Pelvic Floor Exercises: Why Squeezing Alone Is Not Enough, And What Cut Leaks By Two Thirds
Pelvic floor exercises: the short answer
Most women are taught one pelvic floor exercise: squeeze and hold. It helps many women with leaks when they cough or laugh. But squeezing alone is not the whole answer, and for some women it makes things worse. A healthy pelvic floor is springy. It lifts when it needs to, lets go fully, and moves with every breath.
The best evidence now says regular movement with attention to the pelvic floor and the breath is what counts. In a 2024 trial, 12 weeks of pelvic yoga cut daily leaks by about two thirds. Here is the article in short form:
- Squeezing exercises help, but they are not the whole answer.
- A pelvic floor can be too tight as well as too weak.
- The pelvic floor moves with every breath, about 20,000 times a day.
- 240 women: yoga cut leaks by about two thirds in 12 weeks.
- A 14-trial review: yoga matched standard pelvic floor training.
- Sit on the sitting bones, not the tail.
A quick word on Iyengar yoga. Iyengar yoga is the style developed by Mr BKS Iyengar. His daughter Geeta Iyengar did more than anyone to work out how yoga should change for women at each stage of life. The pelvic yoga in the big American leak trials was informed by Iyengar yoga. It is the style we teach at Flametree, in Darwin and live online.
Sitting on the sitting bones, not the tail. The pelvic floor can only work well from an upright pelvis.
Are pelvic floor exercises enough for bladder leaks?
Squeezing on its own often is not. Kegel exercises, squeezing the muscles you would use to stop the flow of urine, were devised by an American gynaecologist, Dr Arnold Kegel, in the 1940s. They help many women with stress leaks. But they became the answer for everything.
Leslie Howard, an American yoga teacher trained in the Iyengar tradition who works on the pelvis, and Judith Hanson Lasater, a yoga teacher since 1971, both point out that for a tight pelvic floor, and for urge leaks, more squeezing can make things worse. Howard adds two traps. Practising by stopping the stream halfway can stop the bladder emptying properly. And many women who think they are lifting are actually bearing down.
The aim is a pelvic floor that can do both: lift when needed, and let go fully.
Can a pelvic floor be too tight?
Yes. A pelvic floor can be too tight as well as too weak, and a tight muscle is not a strong muscle. A too-tight pelvic floor can cause urgency, pain and leaks of its own. Long hours of sitting on the tail, a belly held flat for years and constant stress all keep it clenched.
That is why a good class works on both sides. Standing poses build tone and life in the legs and pelvis, as Geeta taught. The lying rest and the long out-breath teach the muscles to soften.
The shape of a class: tone and life in the standing poses, letting go in the rest. A pelvic floor needs both.
How does breathing affect the pelvic floor?
Directly. The diaphragm, the big breathing muscle under the lungs, is shaped like a dome. On the in-breath it flattens and moves down, the belly and sides widen, and the pelvic floor softens and moves down too. On the out-breath, the deep belly muscle firms like a corset and both domes lift. It happens about 20,000 times a day.
Howard sees many women who do the opposite, which she calls reverse breathing: they pull the belly in on the in-breath, often after a lifetime of holding the stomach flat. That stops both domes moving. A soft belly on the in-breath lets the whole system move again. This is one reason the breath work in our classes matters so much.
Two domes that breathe together. On the in-breath both soften and move down; on the out-breath both lift.
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What did the yoga trials find for leaks?
Researchers at the University of California, San Francisco, have now run three trials of yoga for bladder leaks.
- 2014, 19 women: leaks fell 70% in the yoga group, 13% in the waiting group.
- 2018, 56 women, Iyengar-based yoga: leaks fell 76% with yoga, 56% with stretching.
- 2024, 240 women aged 45 to 90 with daily leaks: 12 weeks of pelvic yoga cut leaks from about 3.4 a day to about 1.1, two thirds fewer. A general stretching and strengthening programme did a little less well, at about 1.5 a day.
And the wider picture: a 2025 review of 14 trials, with 797 women with stress leaks, found yoga, Pilates, breathing and core work worked as well as standard pelvic floor muscle training, and much better than usual care.
How a fair trial works. The leak trials split women by chance, then counted leaks before and after.
What do pelvic floor exercises look like in a yoga class?
Mostly they do not look like pelvic floor exercises at all. Our books and posts explain rather than teach poses step by step, because a teacher adjusts each pose to you. But the principles are simple.
- Spread, don’t tuck. The tailbone is never tucked under. Wide-legged poses spread the pelvis.
- Tone, don’t flop. Standing poses give the legs and pelvis life and lift.
- Sit on the sitting bones. A folded blanket under the sitting bones makes it easy.
- Soft belly on the in-breath, lift on the out-breath. The breath does the pelvic floor work for you, all day.
Wide-legged seated poses spread the pelvis rather than tucking it. Spread, don’t tuck; tone, don’t flop.
Where can I learn pelvic floor exercises in Darwin?
For pelvic floor exercises in Darwin, come to class at Flametree’s Woolner or Coolalinga studio, or join live online from anywhere in Australia. Our beginner classes, Women’s Wellness and restorative classes all work on tone, letting go and the breath. Feel free to check with your professional advisers if you wish, but also give yoga a try.
See also Stress Incontinence, Yoga For Pelvic Floor and Painful Intercourse After Menopause.
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Your free copy of Cool, Calm And Strong is waiting. New to Flametree, or away for 3 months or more? You get 2 free classes + 2 ebooks, only available via this offer. Already coming to class? You can still get the book.
Frequently asked questions
What are the best pelvic floor exercises for women?
Ones that train the pelvic floor to lift and to let go, with the breath. In a 2024 trial of 240 women, 12 weeks of pelvic yoga cut daily leaks by about two thirds, and a 2025 review found yoga worked as well as standard pelvic floor training.
Are Kegels the only pelvic floor exercise?
No. Kegels, squeezing the muscles that stop the flow of urine, help many women with stress leaks. But a pelvic floor also has to let go, and it moves with every breath. Standing poses, breath work and rest train the parts squeezing misses.
How do I know if my pelvic floor is too tight?
Signs can include urgency, pain with sex or on sitting, trouble emptying the bladder, and leaks despite lots of squeezing. A pelvic floor that is always clenched is not strong. Softening on the in-breath and in rest helps it work again.
Should I stop my wee midstream to practise?
No. Leslie Howard warns that practising by stopping the stream halfway can stop the bladder emptying properly. Practise the lift and release away from the toilet, ideally with the breath.
Should I pull my belly in when I breathe?
No. The diaphragm and pelvic floor are two domes that move together: down on the in-breath, up on the out-breath, about 20,000 times a day. Pulling the belly in on the in-breath stops that movement; a soft belly lets it work.
Is it too late to train my pelvic floor after menopause?
No. The 2024 trial included women aged 45 to 90. Standing poses build tone in the legs and pelvis, and the breath work trains the pelvic floor all day. Women in the trial had about two thirds fewer leaks after 12 weeks.
How long do pelvic floor exercises take to work?
The yoga trials ran for 6 weeks to 3 months, and leaks fell by 70% or more in some. Most women notice a difference within a few weeks of regular practice. Keeping it up keeps the gains.
Where can I do pelvic floor exercises in Darwin?
Flametree Yoga Studio teaches Iyengar yoga at Woolner and Coolalinga in Darwin and live online. Beginner, Women’s Wellness and restorative classes all work on pelvic floor tone, letting go and the breath.
Where to next
- New to yoga, or coming back? Start with our half price 10 class pass with 2 classes free, in Darwin or live online.
- For a workplace, team or group: book private yoga classes for groups, online, at a Flametree studio or at your venue.
- Want to see class times first? Look at the beginner timetable.
Flametree Yoga Studio, Darwin and live online. This article is general information, not medical advice. Feel free to check with your professional advisers if you wish, but also give yoga a try.
Sources: Huang AJ and colleagues, Efficacy of a therapeutic pelvic yoga program versus a physical conditioning program on urinary incontinence in women (240 women), Annals of Internal Medicine, 2024; Huang AJ and colleagues, yoga for urinary incontinence pilot trials, 2014 and 2018; Hao J and colleagues, Alternative exercise regimens for stress urinary incontinence in women (14 trials, 797 women), International Urogynecology Journal, 2025; Hjartardottir S and colleagues, The female pelvic floor: a dome, not a basin, Acta Obstetricia et Gynecologica Scandinavica, 1997; Leslie Howard, Pelvic Liberation, 2017, foreword by Judith Hanson Lasater; Geeta Iyengar’s teaching. Further reading: Huang and colleagues, Annals of Internal Medicine, 2024. Full references are in the Cool, Calm And Strong ebook.
