented, but a lot of the time it can. 

If you are an expectant mother, starting to strengthen your pelvic floor while you are pregnant will help reduce the likelihood of long-term weakness post-partum. 

How Can You Improve Your Pelvic Floor Strength?

You have weak calves, so what do you do? You go to the gym and strengthen it.

Your pelvic floor is the SAME as any other muscle group, you need to exercise it. And the good news, you don’t have to go to the gym to do it. 

Below is a diagram from the Continence Foundation of Australia, which demonstrates a correct and an incorrect pelvic floor contraction.


These exercises can be done when you are sitting, standing or lying on your back with your knees bent and feet on the floor (see picture above).

It is important to be able to continue breathing while you tighten your pelvic floor, so don’t hold your breath. This will actually work against you. Holding your breath increasing your intra-abdominal pressure and has a negative effect on your pelvic floor and can actually make it weak!

Finding those exercises easy? Have a try with the ones in the videos below. 

Firstly, engage your pelvic floor, then complete the movement and then relax your pelvic floor. 

Gradually increase the amount of repetitions (up to 10x on each side) you can do without letting go of your pelvic floor.



If your symptoms are getting worse from doing ANY of the above exercises (engaging and relaxing, or the more advanced exercises), consult your local physiotherapist immediately. It can be a sign that you are engaging your pelvic floor incorrectly.

Pregnant or Post-Partum?

If you are pregnant, or have recently had a baby, it is important to get a quick check of your pelvic floor to ensure that it is functioning correctly and you give yourself the best chance of a full recovery. 

Having a strong pelvic floor is important for when you return to exercise or return to running after having a baby.

Speak with your maternal healthy physiotherapist who can guide you when it is appropriate to return to exercise and sport. 

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