Pelvic Floor Training: Should You Squeeze or Not Squeeze?
Pelvic floor training has become one of those topics everyone seems to have an opinion on — squeeze, don’t squeeze, relax, lengthen, brace, breathe… it’s no wonder people feel confused. The conversation around pelvic floor training has become noisy, and somewhere along the way, the actual evidence can get drowned out.
So let’s bring some clarity back.
Pelvic Floor Training Works — And We Have the Highest Level of Evidence to Prove It
Pelvic floor muscle training (PFMT) has Level 1, Grade A evidence behind it. (FYI That’s the gold standard, the strongest endorsement research can give.)
So if you’ve been told pelvic floor exercises “don’t work,” “aren’t necessary,” or “are outdated,” please know this:
Pelvic floor training is still one of the most effective tools we have in pelvic health rehab.
But — and this is where the nuance matters — pelvic floor training is not the only tool.
The Pelvic Floor Is Not an Island
Here’s the thing: we don’t rehab any other part of the body by isolating one muscle forever.
If you injured your shoulder, you wouldn’t only strengthen your rotator cuff. If you had knee pain, you wouldn’t only train your quads. If you sprained your ankle, you wouldn’t only wiggle your toes.
You’d look at the whole system — mobility, strength, load tolerance, coordination, and how it all integrates into movement.
The pelvic floor deserves the same approach.
A pelvic floor training plan that includes only isolated squeezes is incomplete. A plan that includes only global training (hips, diaphragm, core) but no pelvic floor isolation is also incomplete.
You need both:
Pelvic floor isolation to understand the muscle
Whole‑body integration to make it functional
A rehab plan that misses either piece will struggle to shift your symptoms.
When the Pelvic Floor Is “Too Tight” or “Too Sore”
One of the biggest misconceptions is that a higher tone pelvic floor is a strong pelvic floor. It isn’t necessarily strong.
A high‑tone pelvic floor can develop for lots of reasons:
exercise habits
birth history
trauma response
pain response
stress or anxiety
protective bracing
But high tone does not equal good function.
A pelvic floor needs range of motion, just like any other muscle group. Think of a wrist that’s been in a cast — stiff, sore, weak, and lacking control. You wouldn’t strengthen it without restoring movement as well. You wouldn’t just train dexterity and expect it to have good grip strength.
Pelvic floor rehab is exactly the same.
Sometimes you need to teach length first.
Sometimes you need to teach coordination.
Sometimes you need to teach awareness.
Sometimes you need to teach load tolerance.
And yes — sometimes you absolutely need to squeeze.
This is why the Solomon et al paper is so helpful: the answer isn’t “always squeeze” or “never squeeze.”
The answer is: it depends on your pelvic floor.
Feeling Confused? You’re Not Alone.
Most people come to clinic unsure whether they should be:
squeezing
relaxing
breathing differently
avoiding certain movements
doing more
doing less
And honestly, you can’t know without an assessment. Pelvic floor function is complex, and guessing often leads to frustration.
Pelvic Health Physios Are Specialists in Pelvic Floor Assessment
We assess your pelvic floor:
in isolation
in movement
under load
with breath
as part of your whole body
We screen, assess, and build a plan that fits your pelvic floor — not a generic one pulled from the internet.
Our goal is simple: to shift the needle on your symptoms and help you feel confident, strong, and in control.
If you’re ready to stop guessing and start progressing, we’re here to help.