There are a number of reasons why your pelvic floor dysfunction clients aren’t getting results.

I’m not talking about “quick fixes” here, because whilst some of my pelvic floor personal training clients have seen an improvement in their stress incontinence symptoms in just 4 days (which is pretty awesome!), that is certainly NOT the message I usually convey.

To give you some context: I see my personal training clients every 3-4 weeks, over a 5-6 month period, and usually by appointment 2 or 3, they’re beginning to feel the effects of my magic, which is pretty extraordinary.

Perhaps you’ve been working with someone with grade 4 prolapse recently and both you and your client are feeling despondent at not seeing any change in their symptoms.

Why is it that some clients feel the benefits from your work, but not others?

Well today I’m here to spell out some of those missing links you may not be aware of, so here goes.



Let me start with an all too common story…

I remember talking to a corporate Pilates client once who asked me a question about sciatica after class.

She lead with: “My sciatica seems to have come back, Claire. Are there any exercises you’d recommend?“.

I followed up with: “Oh ok, I’ve had sciatica myself…tell me about your week….what you’ve been up to exercise and movement-wise…“.

And, sure enough, we then untangled things for her to highlight that:

a) the Sunday before she did a 10K run, followed by
b) for 3 days after the run (Monday-Wednesday), she spent most of it driving, sitting and being pretty sedentary

So, it’s no wonder her sciatica flared up again: she went from a tonne of repetitive activity in a short space of time (running), to pretty much zero activity in a matter of seconds (sitting).

The moral of the story here: when you learn about all the negative things associated with biomechanics like: torque, tension, friction, incorrect loads, osteoarthritis etc it’s relatively easy to attribute pain or dysfunction to something that the client has done to themselves.

Not in all cases obviously so if you’re thinking: “Yeah, but Claire, surely someone who got prolapse from childbirth didn’t DO that to themselves, did they…?!“.

My answer: “Possibly no, but you know what would’ve been interesting to do? Some prep work with that prolapse client DURING pregnancy to fish out any existing incorrect loads, teach her better ways to “birth” her baby, and address her habits in day-to-day life to get her pelvic floor functioning better.“.



The second missing link is that you’re focusing way too much on the pelvic area and not going further north or south in search of dysfunction that is incorrectly loading the pelvic floor muscles.

pelvic floor personal trainer holding client's pelvis

Treating clients with pelvic floor dysfunction is more than just assessing the pelvis

Here’s a list of what I look at ABOVE the pelvis that affects load on the pelvic floor:

• breathing mechanics
• reflexive core function
• rib cage placement
• rounded shoulders
• lumbar/thoracic immobility
• forward head posture

And, this is what I look at BELOW the pelvis that inhibits pelvic floor function:

  • femur positioning
  • ankle range of movement
  • forefoot immobility
  • quad tension
  • kneecap function
  • calf and hamstring length
  • foot innervation
  • footwear choices

These lists are by no means exhaustive, but if there’s something on these checklists that you’d like clarified, comment below and I’ll happily explain its significance, ok?

Before I started experimenting with the full-body approach, my protocols involved:

  • Kegels
  • Pilates and other core-based exercises
  • squats (because I’d read somewhere that “squats are the new Kegel”)
  • some random butt-building exercises, and
  • a bit of stretching and mobility thrown in for good measure


Nowadays, I follow a full-body protocol, and I haven’t yet worked with a client (male or female) whose pelvic floor hasn’t seen improvement in the time they’ve worked with me, which is really satisfying.



What’s that?  Walking.

As humans, we were put on this planet to hunt and gather, and to do that, we had to walk miles and miles and miles.

“Exercise” is actually a completely made up term and a completely made up activity.

Sure, we wouldn’t ever tell our clients that because we’d lose our livelihoods if we did.

But, if we had to hunt, prepare, cook, preserve and harvest all of our own food to feed ourselves daily, we wouldn’t have as much of an obesity problem, would we?

Agriculture actually relieved us of a lot of our natural duties as a human being.

And nowadays we don’t even need to walk anywhere to get food – we can just click a mouse, or tap our phone a few times and a driver delivers our deliciously essential calories that keep us alive (and sedentary) – straight to our doorstep.

We do very little “natural movement” nowadays.

We drive, we sit, we avoid the stairs…

…and sadly, we have to get gym memberships or go to Pilates classes to lose weight…

…BECAUSE we drive, we sit and we avoid the stairs.

Walking is essential for pelvic floor health, but…it’s not enough to just say to clients “You need to walk more“.

It’s your role as their pelvic floor specialist to help them to walk BETTER, and that’s the missing link here I’m trying to convey here.

• Walking badly = no posterior push off

• Walking well = pelvic floor length and load

I personally walk 100 miles a month and have done since April 2017 because I like to lead by example.

selfie of me walking in woodlands

Walking is essential for optimum pelvic floor function.


I don’t walk because the government guidelines TELL me I need to walk on average 3 miles per day – I do it because I want to continue to be able to do this activity well into my later years.

I feel no soreness, pain or exhaustion when hiking (unless I’m with a group of slower walkers), and that’s because I do a lot of it.

Now over to you.

What lifestyle factors are YOU addressing regularly with clients?

Can you see that there might be a few missing links in the exercises you’re setting for clients, and the dysfunctional red flags you’ve been neglecting?

Want to learn MORE about how simple, yet seemingly insignificant everyday movements and actions can have a positive (or negative) impact on someone’s pelvic floor?

Well, check out Your Pelvic Matters, my signature pelvic floor certification, where I share ALL of the lifestyle factors that attribute to pelvic floor dysfunction, as well as ALL of the exercises and techniques I use to get my pelvic floor clients results, without Kegels.