Article written by Mish Wright.
Let’s clear this up right away: the pelvic floor is a muscle. Like any other muscle in the body, it can get weak and dysfunctional, it can be too tight and dysfunctional, and here’s the good news – it can get stronger at any age or stage of life.
But none of this matters if we can’t even get the words “pelvic floor” out of our mouths. Too many trainers choke on it like a piece of toast loaded with peanut butter. If we can’t name it, how can we possibly train it?
For fitness professionals, learning to talk about the pelvic floor in the same way we talk about glutes, hamstrings or the core is the first step in shifting the culture.
Trainers Don't Have X-Ray Vision
Here’s the reality check: no trainer has x-ray vision. You cannot look at a client and know if they’re on the verge of a prolapse or dealing with incontinence.
A quick sidebar for definitions:
- Prolapse means the bladder, bowel or uterus is shifting down into the vaginal wall, often felt as heaviness, dragging, or pressure.
- Incontinence is involuntary leaking – and yes, this can happen when the pelvic floor is weak, but also when it’s too tight and can’t relax properly.
So, while we can’t “diagnose” with our eyes, we can create safer training environments, ask the right questions, and know when to refer.
Small Shifts Make a Big Difference
Fitness instructors give modifications all the time – especially for people with lower back issues. “Here’s an option if you want to keep it lower impact.” “Here’s a regression if your back’s feeling tight today.”
Why should pelvic floor options be any different?
Even small shifts in language – “if you have any kind of pelvic floor dysfunction, like leaking, here’s another option” – create a safe setting for people to feel included rather than shamed. Trainers don’t need to launch into a lecture mid-class. Just like you would for a sore knee or tight shoulder, provide a choice, normalise it, and keep moving.
Many of the modifications you might give for lower back pain also work here. And this might be your mental trigger to remember to include pelvic floor. The words may be: “If you have dodgy knees, sore lower back or any kind of pelvic floor dysfunction – this is your option.”
The Breath - Pelvic Floor Connection
One of the simplest and most powerful cues you can add for pelvic floor safety is: exhale on exertion (or on the concentric phase of the exercise).
This isn’t a puff of air at the top of the squat. The exhale needs to start before you go. That little shift helps reduce pressure pushing down on the pelvic floor and keeps the diaphragm and pelvic floor working in sync.
The diaphragm and pelvic floor have a synergistic relationship. When you inhale, the diaphragm lowers and the pelvic floor responds; when you exhale, the diaphragm lifts and the pelvic floor recoils. Coaching breath properly means you’re not only protecting the pelvic floor, but also teaching clients how to move with more efficiency, control and mindfulness to what is happening in their body.
It’s a small cue with a big impact – and it can change the way clients feel in their lifts, runs, and even day-to-day movement.
The Forgotten Cue: Relax
Most trainers have at some point said: “Engage your pelvic floor” or “Switch on through the core.” That’s not always wrong, but here’s the missing piece: relaxation matters just as much as contraction.
A tight pelvic floor can cause leaking just as easily as a weak one. Imagine a fist clenched so tightly it can’t pick anything up – same principle.
So, if someone is leaking and you keep telling them to “do more kegels “(the American term for pelvic floor muscle training), you might be sentencing them to a lifetime of pelvic pain and bad sex. Not exactly the outcome anyone is looking for.
Adding cues to let go at the end of class, especially during the cooldown, helps balance the message. “Soften through the jaw, let the pelvic floor relax, breathe into the belly.” Simple, inclusive, and game-changing.
Build Your Referral Network
Here’s where fitness professionals need to park the ego: you are not the pelvic floor expert. That role belongs to pelvic health physiotherapists.
They’ve got the magic tools (and training) to actually assess what’s happening – whether the floor is weak, tight, or a mix of both. They can then guide both the client and the trainer on what to do next.
The smartest move you can make as a trainer? Build a relationship with a local pelvic health physio. Not only will you learn from them, you’ll also show your clients you take their health seriously. That builds trust – and trust is what keeps clients coming back.
Making Pelvic Floor Conversations Normal
This is where the industry needs to evolve. We’ve normalised cues around “core,” “abs,” and “back safety” – so why does the pelvic floor still feel like a taboo word?
The more often trainers name it and include simple options, the more normal it becomes. Clients feel seen, conversations open up, and you avoid the trap of pretending everything below the waist is off-limits.
And here’s the kicker: pelvic floor awareness doesn’t just help women in menopause or post-birth. Men, athletes, and young women all benefit from understanding this muscle group too.
The pelvic floor is a muscle, not a mystery. It can weaken, it can tighten, and it can strengthen – but only if fitness professionals start treating it like the essential part of the body that it is.
You don’t need x-ray vision. You need awareness, a few simple modifications, and a willingness to talk about it. Add in cues for breathing and relaxation, normalise options in group settings, and keep your local women’s health physio on speed dial.
That’s not just good coaching – it’s good business. Because clients who feel safe, understood, and pain-free? They stick around.
Mish Wright (B.Ed, Dip Teach) is an award-winning writer, speaker, and educator recognised as one of the foremost leaders in women’s health and fitness. Named the 2024 Fuel Woman of the Year and Educator of the Year in both Australia (2021, 2024) and New Zealand (2023), Mish has challenged the industry to address the gender gap in fitness education. She is Head of Education at Women’s Fitness Education (WFE), where she delivers women’s health–focused training as part of Certificates III and IV in Fitness. Her four courses, sold in five countries and completed by thousands of professionals, continue to reshape how fitness is taught and practised.
Mish is the creator of the Menopause Training Matrix™, a system that helps trainers translate research into symptom-led, client-centred programming, and the GRACE Protocol™, a simple yet powerful framework for midlife women’s training built around Grit, Regulate, Accumulate, Cardio, and Endurance. Through her writing and speaking, she pushes the industry toward systemic change, making women’s health education both accessible and practical for fitness professionals worldwide.
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