Everything But Kegels

Written by The MOB’s Wellness Specialist Octavia Hamilton, Mobster, Mum and founder of Rebuild With Octavia - you can catch-up on the webinar recording that this blog comes from. Head to The MOB App / Resources section.

Pelvic health is often spoken about only in relation to pregnancy and postpartum recovery. But the truth is, pelvic floor dysfunction can affect women at every stage of life.

From motherhood to perimenopause, from endometriosis to sedentary lifestyles, many women experience symptoms without fully understanding why.

At a recent wellbeing MOB+ webinar we explored a different perspective: pelvic floor health is not simply about doing Kegels. It is about understanding the whole system.

Why Pelvic Floor Health Matters

Pelvic floor dysfunction is common, yet too often normalised or dismissed.

Symptoms may include:

• leaking when coughing, sneezing or exercising

• urgency to urinate

• feelings of heaviness or prolapse

• pain during intimacy

• tightness or discomfort through the pelvis

These symptoms are not always caused by weakness alone.

Contributing factors can include:

• deconditioning

• poor posture

• prolonged sitting

• hip and pelvic stiffness

• loss of coordination between the diaphragm and pelvic floor

• hormonal changes

• stress

• scarring from surgery or birth

• lifestyle and nutrition factors

This is why many women do Kegels repeatedly and see little change. It is much more complex than one muscle group.

Your Pelvic Floor Is Part of a Bigger System

One of the most important shifts in thinking is recognising that the pelvic floor does not work in isolation.

It is part of your deep core system, working closely with:

• the diaphragm

• abdominal muscles

• Pelvic and hip mobility

• spinal stabilisers

• posture and alignment

• pressure management through movement and breathing

When one part of the system is not functioning well, compensation patterns often develop elsewhere.

Sometimes the issue is not weakness. It is poor coordination, tension, breath-holding, or inefficient pressure control.

Breathing: The Missing Foundation

Many women are surprised to learn how strongly breathing affects pelvic floor function.

In a healthy pattern:

• on the inhale, the diaphragm lowers and the pelvic floor lengthens

• on the exhale, both gently recoil and lift

This natural rhythm supports:

• pelvic floor rehabilitation

• core strength

• pressure control

• nervous system regulation

Yet many women live in upper chest breathing patterns, especially when stressed, busy or overwhelmed.

Learning to breathe deeply into the ribcage and abdomen can be one of the simplest and most effective starting points for recovery.

Begin lying down, then progress to sitting, standing and movement.

Try this video here and see how you feel and what it feels like to really do a deep, wide abdominal breath.

https://vimeo.com/813616862?share=copy

Hormones, Motherhood and Midlife

Hormonal changes play a significant role in pelvic health.

Symptoms may appear or worsen during:

• pregnancy

• postpartum recovery

• breastfeeding

• perimenopause

• menopause

During perimenopause, declining oestrogen can reduce tissue resilience and muscle tone, making previously manageable issues more noticeable.

Many women only begin to experience symptoms later in life because rehabilitation was never fully addressed earlier in life or after childbirth.

Why Kegels Alone Are Not Enough

Kegels have their place, but they are only one tool.

The pelvic floor needs to:

• contract

• relax

• respond to movement

• adapt to load

• sustain endurance over time

Around daily life, endurance matters more than maximal squeezing effort.

A pelvic floor that is too tight can create just as many problems as one that is underactive.

This is why accurate assessment matters.

Functional Strength for Real Life

True rehabilitation should reflect real life.

For mothers, that means building strength for:

• lifting children

• carrying bags

• getting up from the floor

• walking, running and exercising

• long-term resilience through midlife and beyond

Useful movements include:

• squats

• lunges

• step patterns

• single-leg control

• rotational strength work

The aim is not to constantly think about your core.

The aim is for your body to work automatically.

Daily Habits That Matter

Small habits often have a large cumulative impact.

• Posture

Feeding positions, carrying children and desk work can all alter alignment and breathing mechanics.

• Mobility

Tight hips and reduced thoracic movement can affect pelvic floor function.

• Bowel Habits

Straining increases downward pressure. Using a footstool to create a squat-like position can help.

• Nutrition and Hydration

Essential for healing, bowel health, energy and reducing inflammation.

• Scar Recovery and Pelvic Function

Previous surgery can influence pelvic health more than many women realise.

This may include:

• Caesarean birth

• abdominal surgery

• laparoscopy

• endometriosis surgery

• episiotomy or tearing scars

Scar tissue can alter movement, sensation and pressure transfer.

The good news: it is never too late to improve function.

The Bigger Message

Women are often told to wait, rest, or accept symptoms as normal after motherhood.

But discomfort, leaking, heaviness and pain are common - not normal.

One of the greatest myths in rehabilitation is that time alone heals everything.

Healing often requires:

• understanding

• assessment

• guided rehabilitation

• consistency

• progressive strength

Your body usually tells you when something is not right.

Listen early.

If This Resonates With You

If you have symptoms, seek support from a qualified women’s health physiotherapist or pelvic health specialist.

You do not need to accept dysfunction as the price of  womanhood, motherhood or ageing.

With the right approach, many women can rebuild strength, confidence and resilience at any stage of life.

About Octavia

Octavia runs a dedicated wellbeing channel over in MOB+ Slack Community. Each week she shares tips on how you can look after your wellbeing as a woman building a business and career alongside motherhood. From hormones, to pelvic floor health and beyond, Octavia has you covered. 

Read more about her here: