A short set of targeted moves that combine pelvic-floor squeezes with glute and core work can cut leakage, ease urgency and improve quality of life for many people — and new evidence continues to back pelvic‑floor muscle training as a first‑line therapy. Pelvic‑floor physical therapist advice published on a lifestyle site this week echoes long‑standing scientific findings: regular pelvic‑floor squeezes (Kegels) plus compound strength moves such as squats and core stabilisers recruit supporting muscles and protect against future problems. For Thai readers — where an ageing population and cultural practices around pregnancy and postpartum care shape women’s pelvic health — the message is simple and practical: prevention pays, supervised training is preferable, and these three low‑cost exercises can be started safely at home while seeking professional help when symptoms appear (Fit & Well; Cochrane review, 2018/2019).
Pelvic‑floor dysfunction matters because it is common and often hidden. International evidence shows urinary incontinence affects a large share of adults, especially women, and rises with age; many studies place lifetime prevalence for women between roughly 25–45% depending on definitions and age groups (Cochrane review summary). The lifestyle article quotes a figure for the US of “over 25 million” adults with temporary or chronic incontinence, underlining how widespread the issue can be in large populations (Fit & Well). Beyond leaking, pelvic‑floor problems can produce pain, sexual dysfunction and social isolation; they also reduce confidence in daily life and at work, an increasingly important public‑health and workforce issue as Thailand’s population ages.
The scientific backbone: what the evidence says. The largest and most authoritative summaries of trials endorse pelvic‑floor muscle training (PFMT) as first‑line care for women with urinary incontinence. A Cochrane systematic review and summary published in 2019 analysed 31 trials (about 1,800 women) and concluded that structured pelvic‑floor muscle training can “cure or improve” symptoms of stress, urgency and mixed urinary incontinence, reduce leakage episodes and improve condition‑specific quality of life; women with stress incontinence were many times more likely to report cure after PFMT than controls in pooled trials (Cochrane summary, 2019). Trials vary in size and methods, but the overall signal is strong enough that international clinical groups recommend PFMT as the first conservative step before devices, drugs or surgery.
Men also benefit, particularly after prostate surgery. Although most pelvic‑floor research historically focused on women, randomized trials and systematic reviews show PFMT helps men recover continence after radical prostatectomy and can shorten recovery time (systematic review — men after prostatectomy, 2019). This is why clinicians now encourage men as well as women to learn how to contract and lift the pelvic floor rather than assuming Kegels are “for women only.”
How the exercises work together. Pelvic‑floor muscles do not act in isolation: they form a functional unit with the deep abdominal (transversus abdominis) and gluteal muscles that stabilise the pelvis and support the bladder and urethra. When the glutes and core are weak, the pelvic floor must compensate; strengthening the supporting muscles improves coordination and reduces load on the pelvic floor. That is the practical rationale behind combining Kegels with squats and core‑stability moves — a point emphasised by a practising pelvic‑floor physical therapist quoted in the lifestyle article: “The pelvic floor works with other muscles around the pelvis. If you have weakness through the gluteal muscles or abdominal muscles, it means that the pelvic floor has to work harder” (Fit & Well interview).
Three practical moves backed by clinicians and trials. The therapist in the article recommends three accessible exercises that target the pelvic floor directly and its supporting systems: (1) squeeze and lift (pelvic‑floor squeeze/Kegel), (2) squat, and (3) tabletop toe tap (a lower‑abdominal stabiliser). A clear how‑to appears in the article: imagine stopping a bowel movement or “stopping yourself from farting,” squeeze and lift, hold for up to 10 seconds, then rest for five seconds; repeat for sets of up to 10 (Fit & Well how‑to). Squats recruit glutes and lengthen the pelvic floor when done with good form, and lower‑abdominal moves that engage the transversus abdominis will help the pelvic floor to switch on in coordination. These cues align with the supervised PFMT protocols used in many clinical trials cited in the Cochrane review (Cochrane protocols and trial descriptions).
Safety and warning signs. The therapist cautions — and the evidence supports — that exercises should not cause symptoms. “You should never be symptomatic during the exercise, so you shouldn’t have any leaking or any urgency when you’re doing the exercise, because that suggests you’re over challenging the pelvic floor,” the therapist told the lifestyle site (Fit & Well quote). Trials typically confirm correct contraction before training, often using biofeedback or clinician assessment, because many people believe they are doing Kegels but are either contracting the wrong muscles or bearing down instead of lifting. Supervision improves technique, adherence and outcomes; unsupervised programs are better than nothing but are generally less effective than supervised, progressive training (Cochrane review findings).
Thailand‑specific implications. Thailand’s demographic shift toward an older population and the cultural reality of high childbirth rates in older cohorts make pelvic‑floor health a local priority. Many Thai women observe traditional postpartum practices such as yu fai (postnatal rest by fire/heat therapy), which focus on recovery and care; adding gentle pelvic‑floor training into postnatal guidance — alongside education given at antenatal clinics and community health centres — could reduce long‑term incontinence risk. For working Thai men and women who perform heavy manual tasks (rice farming, market vending, construction, hospitality), strengthened pelvic support can reduce occupational leakage and improve comfort at work. Public hospitals and physiotherapy departments can incorporate basic PFMT instruction into routine antenatal, postnatal and geriatric care; community health volunteers and primary care nurses can teach the three‑move routine and escalate persistent symptoms to specialist pelvic‑floor physiotherapists.
Cultural factors and stigma. In Thailand, as elsewhere in Asia, pelvic‑floor symptoms carry stigma that discourages open discussion and retreat from social life; this contributes to under‑reporting and under‑treatment. Simple messages that frame pelvic‑floor exercises as “core and posture work” — comparable to well‑accepted practices like Tai Chi or yoga for balance — may reduce embarrassment and increase uptake. Apps and self‑management programs are promising: the Cochrane review and associated trials include app‑based programs that achieved good outcomes and cost‑effectiveness in some settings, showing digital approaches can complement clinic care when access is limited (Cochrane summary mentioning app trial).
What to expect and where the research is heading. Randomised trials consistently show meaningful reductions in leak frequency (about one fewer episode per day in many trials) and improved condition‑specific quality of life after several weeks to months of structured PFMT; longer‑term durability of benefit needs more robust trials and reporting, according to the Cochrane authors (Cochrane review conclusions). For men after prostate surgery, systematic reviews find PFMT helps speed the return to continence, but heterogeneity in protocols suggests optimal timing and supervision models still need clarification (systematic review — men). Future research will likely look at digital delivery (apps), hybrid supervised+home programs, and how best to integrate PFMT into primary care and maternal health pathways in middle‑income countries such as Thailand.
Actionable recommendations for Thai readers. Start small and prioritise correct technique: find a quiet moment to practise pelvic‑floor “squeeze and lift” by imagining stopping a bowel movement or holding in wind, try a 10‑second hold with a 5‑second rest for up to 10 repeats; add 8–12 squats with attention to hip and spine alignment; and include controlled lower‑abdominal stabilisers such as tabletop toe taps to recruit the transversus abdominis. Aim for strength sessions twice weekly, increasing to three times a week if you have symptoms, and avoid straining or bearing down during contractions (Fit & Well instructions; Cochrane evidence). If you experience leaking, urgency during exercise, pelvic pain or if you have had pelvic surgery (including prostate or gynaecological surgery), consult a healthcare professional: trained pelvic‑floor physiotherapists, obstetrics clinics, urology or general hospital physiotherapy departments can assess technique — often with biofeedback or supervised training — and tailor a program. Men recovering from prostatectomy should be referred for pelvic‑floor assessment early, since supervised programmes can accelerate recovery (men’s PFMT review).
A final note for policy and providers. Integrating basic PFMT education into antenatal classes, community health services and workplace wellness programmes in Thailand would be low‑cost and likely high‑impact. Training community health workers and primary‑care nurses to teach the three‑move routine, and setting up referral pathways to pelvic‑floor physiotherapy for complex cases, would address stigma and access barriers. Digital self‑management tools (apps) show promise for scalability where clinician time is limited, but they work best when initial technique is checked by a clinician.
Sources: the lifestyle interview and exercise guide were published by Fit & Well, which quoted a practising pelvic‑floor physical therapist and provided step‑by‑step instructions (Fit & Well article). The most recent high‑quality evidence synthesis is the Cochrane systematic review and abridged republication summarising 31 trials and finding PFMT effective for women with urinary incontinence (Cochrane summary, 2019). For men, a 2019 review of randomized trials examined PFMT after radical prostatectomy and reported benefits in recovery (systematic review — men after prostatectomy, 2019). For general pelvic anatomy and why core and glute work matter, see clinical overviews such as the Cleveland Clinic’s pelvic anatomy page (Cleveland Clinic — pelvis overview).
If you would like, I can prepare a one‑page printable handout in Thai that shows the three‑move routine with clear cues and common mistakes to avoid — suitable for antenatal classes or community clinics. Tags: #Health #WomensHealth #MensHealth #PelvicFloor #PhysicalTherapy #UrinaryIncontinence #Fitness #Thailand