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Can lack of exercise cause weak pelvic floor?

A weak pelvic floor can cause a variety of problems, from urinary incontinence to pelvic organ prolapse. The pelvic floor muscles support the bladder, uterus, and rectum, and weak pelvic floor muscles may cause these organs to drop down into the vagina (prolapse). Many factors can contribute to a weak pelvic floor, including pregnancy, childbirth, aging, obesity, and genetics. But could lack of exercise also be a culprit? Let’s take a closer look at the pelvic floor, whether exercise strengthens it, and if inactivity can lead to weakness.

What is the pelvic floor?

The pelvic floor is a group of muscles at the base of the pelvis that spans the area between the pubic bone and coccyx (tailbone). These muscles work together to support the pelvic organs, assist with urinary and fecal continence, and play a role in sexual function.

The major muscles of the pelvic floor include:

– Levator ani – Supports the bladder, uterus, and rectum. This muscle group has three parts: pubococcygeus, iliococcygeus, and puborectalis.

– Coccygeus – Pulls the coccyx forward and supports pelvic organs.

– Transversus perinei – Spans the muscular area between the ischial tuberosities.

– External anal sphincter – Wraps around the anus.

These muscles are often described as a “hammock” or “sling” that holds up and supports the pelvic organs. When the pelvic floor muscles are toned and strong, they compress the urethra, vagina, and rectum closed to prevent urinary and fecal incontinence. Pelvic floor weakness allows organs to drop and protrude into the vagina.

What causes weak pelvic floor muscles?

There are several factors that can lead to weak pelvic floor muscles:

Pregnancy and childbirth – Carrying a baby and vaginal delivery put tremendous strain and pressure on the pelvic floor. The weight of the growing baby stresses the muscles over months, and vaginal childbirth stretches them intensely.

Aging – Pelvic floor muscles weaken with age just like other muscles in the body. Menopausal declines in estrogen may also contribute.

Obesity – Carrying excess weight increases downward pressure on pelvic floor muscles. Obese women have a higher risk of pelvic floor disorders.

Genetics – Some women are just born with weaker connective tissue and pelvic floor muscles. Genetics account for 50% of pelvic floor dysfunction risk.

Chronic constipation/straining – Repeatedly straining to pass hard stools increases pressure on pelvic floor.

Coughing/heavy lifting – Anything that causes repeated rises in abdominal pressure can stress pelvic floor over time.

Pelvic surgery – Hysterectomy, prostate surgery, etc. can sometimes damage pelvic floor nerves and muscles.

Lack of exercise – Not using pelvic floor muscles leads them to become weak and atrophied like any other unused muscles.

So pregnancy, childbirth, aging, genetics, and obesity are some of the main factors that predispose women to pelvic floor issues. But could lack of exercise also be playing a role?

Does exercise strengthen the pelvic floor?

Yes, many studies show that regular exercise helps maintain strong pelvic floor muscles and reduce incontinence problems:

– High-impact exercise: Activities like jogging, jumping jacks, and aerobics cause an increase in abdominal pressure and engage pelvic floor contraction to counteract that force. This repetitive contraction strengthens the muscles.

– Strength training: Weight lifting engages the entire core musculature including the pelvic floor. Squats, lunges, and deadlifts are especially helpful.

– Yoga: Positions that require holding the lower abdominal muscles tight like plank and bridge tones pelvic floor. Balancing poses also activate contraction.

– Pilates: Focused movement and breath control aims to strengthen core stability muscles including pelvic floor.

In one study, women did 24 weeks of high-impact aerobics, strength training with weights, or no exercise. The exercise groups had significantly increased pelvic floor muscle strength and reduced incontinence episodes compared to no exercise.

So we know the pelvic floor can be strengthened with exercise like any other muscle group. But can lack of exercise cause it to become weak?

Can inactivity lead to weak pelvic floor?

Some research indicates that lack of exercise is linked to increased pelvic floor problems:

– A study found women who sat more than 6 hours a day had a 43% higher risk of greater pelvic organ prolapse than those who sat less than 3 hours per day. More sitting means less time standing and moving.

– Researchers surveyed over 3,000 women and found a strong association between lower physical activity levels and urinary incontinence.

– A literature review found exercise can reduce urinary incontinence by up to 57% compared to non-exercising control groups. The benefits stemmed from pelvic floor strengthening.

– Multiple studies associate sedentary lifestyles and less physical activity with increased pelvic floor dysfunction risk in both men and women.

Just like other muscles in the body, research indicates the pelvic floor muscles need regular exercise and activation. Sitting for long periods, low daily activity, and lack of targeted strengthening fails to adequately “use and thus tone” the pelvic floor according to experts.

This inactivity allows the muscles to become weak, limiting their ability to counteract increasing downward abdominal pressure from obesity, pregnancy, aging, etc. Weakness then allows pelvic organs to drop and prolapse.

So while pregnancy, aging, and genetics are major factors, lack of exercise also seems to contribute significantly to weakening of the pelvic floor over time.

Tips to strengthen your pelvic floor through exercise

If you want to keep your pelvic floor toned and prevent weakness, here are some tips:

– Get at least 150 minutes of moderate aerobic exercise like brisk walking each week. Anything that gets you breathing harder strengthens the pelvic floor.

– Add high-impact moves like jogging, jumping jacks, or skipping rope to engage more pelvic floor contraction.

– Lift weights 2-3 times per week focusing on legs and glutes to tone the entire core. Squats, bridges, and deadlifts are great choices.

– Practice yoga poses like plank, cobra, and boat which tighten the pelvic floor. Balance poses also activate contraction.

– Try Pilates exercises on a mat or reformer machine to strengthen the core stabilizers. Many moves specifically target the pelvic floor.

– Switch between sitting, standing, and moving throughout the day. Avoid sitting for more than 1-2 hours at a time.

– Learn how to actively contract your pelvic floor muscles. Squeeze as if holding in urine 10-15 times, holding 5 seconds each. Do this several times per day.

– Consider seeing a pelvic floor physical therapist if you already have weakness or incontinence. They offer specialized exercise programs.


Research indicates lack of exercise and a sedentary lifestyle can indeed contribute to weak pelvic floor muscles over time. Pregnancy, childbirth, aging, and genetics are also major factors. But without regular aerobic exercise, core and pelvic floor strengthening, and avoiding long periods of sitting, the pelvic floor muscles become weak and atrophied just like any other muscles in the body.

To maintain pelvic floor strength and continence, make sure to engage in regular physical activity focusing on high-impact cardio, core strength training, and pelvic floor exercises. Leading an active lifestyle can help prevent and even reverse some pelvic floor weakness.