Best exercises for pelvic floor dysfunction
According to studies all 4's might be one of the best positions for your pelvic floor and core- and you know that theres a reason behind everything we do in hypopressives.
If you have ever been in a hypopressives session, or explored any pelvic floor rehabilitation work, you will likely have spent some time on all fours, the quadruped position. It might feel like a simple starting point, but the research behind this posture is strong!
A 2025 study published in PMC - Which Positions Optimise Pelvic Floor Activation in Female Athletes? compared pelvic floor muscle activation across multiple exercise positions using electromyography (EMG).
The findings were clear. The squat produced the highest activation, followed closely by the plank and the quadruped (all fours) position. Supine and standing positions produced significantly lower levels of activation by comparison.
Crucially, the authors also noted that these positions did not produce significant negative effects on intra-abdominal pressure - challenging the traditional view that load-bearing or gravity-defying positions should be avoided in pelvic floor rehabilitation.
A further body of EMG research reviewed by the Brookbush Institute on core muscle activity in the quadruped position confirmed that trunk and extremity muscles work in synergy during four-point kneeling exercises.
The highest muscle activity was recorded in the ipsilateral multifidus lumborum and gluteus maximus, two muscles that are frequently underactive in women with pelvic floor dysfunction, lower back pain and postural disorganisation.
Importantly, the research concluded that no single muscle is solely responsible for core stabilisation in this position. It is a team effort and the quadruped position appears to recruit that team efficiently.
In hypopressives we have 3 quadruped positions with variations/progressions in all of those.
In this weeks class we explored those and played with adding more activation with some progressions.
If you've already trained in hypopressives and want to join my Keep It Up Club follow the link or message me for more details.
New to hypopressives?
The Pelvic Power Workshop is the perfect introduction - practical, evidence-informed and designed to make this method accessible from day one.
Interested in teaching hypopressives?
Find out more about the Hypopressives Teacher Training - a comprehensive pathway accredited by the International Hypopressive Council.