Pelvic Floor & Core Rehabilitation

Pelvic Floor & Core Rehabilitation

Your foundation for strength, confidence, and control

Your pelvic floor has been through a lot. Surgery changes how it supports your organs, how it responds to pressure, and how it feels when you move. The good news is that this system is designed to adapt and recover. You don’t need to rush or overthink it, but you do need to reconnect with it gently and consistently.

This section is not about squeezing harder or chasing a six-pack. It’s about coordination, confidence, and rebuilding your relationship with your body.

What the Pelvic Floor Does

Your pelvic floor is a group of muscles and connective tissue that forms a supportive sling at the base of your pelvis. It holds up your bladder, bowel, and vagina, and it works automatically every time you breathe, move, or lift.

After a hysterectomy, it may feel different; heavier, weaker, or uncoordinated. That’s completely normal. These muscles can absolutely retrain with time and care.

When to start

Most women can begin gentle pelvic floor connection exercises within the first few days after surgery, as long as there’s no pain. You are not “working out” yet - you’re reconnecting.

Start by focusing on awareness and breath. If your surgery was complex or included pelvic floor repair, your surgeon or physiotherapist may adjust the timing, so always check first.

Early gentle activation helps reduce swelling and improves circulation, but forceful squeezing too soon can cause discomfort and delay healing.

Early Connection: Breathe, Feel, Reconnect

Start with your breath. When you inhale, your diaphragm moves down, and your pelvic floor naturally relaxes. As you exhale, the diaphragm rises and the pelvic floor gently lifts.

Try this once or twice a day:

  1. Lie comfortably with knees bent and shoulders relaxed.

  1. Inhale slowly through your nose, feeling your belly and ribs expand.

  2. Exhale gently through your mouth and notice a soft lift or tightening around your vagina or anus.

  3. Relax fully at the end of each breath.

This isn’t a competition or a test. The goal is awareness and coordination, not intensity.

What to Avoid

Don’t hold your breath while tightening your pelvic floor.

  • Don’t clench your buttocks, thighs, or jaw — these muscles love to “help” but only get in the way.

  • Don’t do hundreds of fast squeezes or “challenge” routines from social media.

  • Don’t panic if you feel nothing at first. Connection returns gradually.

Remember, you’re healing from major surgery. Your pelvic floor needs the same respect as your incisions.

When and How to Progress

By six to eight weeks, once cleared by your consultant or pelvic health physiotherapist, you can begin structured pelvic floor training.

Start with a simple pattern: gently tighten the muscles as if stopping a wee, hold for three to five seconds, then relax fully for the same time. Repeat five times. Over time, you’ll build both strength and endurance.

Combine this with gentle core exercises such as supported bridges or deep belly breathing. These build stability without straining your abdominal wall or internal sutures.

When ready, your physio will guide you through functional retraining, learning how your pelvic floor responds during real-life tasks like lifting, coughing, or exercising.

Professional Support

A pelvic health physiotherapist is your best ally here. They can assess how your pelvic floor is healing, guide you on correct activation, and help you progress safely toward your personal goals.

If you experience leaking, heaviness, bulging, or pain, please don’t push through it. These are signals that your body needs more guidance, not that you’ve failed.

The Bigger Picture

Reconnecting with your pelvic floor is about trust, not tension. These muscles are part of how you move, laugh, lift, and live, they’re your foundation, not your limitation.

Start small, be patient, and celebrate progress. Strength and confidence will come back, one mindful breath at a time.

When you feel ready, we’ll build on this foundation in Return to Exercise & Loading where you’ll learn how to add strength, impact, and freedom back into movement safely.