What Are Pelvic Floor Exercises? (From an Occupational Therapy Lens)
Understanding how OTs help strengthen, relax, and coordinate the pelvic floor for better function
Pelvic floor exercises are one of the most commonly recommended ways to improve bladder control, reduce leaking, ease pelvic pain, and support postpartum recovery. But most people never learn what pelvic floor exercises actually are—or how to do them correctly.
As pelvic health occupational therapists serving York and Hanover, Pennsylvania, we approach pelvic floor rehabilitation differently. We look beyond “just do Kegels” and focus on the pelvic floor’s relationship to breathing, posture, daily habits, stress, core strength, and functional movement.
This guide explains what pelvic floor exercises are, why they matter, and how an OT-guided approach can create long-lasting change.
What Is the Pelvic Floor?
Your pelvic floor is a group of muscles at the base of your pelvis that supports the bladder, uterus or prostate, and rectum. These muscles influence:
Bladder and bowel control
Sexual function
Core strength and stability
Breathing
Pregnancy and postpartum recovery
Spine and hip alignment
Everyday movements like lifting, bending, and standing
When these muscles become weak, tight, uncoordinated, or overwhelmed, symptoms often follow—think leaking, urgency, constipation, pelvic pain, or painful intimacy.
This is why pelvic floor exercises exist—but not all exercises are created equal.
What Are Pelvic Floor Exercises?
Pelvic floor exercises are intentional movements and breath-based coordination drills that improve how the pelvic floor:
Contracts (strengthens)
Relaxes (releases)
Lengthens
Coordinates with the core and diaphragm
Supports real-life movement
Contrary to popular belief, pelvic floor exercises are not just Kegels. In fact, many people with pelvic pain, constipation, urgency, or painful sex actually have a tight pelvic floor—not a weak one. Kegels can make these symptoms worse if done incorrectly or unnecessarily.
This is where the occupational therapy lens makes a difference.
Why Occupational Therapists Approach Pelvic Floor Exercises Differently
Occupational therapists are trained to understand how the body functions during real-life activities—lifting your child, going to the bathroom, breathing during stress, returning to exercise, intimacy, and more.
A pelvic health OT considers:
✔ Breathing mechanics - The diaphragm and pelvic floor move together. OTs teach rib-based, diaphragmatic breathing that reduces pressure and improves mobility.
✔ Posture and core alignment - OTs assess how you stand, sit, squat, lift, and transition between postures—because these patterns directly influence pelvic floor tension.
✔ Daily habits that affect symptoms - Examples include “just in case” peeing, breath-holding, glute clenching, prolonged sitting, and skipping bowel urges.
✔ Nervous system regulation - Stress = tension, and tension often lives in the pelvic floor. OTs incorporate grounding techniques, body awareness, and relaxation practices.
✔ Functional movement - Your pelvic floor must work while you live your life. OTs train coordination during lifting, carrying, bending, reaching, and transitional movements.
✔ Lifestyle + environmental factors - Work setup, childcare routines, athletics, bowel habits, postpartum recovery demands, and past surgeries all influence pelvic health.
This whole-person lens transforms pelvic floor exercises from generic routines into meaningful, long-term solutions.
Types of Pelvic Floor Exercises (OT-Recommended)
1. Diaphragmatic Breathing
The most essential pelvic floor exercise.
Deep rib and belly breathing allows the pelvic floor to lengthen on inhale and recoil on exhale. It reduces tension, supports coordination, and sets the foundation for all strengthening work.
2. Pelvic Floor Relaxation Exercises
For people with pelvic pain, urgency, constipation, or painful sex, downtraining is critical.
This may include:
Supported child’s pose
Deep hip stretches
Body scanning
Gentle pelvic wand work
Pelvic floor drops
Nervous system grounding techniques
Relaxation is often the missing step that makes everything else effective.
3. Strengthening (Kegels Done Correctly)
When strengthening is appropriate, OTs teach:
How to isolate the pelvic floor without squeezing hips or glutes
How to breathe properly during contractions
Short, quick contractions for power
Longer holds for endurance
Functional strengthening during daily tasks
Kegels alone, without guidance, rarely solve symptoms.
4. Core + Pelvic Floor Coordination
Your pelvic floor doesn’t work alone. OTs teach you how to connect:
Pelvic floor muscles
Deep core (transverse abdominis)
Diaphragm
Hips and glutes
Rib and spine movement
This improves stability and reduces symptoms during everyday movement.
5. Functional Pelvic Floor Training
The pelvic floor should support real-life activities, such as:
Lifting kids
Carrying heavy objects
Squatting
Getting up from the floor
Running and jumping
OTs integrate pelvic floor activation + breath strategies into real movement to build confidence and reduce leakage.
Do Pelvic Floor Exercises Really Work?
Yes—when they’re personalized and done correctly.
Pelvic floor therapy has been shown to improve:
Stress urinary incontinence
Urgency and urge incontinence
Constipation and bowel dysfunction
Pelvic pain
Pain with intercourse
Prolapse symptoms
Postpartum recovery
Core stability
The most effective exercises are those tailored to your unique body, symptoms, and goals.
Signs You May Benefit From Pelvic Floor Exercises
You may be a good candidate if you experience:
Leaking urine with coughing, sneezing, or exercise
Urinary urgency or frequency
Bowel leakage or constipation
Pelvic pressure or heaviness
Pain with intimacy
Chronic hip, back, or pelvic pain
Diastasis recti
Core weakness postpartum
Difficulty holding urine
Painful periods or endometriosis symptoms
These symptoms are common—but not normal.
Why Work With a Pelvic Health OT in York or Hanover, PA?
A pelvic health OT at Imagine Pelvic Health offers:
Personalized treatment plans
Hands-on therapy
Breath + core coordination
Scar tissue mobilization
Education for long-term relief
Support for pregnancy, postpartum, endometriosis, incontinence, and pelvic pain
We focus on helping you move, lift, breathe, exercise, care for your family, return to intimacy, and live comfortably again.
Your Next Step:
Get Support From a Pelvic Health OT
If you're experiencing pelvic floor dysfunction—whether leaking, pressure, pain, constipation, sexual discomfort, or postpartum challenges—you're not alone, and you don’t have to figure it out yourself.
At Imagine Pelvic Health, we help women and men in York and Hanover, PA recover confidently with personalized, evidence-based care.
Get started by scheduling a free phone consultation to get started.
