12 Week Pelvic Floor Physical Therapy Exercise Program

Before starting your pelvic floor physical therapy program, it is important to prepare your space and gather the necessary equipment. Creating a safe and comfortable environment will enhance your overall experience and help you achieve your therapy goals. Here are some key steps to consider when setting up your space.

First, designate a specific area in your home, office, or wherever you will be doing your physical therapy exercises. This area should be well-lit, spacious, and free of clutter to avoid any potential accidents. Make sure to have a comfortable mat or towel to use for floor exercises and have a sturdy chair nearby for seated exercises. The Pelvic Floor Physical Therapy Program will have you safely and effectively using resistance bands. We recommend both loop bands, that are placed around your thighs, and 6 foot or greater length standard resistance bands. You may use equipment you already own, purchase them from our website, or purchase from a retailer near you. These bands are used often in physical therapy and gym environments and are easily attainable. (Currently, we only offer shipping within the U.S.A.)

Get your Resistance Band Set ? https://pelvicfloorexercise.org/shop

Welcome to your pelvic floor fitness program presented by Dr. Alona Stein. The course is designed to be progressed each week. Each week you will be asked to complete a new set of exercises which are completed daily as instructed by Dr. Stein.

For this program, in a few weeks you will need:

- Loop bands (We sell these on our website)

- Exercise ball

- Stretch strap

- 1 single band with loops on each end, 4 - 6 feet in length will work

Lesson Summary

Before starting your pelvic floor physical therapy program, it is important to prepare your space and gather the necessary equipment for a safe and comfortable environment:

• Designate a specific area in your home or office for exercises, ensuring it's well-lit, spacious, and free of clutter.

• Have a comfortable mat or towel for floor exercises and a sturdy chair nearby for seated exercises.

• For resistance exercises, you will need loop bands and standard resistance bands (6 feet or greater in length).

• Loop bands are placed around your thighs, and you can purchase them from our website or a local retailer.

• The Pelvic Floor Physical Therapy Program will guide you through exercises that can be completed daily for progress.

For the program, you will need:

• Loop bands (available for purchase on our website)

• Exercise ball (65cm or 55cm)

• Stretch strap

• Single band (4-6 feet in length) with loops on each end

• 1, 2, 3, 4, or 5 pound hand weights (cans of food can be used as an alternative)

If you have the required items or can access them, that's great! For shopping options, visit:

• Our store: Pelvic Floor Store

• Amazon links for Exercise Balls: Ball 1, Ball 2

• Amazon links for Stretch Strap: Stretch Strap 1, Stretch Strap 2

Key Lesson Concepts:

• Designate a specific area for exercises

• Gather resistance bands that you already own, purchase from our website, or buy from a local retailer

• Familiarize yourself with exercises and maintain proper form

Get your Resistance Band Set ? https://pelvicfloorexercise.org/shop

In this lesson, we will explore the fundamentals of your body and understanding the key difference between Pain and Soreness can impact your physical health. Understanding the structure and function of your body is essential in maintaining optimal health and preventing injuries.

By learning how to listen to your body and recognize warning signs, you can better protect yourself from serious injuries and promote overall well-being.

Key Lesson Concepts:

• Understanding the structure and function of your body

• Understanding the key concept of feeling Pain versus feeling Soreness

• Recognizing signs and symptoms of injuries

• Recognizing signs and symptoms of muscular soreness as you gain strength and flexibility

Lesson Summary

In this lesson, we will delve into the fundamentals of the human body in order to comprehend the vital disparity between Pain and Soreness and how it can influence your physical health:

• Understanding the structure and function of your body aids in sustaining optimal health and averting injuries.

• Learning how to interpret the signals from your body and identify cautionary indications can enhance your ability to shield yourself from severe injuries and foster overall well-being.

Key Lesson Concepts:

• Understanding the structure and function of your body

• Understanding the key concept of feeling Pain versus feeling Soreness

• Recognizing signs and symptoms of injuries

• Recognizing signs and symptoms of muscular soreness as you gain strength and flexibility

Maintaining 'Neutral Spine' and keeping your spine in optimal alignment is crucial when participating in an exercise program. This helps to reduce the risk of injury and allows the muscles to perform at their best during the workout.

In addition to injury prevention, maintaining neutral spine will allow the nerves that exit your spinal column maximal space and minimizing any pinching or compromise that may occur with repetitive bending and twisting.

Key Lesson Concepts:

• Maintaining Neutral Spine will minimize your chance of injury

• Keeping your back straight during exercise allows optimal muscle balance throughout your upper and lower body

• Maintaining Neutral Spine will allow the nerves exiting your spinal column an optimal environment to work properly and decreases your chance of pinching and compromise

Lesson Summary

Maintaining a neutral spine is crucial during exercise to reduce the risk of injury and allow muscles to perform optimally.

• Neutral spine alignment helps prevent injuries and supports muscle function.

• Keeping your spine straight during workouts promotes muscle balance throughout your body.

• Maintaining a neutral spine provides an optimal environment for the nerves exiting your spinal column, reducing the risk of pinching or compromise.

Most people don't know which muscles we mean when we say "pelvic floor." That's normal. Unlike your biceps, you can't see these muscles move, so it's hard to know what they're doing.

Your pelvic floor is a bowl of muscles that sits at the bottom of your pelvis. Your organs rest in that bowl. When we talk about contracting your pelvic floor, tightening your pelvic floor, or doing a Kegel, it all means the same thing: you're lifting that bowl.

In this lesson, you'll see anatomy models of both a female and a male pelvis, and you'll learn simple cues to find these muscles on your own body.

Key Lesson Concepts:

• Your pelvic floor is a bowl of muscles at the bottom of your pelvis that supports your organs

• Contracting, tightening, and doing a Kegel all mean the same thing: lifting the bowl

• Easy cue for everyone: imagine stopping the flow of urine

• Cue for women: the muscles you use to close the vagina or the anus

• Cue for men: the muscles you use to lift the base of the penis or close the anus

• Men and women look different on the outside, but the pelvic floor muscles are oriented the same and do the same job

Lesson Summary

Before you can train your pelvic floor, you need to know where it is and how it feels when you use it.

• The pelvic floor muscles are internal, so you can't see them work. You learn to feel them instead.

• Think of lifting the bowl of muscles at the base of your pelvis.

• Use the cue that works best for you, whether you're a man or a woman.

• These are the muscles you'll train throughout the entire 12 week program.

Your pelvic floor doesn't work alone. In this lesson, you'll learn how it teams up with your breathing and your core to control the pressure inside your body.

Think of your trunk as a canister. The pelvic floor is the bottom of the canister. Your diaphragm, your main breathing muscle, is the top. Your deep core muscle (the transversus abdominis) wraps around the front, and the multifidus, a small spinal stabilizer, supports the back. These four work together to manage the pressure inside your abdomen.

That's why breathing matters so much in this program. When most people tighten their pelvic floor, they hold their breath and brace. That pushes extra pressure down onto the pelvic floor, which is exactly what we want to avoid. You'll hear us remind you often: remember to breathe, remember to exhale.

Key Lesson Concepts:

• Your trunk works like a canister: pelvic floor at the bottom, diaphragm at the top, deep core in front, spinal stabilizers in the back

• These four muscle groups work together to control the pressure inside your abdomen

• Holding your breath and bracing puts unnecessary pressure on your pelvic floor

• Breathing, especially a controlled exhale, is part of every exercise in this program

Lesson Summary

• Pelvic floor training is really pressure training.

• Your pelvic floor, diaphragm, deep core, and spinal stabilizers all work as one team.

• Don't hold your breath when you tighten. Keep breathing and exhale with control.

• This sets up the breathing cues you'll use through all 12 weeks.

Before you start training, you need to know two things: is this program right for you, and how much is enough?

In the clinic, the most common reasons people start pelvic floor training are urinary leakage (stress or urge), bowel leakage, constipation, pelvic pain, recovery after having a baby, and pelvic organ prolapse.

But pelvic floor strengthening is not for everyone. Some people have pelvic floor muscles that are already too tight and overactive (called hypertonic). Those muscles never get a chance to rest, and adding strengthening on top can make things worse. If your symptoms get worse or don't change while doing this program, see a pelvic floor physical therapist in person.

Then there's the question of how many reps. More is not better. Doing Kegels all day long at every red light and in every checkout line can over-fatigue your muscles and make your symptoms worse. Research shows that 60 to 80 reps a day, spread out through the day, is enough to see real changes. That's the rule for this entire program.

Key Lesson Concepts:

• Common reasons people start pelvic floor training

• Why pelvic floor strengthening isn't right for everyone

• What an overactive (hypertonic) pelvic floor is, and why strengthening can make it worse

• When to stop and see a pelvic floor physical therapist

• The 60 to 80 reps a day rule, spread through the day

Lesson Summary

• This program is built for the most common pelvic floor issues in both men and women.

• If your symptoms get worse or don't change, get checked by a pelvic floor physical therapist.

• Aim for 60 to 80 reps a day total, broken up through the day. Not all at once, and never hundreds.

• Overdoing it can tighten or tire out your muscles and make symptoms worse.

Before you begin Week 1, take your first pelvic floor assessment. It uses questionnaires that physical therapists use in the clinic to measure how your symptoms affect your daily life, and to track progress over time.

? Take the assessment here: https://pelvicfloorexercise.org/pelvic-floor-assessment

How it works

• Choose your gender to see the questionnaires that apply to you

• Answer every question honestly

• Enter your name and email. Your score is sent straight to your inbox.

• Save that email. This is your baseline.

Don't worry about your first score

It's simply your starting point. You'll take the same assessment again after Week 4, Week 8, and Week 12, and compare your results to see your progress.

Key Lesson Concepts:

• A clinical self-assessment used by physical therapists

• Your score is delivered by email, so keep it

• Your first score is your baseline

• Retake after Weeks 4, 8, and 12

Lesson Summary

• Click the link and complete the assessment.

• Check your inbox for your score and save it.

• Then start Week 1.

Week 1.0: Introduction Week 1

Welcome to Week 1. This is where the training starts.

This week you'll learn to find your pelvic floor, contract it, and just as important, relax it. Then you'll connect it with your breathing and your deep core, the same team you learned about in the Foundation section.

Everything this week is done lying on your back. That's the easiest position for your pelvic floor, because gravity isn't pushing down on it. In the coming weeks you'll progress to all fours, sitting, standing, and eventually jumping.

This week's exercises

• 1.1 Isolated Pelvic Floor Holds: hold 5 seconds, rest 10 seconds, 10 reps. Then 10 quick contractions: 1 second on, 1 second off. Keep your breathing normal.

• 1.2 Co-Contraction Exhalations: breathe in through your nose, then tighten your pelvic floor and deep core as you slowly exhale. 10 reps.

• 1.3 Co-Contraction Ball Raises: same breathing and tightening, now with a light weight moving overhead. 10 reps.

• 1.4 Co-Contraction Hip Fall-Outs: same breathing and tightening, now with your knees opening and closing. 10 reps.

Key Lesson Concepts:

• Week 1 is about control, not intensity

• Learn to both tighten and fully relax your pelvic floor

• Isolated holds: breathing stays normal, never hold your breath

• Co-contractions: tighten only on the exhale

• Keep your spine neutral and don't squeeze your glutes

Lesson Summary

• All Week 1 exercises are done lying on your back.

• You'll train long holds for endurance and quick contractions for fast reaction.

• Then you'll pair your pelvic floor with your deep core and breathing.

• Stay within 60 to 80 pelvic floor reps a day, spread through the day.

• Soreness is normal. Pain is not. If something hurts, back off.

Here's your printable program guide again, in case you haven't downloaded or printed it yet.

This is the only guide you need for the full 12 weeks, and it's yours to keep for life. We won't attach it again after this, so save it now.

How to use your guide

• Print it, or save it to your phone so it's always with you.

• Each week, find your week in the guide and follow the exercises in order.

• Check the reps, holds, and breathing cues for every exercise before you start.

• Write down your assessment scores (before Week 1, and after Weeks 4, 8, and 12) so you can see your progress.

• Keep your total at 60 to 80 pelvic floor reps a day, spread through the day.

If you feel pain, stop and rest for a day or two. If your symptoms get worse or don't change, see a pelvic floor physical therapist.

Key Lesson Concepts:

• One guide covers all 12 weeks

• Download or print it now, it won't be attached again

• Follow your current week in order

• Track your assessment scores to see your progress

Lesson Summary

• Download the attached PDF and keep it handy.

• Use it every week to follow your exercises, reps, and breathing.

• Log your assessment scores after Weeks 4, 8, and 12.

Your first real pelvic floor exercise. Here you'll train your pelvic floor on its own, without any other muscles helping.

Your pelvic floor has two types of muscle fibers. Slow twitch fibers are your endurance muscles. They hold and stabilize. Fast twitch fibers react quickly, like when you cough or sneeze. This exercise trains both.

Part 1: Long holds (slow twitch)

Think of your pelvic floor like an elevator. Don't sprint to the top floor. Lift slowly and stop at each floor on the way up. If you put all your effort into the first two seconds, your muscles tire out before the hold is done.

• Hold 5 seconds, rest 10 seconds

• 10 reps

• The rest matters just as much as the hold

Part 2: Quick contractions (fast twitch)

Think of a light switch: on, off, on, off. You won't lift as high or relax as fully as with the long holds. Focus on a smooth switch between on and off.

• 1 second on, 1 second off

• 10 reps

Breathing is the key

Keep your breathing normal the whole time. Don't hold your breath, don't bear down, and don't try to time your breathing with the contractions. If that's hard, sing a song or talk out loud while you do the exercise. It forces you to keep breathing.

Key Lesson Concepts:

• Train both slow twitch (endurance) and fast twitch (quick reaction) fibers

• Long holds: 5 seconds on, 10 seconds rest, 10 reps

• Quick contractions: 1 second on, 1 second off, 10 reps

• Lift slowly like an elevator, not a sprint

• Keep breathing normal. Sing or talk out loud if needed

• Squeezing your glutes is not a pelvic floor contraction

Lesson Summary

• Lie on your back and do 10 long holds (5 seconds on, 10 seconds rest).

• Follow with 10 quick contractions (1 second on, 1 second off).

• Breathing stays normal. Don't hold your breath or bear down.

• Keep your glutes relaxed. You're lifting the bowl of muscles, not squeezing your butt.

Your pelvic floor doesn't work by itself. It works together with your core and hip muscles as one pelvic stabilization system. In this exercise, you'll train your pelvic floor and your deep core at the same time. This is called a co-contraction.

Find your deep core

Most people think of the six-pack muscles when they hear "core." We're talking about a deeper muscle, the transversus abdominis. It wraps around your spine like a corset. To find it, place your hands just inside your hip bones and gently tighten your belly. Think about drawing your hip bones toward each other.

The breathing changes

In Week 1.1, your breathing stayed normal. Now you'll coordinate the muscle contraction with your breath:

• Breathe in slowly through your nose. Everything stays relaxed.

• Exhale slowly and with control, and tighten your deep core and pelvic floor together.

• The exhale should be gentle, like making a candle flame flicker. Not a forceful blow.

How to do it

• Lie on your back with your knees bent

• 10 reps

• Keep your spine neutral. Nothing moves: no tilting your pelvis up or down

Key Lesson Concepts:

• Your pelvic floor, core, and hips work together as one system

• Co-contraction means tightening your pelvic floor and deep core at the same time

• Find your deep core just inside your hip bones

• Inhale to relax, exhale to tighten

• A slow, controlled exhale helps you control the pressure inside your abdomen

• Keep your spine still and neutral

Lesson Summary

• Breathe in through your nose and stay relaxed.

• As you slowly exhale, tighten your deep core and pelvic floor together.

• Do 10 reps lying on your back.

• Keep the exhale gentle and your spine still.

This is the same co-contraction you learned in Week 1.2, tightening your pelvic floor and deep core together, but now with arm movement to make it more challenging.

What you need

Something with a little weight. In the clinic we use a 2 lb ball or dumbbell. At home, a water bottle, a can of food, or a bag of potatoes works fine.

How to do it

• Lie on your back with your knees bent, holding the weight with both hands

• Breathe in and bring the weight up over your head. Everything stays relaxed.

• Exhale and bring the weight back down while you tighten your deep core and pelvic floor

• Make the exhale a second or two longer than the inhale

• 10 reps, slow and controlled

Watch your form

Your spine stays neutral the whole time. No tilting, no arching, and no squeezing your glutes. The arms move, your trunk stays still.

Key Lesson Concepts:

• Same co-contraction as Week 1.2, now with arm movement

• Use any light household item, around 2 lbs

• Inhale as the weight goes up, exhale and tighten as it comes down

• Tighten only on the exhale

• Exhale a little longer than you inhale

• Keep your spine neutral and your glutes relaxed

Lesson Summary

• Hold a light weight and lie on your back.

• Inhale, weight goes overhead. Exhale, tighten, bring it back down.

• Do 10 slow, controlled reps.

• Your arms move, your spine stays still.

The last exercise of Week 1. It's the same co-contraction of your pelvic floor and deep core, but this time you challenge it with leg movement instead of arm movement.

How to do it

• Lie on your back with your knees bent and feet flat

• Breathe in and let your knees slowly open apart. Everything stays relaxed.

• Exhale slowly, tighten your deep core and pelvic floor, and bring your knees back together

• 10 reps, slow and controlled

Watch your form

Keep the breathing slow and gentle, never forceful. Place your hands on your belly: when you exhale, it should stay flat, not bulge or push up. That shows you're controlling the pressure inside your abdomen.

Key Lesson Concepts:

• Same co-contraction as Weeks 1.2 and 1.3, now with leg movement

• Inhale as your knees open, exhale and tighten as they close

• Tighten only on the exhale

• Your belly stays flat on the exhale, no bulging

• Slow and controlled, never forceful

Lesson Summary

• Lie on your back with your knees bent.

• Inhale, knees open. Exhale, tighten, knees close.

• Do 10 slow, controlled reps.

• Keep your belly flat as you exhale.

This week we shift from strengthening to relaxing, breathing, and stretching. Strength matters, but knowing how to relax your pelvic floor and breathe properly matters just as much. Tight muscles and poor breathing habits can work against your pelvic floor over time.

Why breathing matters

Remember the canister from the Foundation section: your diaphragm sits at the top, your pelvic floor at the bottom. They work together. Many people, especially those dealing with ongoing pain or tension, breathe shallow from the chest. When your diaphragm doesn't fully expand, your pelvic floor feels it too.

Get comfortable

Lie on your back. If you have a pillow, wedge, or bolster, place it under your knees. This helps your pelvic floor and belly muscles soften, and it's usually easier on your lower back.

How to do it

• Put one hand on your belly and one hand on your chest

• Breathe in slowly. Your belly and ribs should rise before your chest.

• Think 360 degrees: your belly, ribs, and back all expand

• Exhale slowly and with control

• 3 to 4 breaths to learn it, then 7 to 8 breaths at the end of each session

Key Lesson Concepts:

• Relaxing your pelvic floor is just as important as strengthening it

• Your diaphragm and pelvic floor work together

• Shallow chest breathing can work against your pelvic floor

• Belly and ribs rise first, then the chest

• A pillow under your knees helps everything relax

Lesson Summary

• Lie on your back, pillow under your knees if you have one.

• One hand on your belly, one on your chest.

• Breathe in slow and deep so your belly and ribs expand first. Exhale slow and controlled.

• Use 7 to 8 breaths to finish every exercise session.

A simple stretch for your glutes and lower back. When these muscles relax, it helps your pelvic floor relax too.

How to do it

• Lie on your back

• Grab one knee and gently pull it toward your chest

• Stop when you feel a strong but comfortable stretch in your butt and lower back

• Hold for 30 seconds, breathing normally

• Switch legs

• 2 reps on each side

Keep it comfortable

A stretch should never be painful. Every stretch in this program is held for 30 seconds. That's longer than it sounds, so use a timer.

Key Lesson Concepts:

• Stretches your glutes and lower back

• Relaxed hips and back help your pelvic floor relax

• Hold every stretch for 30 seconds

• Strong but comfortable, never painful

• Keep breathing normally

Lesson Summary

• Lie on your back and pull one knee gently to your chest.

• Hold 30 seconds, then switch legs.

• Do 2 reps on each side.

• Comfortable stretch, normal breathing, no pain.

The piriformis is a muscle that runs across your butt. It's not part of the pelvic floor itself, but it's part of the pelvic wall, right next to it. When it's tight, it can cause low back issues and pain, so we want to release it.

There are two ways to do this stretch. Pick the one that feels better, especially if you have any hip issues.

How to do it

• Lie on your back with both knees bent

• Cross one leg over the other

• With both hands, grab your knee and gently pull it toward your opposite shoulder

• You should feel the stretch across your butt

• Hold for 30 seconds, breathing normally

• Switch sides and follow along with the video

Key Lesson Concepts:

• The piriformis sits in the pelvic wall, next to your pelvic floor

• Tightness here can lead to low back issues and pain

• Two versions: choose the one that's more comfortable for your hips

• Hold 30 seconds, comfortable stretch, no pain

Lesson Summary

• Lie on your back, cross one leg over the other.

• Pull your knee toward the opposite shoulder.

• Hold 30 seconds, then switch sides.

• Keep it comfortable and keep breathing.

A favorite for the whole pelvic floor area. If you've done yoga, you may know this one as happy baby pose. Many patients tell us that on busy days when they can only fit in a few stretches, this is the one they always keep.

Full version

• Lie on your back and bring your knees up toward your chest

• Reach inside your legs and grab the bottoms of your feet

• Gently pull your legs out to the sides

• Hold for 30 seconds, breathing normally

• 2 reps

Modified version (if you're less flexible)

Not everyone can reach their feet, and that's completely fine.

• Grab the outside of your knees instead

• Gently pull them out to the sides

• You should still feel a stretch through your whole pelvic area

• Hold for 30 seconds

• 2 reps

Key Lesson Concepts:

• One of the best stretches for your pelvic floor

• Full version: hold the bottoms of your feet

• Modified version: hold the outside of your knees

• Hold 30 seconds, comfortable, never painful

• Breathing stays normal, no straining

Lesson Summary

• Lie on your back and pull your legs gently out to the sides.

• Use the full or modified version, whichever fits your flexibility.

• Hold 30 seconds, 2 reps.

• If you only have time for one stretch, make it this one.

This week is all about loosening the muscles in your legs that pull on your pelvis. First up: your hamstrings, the muscles along the back of your thigh.

What you need

A strap or belt that does NOT stretch. A dog leash, a bathrobe belt, or even a bedsheet works. Save your elastic bands for strengthening. They shouldn't be used for stretches.

How to do it

• Lie on your back and loop the strap around one foot

• Keep that knee straight. The other knee can stay bent if it's more comfortable for your back.

• Use the strap to lift your straight leg until you feel a comfortable stretch behind your knee

• Want more stretch in your calf? Gently pull down on the top of your foot.

• Hold for 30 seconds, rest about 5 seconds, repeat

• Do all your reps on one side, then switch

Keep it comfortable

"No pain, no gain" doesn't apply here. If it feels like too much, back off a little. You want a strong, comfortable stretch you can hold.

Key Lesson Concepts:

• Stretches the back of your thigh and your calf

• Use a non-elastic strap, never a resistance band

• Keep the stretching knee straight the whole time

• Hold 30 seconds, comfortable, not painful

• Breathing stays normal

Lesson Summary

• Strap around one foot, knee straight, lift the leg.

• Stop at a comfortable stretch behind the knee.

• Hold 30 seconds, then repeat. Finish one side before switching.

• Back off if it hurts.

The IT band runs down the outside of your thigh, from your hip to your knee. It's a thick band of connective tissue, and it gets tight in a lot of people, especially runners.

How to do it

• Lie on your back and loop the non-elastic strap around one foot

• Lift that leg up and cross it over your other leg

• Turn the leg inward (rotate your hip in) and gently pull it up toward you

• You'll feel the stretch somewhere between your hip and your knee, wherever you're tightest

• Keep both hips on the floor. Only your leg crosses over, not your whole body.

• Hold for 30 seconds, 2 reps, then switch sides

Bonus tip

If you have a foam roller, rolling the outside of your thigh is a great add-on to this stretch.

Key Lesson Concepts:

• The IT band runs from your hip to your knee on the outside of your thigh

• Cross the leg over, turn it in, pull up

• Keep your hips flat on the floor

• Hold 30 seconds, comfortable, not painful

• A foam roller can help too

Lesson Summary

• Strap on one foot, cross the leg over your body.

• Turn it in and pull up until you feel the outside of your thigh stretch.

• Hips stay down. Hold 30 seconds, 2 reps per side.

• Breathe normally and back off if needed.

Your adductors are the muscles along the inside of your thigh. They attach to your pelvis, so when they're tight, they can affect your pelvic floor.

How to do it

• Lie on your back

• Loop the non-elastic strap around the inside of one leg so it cradles your foot

• Hold the strap and bring that leg up and out to the side

• Stop when you feel a comfortable stretch along your inner thigh

• Your other leg can stay straight or bent, whichever feels better on your back

• Hold for 30 seconds, 2 reps, then switch sides

Key Lesson Concepts:

• Adductors run along your inner thigh and attach to your pelvis

• Tight adductors can affect your pelvic floor

• Loop the strap on the inside of your leg

• Other leg straight or bent, both work the same

• Hold 30 seconds, comfortable, not painful

Lesson Summary

• Strap on the inside of one leg.

• Bring the leg up and out to the side.

• Hold 30 seconds, 2 reps per side.

• Keep it comfortable and keep breathing.

The last stretch of the series. This one targets your hip flexors and quads, the muscles that run from your pelvis down the front of your thigh to your knee.

Where to do it

Lie at the edge of a bed, couch, or table. Just make sure you don't roll off.

How to do it

• Lie on your back near the edge and let one leg drop off the side

• Keep your other knee bent for comfort

• Loop the non-elastic strap around the foot of the dropped leg

• Gently pull your heel back toward you

• You should feel the stretch in the front of your thigh and a little in your groin

• Keep your back fully on the surface. Don't slide partway off to make the stretch happen.

• Hold for 30 seconds, 2 reps, then switch sides

Key Lesson Concepts:

• Stretches your hip flexors and quads, front of the thigh

• Use the edge of a bed, couch, or table

• Pull your heel back with the strap

• Your back stays on the surface

• Hold 30 seconds, comfortable, never hurting your back

Lesson Summary

• Lie at the edge, drop one leg off the side.

• Strap around the foot, pull the heel back.

• Hold 30 seconds, 2 reps per side.

• Back stays down, stretch stays comfortable.

Time to progress the isolated pelvic floor holds you learned in Week 1.

There are two ways we progress these exercises: longer holds, or a harder position. You're still lying on your back this week, where gravity has the least effect on your pelvic floor. So this time, we make the holds longer.

How to do it

• Lie on your back

• Long holds: hold 7 seconds, rest 13 seconds, 10 reps

• Then quick contractions: 1 second on, 1 second off, 10 reps

• Lift slowly like an elevator, stopping at each floor

• Keep your breathing normal the whole time

Key Lesson Concepts:

• Two ways to progress: longer holds or harder positions

• Week 4 progression: 7 second holds instead of 5

• Rest is longer too: 13 seconds

• Still train both long holds and quick contractions

• Breathing stays normal, no breath holding

Lesson Summary

• Lie on your back.

• 10 long holds: 7 seconds on, 13 seconds rest.

• 10 quick contractions: 1 second on, 1 second off.

• Breathe normally and keep your glutes relaxed.

The same pelvic floor and deep core co-contraction from Week 1, now with a bigger challenge: marching your legs while you keep control.

Breathing

Don't brace or hold your breath. When you exhale, your pelvic floor naturally contracts, so we use that. The real effort happens as you lower your leg.

How to do it

• Lie on your back with your knees bent

• Breathe in and lift one leg up, knee bent

• Exhale, tighten your pelvic floor and deep core, and lower the leg back down

• Alternate legs

• 10 reps on each side

Watch your form

• Your spine stays neutral. No tilting your pelvis up or down.

• Your hips stay level. They shouldn't rock or rotate.

• If your hips move a lot, go back to the Week 1 ball raises and hip fall-outs. Come back to marching once you're stronger.

Key Lesson Concepts:

• Progression of the Week 1 co-contractions

• Inhale as the leg lifts, exhale and tighten as it lowers

• The effort is in lowering the leg

• Spine neutral, hips level

• Scale back to Week 1 if your hips rock

Lesson Summary

• Knees bent, lying on your back.

• Inhale, leg up. Exhale, tighten, leg down.

• Alternate legs, 10 reps each side.

• Keep your hips still and your spine neutral.

A step up from marching. Your leg is now straight, which makes it a longer lever. That means your core and pelvic floor have to work harder to keep your spine still.

How to do it

• Lie on your back. One knee bent, the other leg straight.

• Breathe in

• Exhale, tighten your pelvic floor and deep core, and lift the straight leg just 1 to 3 inches off the floor

• Keep the exhale and the contraction going as you lower it back down

• 10 reps on each side. You can do all 10 on one side first, or alternate.

Watch your form

When you lift a straight leg, your lower back naturally wants to lift off the floor too. Don't let it. Keeping your back flat shows your core is doing its job.

Key Lesson Concepts:

• A harder version of marching, with a straight leg

• Lift only 1 to 3 inches

• Lift and lower on one long exhale

• Your lower back stays on the floor

• Do sides in a row or alternate, whichever works for you

Lesson Summary

• Inhale to prepare.

• Exhale, tighten, lift the straight leg 1 to 3 inches and lower it.

• 10 reps on each side.

• Don't let your lower back arch up.

Your pelvis is supported by three muscle groups: your pelvic floor, your core, and your glutes. This exercise gives your pelvic floor and core a short break and focuses on your glutes.

What you need

A loop band around your thighs. The video uses the green (light) band. If it's too easy, move up to a band with more resistance.

How to do it

• Lie on your side with the loop band just above your knees

• Keep your feet together and your knees bent

• Open your top knee away from your bottom knee, like a clam opening

• Lower it back down slowly

• 10 reps, then flip sides and do 10 more

Watch your form

• Keep your back straight. Don't let your body roll backward as your knee opens.

• Put your hand on the side of your hip. You should feel the muscle working under your fingers.

• No special breathing here. Just breathe normally and don't hold your breath.

Key Lesson Concepts:

• Pelvic floor, core, and glutes all support your pelvis

• This one targets your glutes

• Feet together, open the top knee

• Don't roll your body backward

• Normal breathing

• Move up a band color if it's too easy

Lesson Summary

• Lie on your side, loop band above your knees.

• Keep your feet together and open your top knee.

• 10 reps each side.

• Keep your back still and breathe normally.

This one works all three muscle groups at the same time: your pelvic floor, your deep core, and your glutes.

Set up

• Lie on your back with your knees bent

• Loop band around your thighs, just above your knees

• Move your feet a little apart so there's tension on the band

• Keep that tension the whole time. Push your whole leg out, not just your knees.

How to do it

• Breathe in

• Exhale, squeeze your glutes, tighten your pelvic floor and deep core, and lift your bottom off the floor

• Breathe in as you lower back down

• 10 reps

If the band feels too easy, move up to one with more resistance.

Key Lesson Concepts:

• Works pelvic floor, core, and glutes together

• Keep tension on the band the whole time

• Exhale and tighten as you lift, inhale as you lower

• Move up a band color when it gets easy

Lesson Summary

• Loop band above your knees, feet apart, tension on.

• Exhale, squeeze, tighten, lift your hips.

• Inhale, lower down.

• 10 reps.

You've completed the first four weeks. Time to take your pelvic floor assessment again.

? Take the assessment here: https://pelvicfloorexercise.org/pelvic-floor-assessment

Answer as honestly as you did the first time. Your new score will be sent to your inbox.

Then compare it to your baseline score from before Week 1. Progress isn't always a straight line, but many people start noticing real changes by this point.

Keep up the great work, then move on to Week 5.

Up to now, your isolated pelvic floor holds have all been done lying on your back. This week we progress by changing position. On all fours, gravity works on your pelvic floor differently, so it's a new challenge.

Set up

Get on your hands and knees with your back flat and neutral. Not arched up, not sagging down. Imagine a stick lying along the center of your spine. It shouldn't move or fall off.

How to do it

• Long holds: hold 5 seconds, rest 10 seconds, 10 reps

• Then quick contractions: 1 second on, 1 second off, 10 reps

• Lift slowly like an elevator, stopping at each floor

• Keep your breathing normal. You should be able to hold a conversation.

Good to know

• You might feel your deep core tighten along with your pelvic floor. That's fine. We want them working together.

• Once 5 second holds feel easy, move up to 7 seconds. When 7 is easy, go to 10.

Key Lesson Concepts:

• Progressing to a new position: all fours

• Keep your spine flat, like a stick is resting on it

• 5 second holds, 10 second rest, 10 reps

• 10 quick contractions after

• Breathing stays normal

• Increase hold time as it gets easier

Lesson Summary

• Hands and knees, back flat.

• 10 long holds, then 10 quick contractions.

• Breathe normally the whole time.

• Progress to 7 or 10 second holds when ready.

A pelvic floor and deep core co-contraction in a more upright position. Since all your co-contractions so far were lying on your back, this makes gravity work harder against you.

Set up

Kneel in front of an exercise ball and rest your forearms on it, like a modified plank. Keep a little space between you and the ball. Don't lean your whole body on it.

How to do it

• Breathe in as you roll the ball forward

• Exhale as you roll it back, tightening your deep core and pelvic floor

• Follow along with the reps in the video

Watch your form

• Your spine stays neutral. No sagging and no rounding up.

• Only roll as far as you can control. Don't roll so far that you can't come back to the start with the contraction still on.

Want more challenge?

Do it with your arms straight instead of on your forearms. It's much harder.

Key Lesson Concepts:

• Co-contraction in a more upright position

• Inhale to roll forward, exhale and tighten to roll back

• Keep your spine neutral

• Only roll as far as you can control

• Progression: straight arms

Lesson Summary

• Forearms on the ball, a little space between you and it.

• Inhale, roll forward. Exhale, tighten, roll back.

• Stay in a range you can control.

• Keep your back flat the whole time.

Another pelvic floor and deep core co-contraction on all fours, this time with arm and leg movement.

How to do it

• Get on your hands and knees with your spine neutral

• Breathe in

• Exhale, tighten your deep core and pelvic floor, and reach one arm forward and the opposite leg back

• Come back to the start and switch sides

• 10 reps on each side

Watch your form

Remember the stick along your spine. It shouldn't move as you reach.

Too hard?

Coordinating an arm and the opposite leg takes practice. Start with just legs or just arms. Once that feels controlled, put them together.

Key Lesson Concepts:

• Co-contraction on all fours with arm and leg movement

• Exhale and tighten as you reach

• Opposite arm and leg together

• Spine stays still and neutral

• Scale down to legs only or arms only if needed

Lesson Summary

• Hands and knees, spine neutral.

• Inhale. Exhale, tighten, reach opposite arm and leg.

• Alternate sides, 10 reps each.

• Keep your back flat and still.

One of the best exercises in the program, because it works your pelvic floor, deep core, and glutes all at once.

What you need

A light weight. Anything around the house with a little weight works, like a water bottle.

How to do it

• Start in short kneeling: on your knees, sitting back toward your heels, holding the weight

• Breathe in

• Exhale and rise up to tall kneeling. Lift the weight overhead, squeeze your glutes, and tighten your deep core and pelvic floor.

• Breathe in as you lower back down

• 10 reps

Watch your form

Keep your spine neutral as you come up and go down.

Want more challenge?

Use a heavier item.

Key Lesson Concepts:

• Works pelvic floor, core, and glutes together

• Short kneel to tall kneel

• Exhale, squeeze, tighten as you rise

• Inhale as you lower

• Progress with a heavier weight

Lesson Summary

• Start sitting back toward your heels, holding a light weight.

• Exhale, rise to tall kneeling, weight overhead, squeeze and tighten.

• Inhale, lower down.

• 10 reps, spine neutral.

Back to isolated pelvic floor holds, now in a new position: sitting. Your pelvic floor has to work against gravity here, and there's more weight resting on it than when you're lying down.

Set up

• Sit on a chair (the video uses an exercise ball, which is harder because it moves)

• Feet flat on the floor. Don't sit anywhere your legs dangle, because your pelvic floor can't rest in that position.

• Sit tall with a neutral spine. Not slumped, not over-arched.

How to do it

• Long holds: hold 5 seconds, rest 10 seconds, 10 reps

• Then quick contractions: 1 second on, 1 second off, 10 reps

• Lift slowly like an elevator

• Keep your breathing normal. Talk or sing out loud if that helps.

Good to know

• It's normal to feel a weaker contraction sitting than lying down. That's exactly why we train it.

• Your deep core may tighten along with your pelvic floor. That's fine.

• When 5 second holds are easy, go to 7 seconds (13 second rest). When 7 is easy, go to 10.

Key Lesson Concepts:

• New position: sitting, working against gravity

• Feet flat on the floor, no dangling legs

• 5 second holds, 10 second rest, 10 reps

• 10 quick contractions after

• A weaker feeling while seated is normal

• Increase hold time as it gets easier

Lesson Summary

• Sit tall on a chair, feet flat.

• 10 long holds, then 10 quick contractions.

• Breathe normally the whole time.

• Progress to 7 or 10 second holds when ready.

A short break from the pelvic floor, core, and glutes. This one targets the smaller muscles that rotate your hip. Some of them are part of the pelvic wall, right next to your pelvic floor, so they matter too.

Set up

• Tie a knot in one end of your long resistance band and close it in a door so it's secure

• Loop the other end around your ankle

• Sit on the edge of a bed or table with your thigh resting flat

• The farther you sit from the door, the more resistance

How to do it

• Keep your thigh flat. Only your lower leg moves.

• Outward rotation: move your lower leg in toward your other leg, then back. 10 reps.

• Inward rotation: switch the band direction and move your lower leg out to the side, then back. 10 reps.

• Do both directions on both legs

• Slow and controlled. You should feel it in your hip.

Key Lesson Concepts:

• Targets the small rotator muscles of your hip

• Some of these muscles are part of your pelvic wall

• Anchor the band securely in a door

• Thigh stays still, lower leg moves

• Adjust resistance by moving closer or farther away

Lesson Summary

• Band around your ankle, anchored in a door.

• Rotate your lower leg in, then out, keeping your thigh still.

• 10 reps each direction, both legs.

• Slow and controlled.

Remember the Week 1 ball raises, where you lifted a weight while tightening your core and pelvic floor? This is the seated version. Sitting makes gravity work harder against your pelvic floor.

How to do it

• Sit tall holding a light weight close to your chest

• Breathe in

• Exhale and push the weight straight out in front of you while tightening your deep core and pelvic floor

• Breathe in as you pull it back in

• 10 reps

Watch your form

• Sit in a neutral position. Not slumped, not over-arched.

• Keep your shoulders relaxed and down, not shrugged up.

• Tighten only on the exhale. Never hold your breath and brace.

Key Lesson Concepts:

• Seated version of the Week 1 ball raises

• Exhale and tighten as you push out

• Inhale as you pull in

• Neutral spine, relaxed shoulders

• No breath holding

Lesson Summary

• Sit tall with a light weight.

• Exhale, tighten, push the weight out.

• Inhale, pull it back.

• 10 reps with relaxed shoulders.

Congratulations, you've made it to standing. This is the hardest position for your pelvic floor. When you stand, gravity and all your organs are resting on that bowl of muscles.

How to do it

• Stand tall with your arms relaxed at your sides

• Hold 5 seconds, rest 10 seconds

• 10 reps

• When 5 seconds feels easy, progress to 7 second holds with 13 seconds rest

Breathing

Keep your breathing normal. Don't tighten and then hold your breath. This is an isolated hold, so you're not timing it with your exhale.

Good to know

Your deep core will probably kick in when you tighten your pelvic floor. That's fine. You don't need to separate them. We want them working together.

Key Lesson Concepts:

• Standing is the hardest position for your pelvic floor

• 5 second holds, 10 second rest, 10 reps

• Breathing stays normal, no breath holding

• Your core joining in is a good thing

• Progress to 7 second holds when ready

Lesson Summary

• Stand tall and relaxed.

• 10 long holds: 5 seconds on, 10 seconds rest.

• Keep breathing normally.

• Move up to 7 second holds when it gets easy.

Your pelvic floor, core, and hip muscles all work together to keep your pelvis stable. This exercise gives your pelvic floor and core a break and strengthens your hips in four directions.

Set up

• Anchor your long resistance band low, for example closed in a door

• Loop it around one ankle

• The farther you stand from the anchor, the more resistance. Too hard? Step closer.

How to do it (10 reps each direction)

1. Back: face the anchor and move your leg straight back

2. Out: turn sideways and move your leg out to the side

3. Forward: face away from the anchor and move your leg forward

4. Across: turn to the other side and move your leg across in front of your standing leg

Then switch the band to your other leg. You can do all four directions on one leg first, or alternate.

Watch your form

• Spine stays neutral. Don't lean or twist your trunk to help.

• You don't need big movements. A small range is enough.

• Breathing stays normal.

• Bonus: your standing leg gets a workout too.

Key Lesson Concepts:

• Pelvic floor, core, and hips work together for pelvic stability

• Four directions: back, out, forward, across

• 10 reps each direction, both legs

• Adjust resistance by standing closer or farther

• Trunk stays still, breathing stays normal

Lesson Summary

• Band around your ankle, anchored low.

• Move your leg back, out, forward, and across.

• 10 reps each way, then switch legs.

• Small, controlled movements with a still trunk.

Your pelvic floor and deep core co-contraction, now in a movement you do every day: standing up from a chair.

How to do it

• Sit on a chair or bench

• Breathe in

• Exhale, tighten your pelvic floor and deep core, and stand up

• Breathe in as you sit back down. Everything relaxes.

• 10 reps

Watch your form

• Keep your spine neutral.

• Sit down slowly and with control. Don't just drop into the chair.

• Never hold your breath and bear down as you stand.

Key Lesson Concepts:

• Co-contraction during an everyday movement

• Exhale and tighten as you stand

• Inhale and relax as you sit

• Controlled sitting, no plopping down

• No breath holding or bearing down

Lesson Summary

• Sit on a chair.

• Inhale. Exhale, tighten, stand up.

• Inhale, sit down slowly.

• 10 reps.

The same sit to stand as Week 7.3, now with a loop band around your thighs to bring your glutes into the work.

How to do it

• Sit with a loop band just above your knees

• Push your knees out slightly so there's tension on the band. Keep that tension the whole time, sitting and standing.

• Breathe in

• Exhale, tighten your pelvic floor and deep core, and stand up

• Breathe in as you sit back down with control

• 10 reps

Watch your form

Keep your knees pointing forward. Don't let them fall inward. That shows your glutes are doing their job.

Key Lesson Concepts:

• Sit to stand plus glute activation

• Keep tension on the band the whole time

• Exhale and tighten as you stand

• Knees point forward, not inward

• Controlled sitting

Lesson Summary

• Loop band above your knees, tension on.

• Inhale. Exhale, tighten, stand up.

• Inhale, sit down slowly.

• 10 reps, knees pointing forward.