Signs of a Weak Pelvic Floor

The most common sign of a weak pelvic floor is leaking a little urine when you cough, sneeze, laugh, jump or lift something heavy. Other signs include a sudden, urgent need to go to the toilet, difficulty controlling wind, and a feeling of heaviness or dragging in the pelvis. These symptoms are common, especially after pregnancy, with age or with heavy lifting, but they are not something you simply have to live with. Below we list the signs, explain what the pelvic floor does, and show how Pilates can help you strengthen it, alongside advice from your doctor or physio.

Everyone’s experience is different, but these are the signs most often linked with pelvic floor weakness:

Leaking urine when you cough, sneeze, laugh, run, jump or lift (often called stress incontinence).
A sudden, strong urge to urinate, needing to go often, or not always making it to the toilet in time.
Difficulty controlling wind, or occasional bowel leakage.
A feeling of heaviness, dragging or pressure in the pelvis or vagina, or a sensation of a bulge, which can be a sign of pelvic organ prolapse.
Reduced sensation or control during sex.
In men, dribbling of urine just after going to the toilet.

When to see a doctor or physio

If you notice any of these signs, speak to your doctor or a women’s (pelvic) health physiotherapist before starting an exercise programme. They can confirm what is going on, rule out other causes and check whether your pelvic floor is weak or, in some cases, overactive and tight, which needs a different approach. See a doctor promptly if you have pain, blood in your urine or stool, or a new bulge. At Pilates Dynamics, our biokineticist, Aurelie, can then help you build a safe, progressive programme.

What are the pelvic floor muscles?

The pelvic floor is a group of muscles that forms the base of your core. It stretches like a hammock from the pubic bone at the front to the tailbone at the back, and from one sitting bone to the other. The main muscles are the puborectalis, pubococcygeus, iliococcygeus and ischiococcygeus.

What does the pelvic floor do?

Lets you control the release of urine, faeces and wind, and delay it until it is convenient.
Supports the bladder, bowel and, in women, the uterus.
Helps stabilise the joints of the pelvis, including the sacroiliac joints.
Contributes to sexual function in both men and women.
Supports the growing baby during pregnancy.
Works together with the diaphragm and abdominal muscles to manage pressure inside the abdomen.

Endurance and power

The pelvic floor contains both slow-twitch (endurance) and fast-twitch (power) muscle fibres. The slow fibres keep up gentle support all day, while the fast fibres switch on quickly when you cough, sneeze or jump. Good pelvic floor training works both.

How Pilates can help a weak pelvic floor

The pelvic floor can be trained with regular, specific exercise, but first you need to learn to find the right muscles and switch them on correctly. This is where Pilates comes in.

Learning to engage: instructors teach you to locate and gently activate your pelvic floor before and during movement.
Working with the deep abdominals: the pelvic floor and deep abdominal muscles work together, so Pilates trains them as a team rather than in isolation.
Breathing: Pilates breathing helps you coordinate the diaphragm and pelvic floor.
Alignment: good pelvic and spinal position makes it easier for the pelvic floor to work. Our post on neutral spine vs imprinted spine explains why this matters.
Carry-over: because you practise engaging your pelvic floor throughout every class, it becomes a habit in daily life.

Many clients find this steady, mindful approach helps, but results vary and Pilates works best as part of the plan your doctor or physio recommends.

Pelvic floor health during and after pregnancy

Pregnancy and birth place extra load on the pelvic floor, so it is one of the most common times for symptoms to appear. Once your doctor has cleared you to exercise, our pre- and post-natal Pilates classes are adapted for each stage, with a focus on the core, back and pelvic floor. Aurelie can also work with you one-on-one if you need more support.

Frequently asked questions

Do I need Pilates experience to join a class?

No. New clients start with a beginner assessment that covers the basics of muscle recruitment and alignment. If you need a few private classes before joining a group, we can arrange that.

Can men have pelvic floor weakness too?

Yes. It can follow prostate surgery, heavy lifting, chronic coughing or ageing. The same advice applies: see your doctor first.

Is pelvic floor weakness just part of getting older?

It is common, but not something you should ignore. Many people improve with the right guidance.

Book a class or speak to Aurelie

Start with a beginner assessment and let us know about any pelvic floor concerns so we can plan your classes around them. See current class prices, or contact us on 011 792 5459 / 072 999 2229 (WhatsApp 072 999 2229) or info@pilatesdynamics.co.za.

Signs of a weak pelvic floor and how Pilates can help