Imogen Williams Physiotherapy and Pilates

05/10/2026

The reason you leak during high impact is not always weakness. Here is why your muscles are overworking.

Most people are told to just squeeze harder and do endless pelvic floor exercises. But think about your pelvic floor like a trampoline. If that trampoline is already pulled completely tight, it has zero give when your foot strikes the ground.

When muscles stay gripped all day to protect you, they get exhausted. When running impact hits, an already contracted muscle cannot contract any further to support you. That sudden pressure spike is why leaks happen.

Before you can build strength for impact, you have to teach your pelvic floor how to let go.

01/10/2026

When should you breathe out when lifting… for your pelvic floor?

I get asked this all the time in clinic, and my answer is always the same: it depends!

There isn’t one right way, and what works for you might change with the lift, the weight, or even the day.

Here’s what I’d play around with:

1. Breathe out at different points. Try the pull, then the press, then the lower, and see which feels best.

2. Try breathing in at different points too. Some people feel more supported breathing in as they lower, others as they lift.

3. Brace when you need to. For a really heavy lift, holding your breath and bracing can give you more stability, and that’s fine. But you don’t need to brace for everything. Doing it for lighter weights or everyday movements just adds pressure and tension you don’t need.

4. Don’t bear down. Pushing or straining downwards puts more load through your pelvic floor and makes pressure harder to manage. A good brace should feel like support all the way round your middle, not a push down.

Your pelvic floor and diaphragm work together like a piston, so notice how each option feels. Leaking, heaviness or dragging are just your body’s way of telling you to try something different, or drop the weight for now.

If things don’t settle, a pelvic health physio can help you work out what suits your body.

What do you usually do? Let me know below 👇

This is general education, not individual advice.

25/08/2026

Two weeks off, lots of family time, sandy shoes still in the hallway, and now back in clinic.

Always strange going from full family mode to full clinic mode in the space of a weekend, but I’m genuinely looking forward to seeing everyone I’ve got booked in over the next few weeks.

15/08/2026

So much of what people know about the pelvic floor comes from vague advice, “just do your pelvic floor exercises,” with no real explanation of what that means or whether it’s even the right thing for you.

Here’s what I wish more women knew…

Save this and share it with someone who needs to hear it 💜

11/08/2026

Whether you’ve had a baby, a caesarean, or gynae surgery like an endometriosis excision or a hysterectomy, there’s no universal week number for when you’re “ready.”

Healing depends on so much.

-What kind of birth or surgery you had
-How your body is recovering
-Your energy levels
-Your sleep
-Even how much support you have around you.

Comparing your timeline to someone else’s just adds pressure you don’t need.

Focus on your own signs of progress. How you’re actually feeling and functioning matters far more than how many weeks have passed.

That said, feeling good isn’t the full picture either.

Tissue takes time to heal, often longer than symptoms suggest. Muscle and skin heal fairly quickly, but deeper connective tissue and surgical repairs can take from a few months up to a year to fully regain strength.

Feeling great at 6 weeks doesn’t mean everything underneath is fully robust yet.

So it’s not about waiting until you feel ready, or ignoring how you feel and just following a calendar. It’s both.

How you’re functioning matters, and so does giving deeper tissue the time it actually needs.

Save this for the days you need reminding that your pace is the right pace, and that healing well is worth more than healing fast.

08/08/2026

A strong core isn’t about how it looks, it’s about how it functions.

So what should you actually pay attention to?

Can you keep breathing normally while you lift, carry or move, rather than holding your breath or gripping hard just to feel “held”?

Can you manage a cough, a sneeze or a lift without leaking or doming through your midline?

Can you get through your day, lifting kids, carrying shopping, getting up off the floor, without your core giving out?

That’s what core strength actually looks like.

What it looks like in the mirror has nothing to do with any of that.

Save this for the next time you catch yourself judging your stomach instead of noticing what it can actually do.

06/08/2026

Two years postnatal, a long distance runner, and she’d already been assessed and given the all clear. Her pelvic floor was strong. On paper, nothing wrong. But she was still leaking on every long run.

The all clear wasn’t wrong exactly, it just wasn’t the whole picture. Strength was never really the issue. Once we looked closer, here’s what we found:

Good pelvic floor strength but poor coordination, she was better at contracting than releasing.

A pattern of breath holding under load instead of coordinating breath with effort.

Underactive glutes, so her pelvic floor was compensating for work her hips should have been doing.

Reduced hip internal rotation and abduction strength.

Balance and lower limb control that broke down with fatigue, which is exactly when the leaking started.

So we built a plan around the full picture. Pelvic floor coordination work, hip strength, balance and running specific drills, and a proper warm up that preps hips and pelvic floor before she runs.

Three sessions in, she’s running 10km leak free.

Pelvic floor strength is one part of the picture. Coordination, breath, hips and running mechanics are often the parts that get missed.

Save this if you’ve been given the all clear but you’re still leaking on runs, there might be more going on.

04/08/2026

This is one of the most common questions I get, and honestly, there’s no single answer that fits everyone.

It depends on your birth (vaginal or caesarean), how you’re recovering, your pelvic floor and core function, your sleep, your stress levels, even how many kids you’ve had. Two women at 8 weeks postpartum can be in completely different places.

Rather than chasing a specific week number, start by rebuilding the basics. Bodyweight squats, walking, lunges, Pilates based movement. These build strength, load tolerance and control without overwhelming a system that’s still healing.

From there you gradually add intensity, more load, more impact, more speed, based on how your body responds rather than a date on a calendar.

If running, jumping or heavier lifting is the goal, it’s still there waiting for you. Building the foundation first just means you get back to it with a body that’s actually ready, not one that’s guessing.

Save this if you’re in the “not sure when to start” phase. It’s normal to feel unsure, and it’s okay to start small.

01/06/2026

I speak to so many women who have quietly stopped running, changed routes based on toilet access, worn dark leggings “just in case”, or accepted leaking as something they have to live with after having children.

But leaking with running is common… not normal.

Your pelvic floor is part of your whole system. Running places repeated load and pressure through the body, and if the pelvic floor isn’t managing that pressure well, symptoms like leaking can happen.

That doesn’t automatically mean your pelvic floor is “weak” either.

Sometimes it’s about:

* pressure management
* breathing mechanics
* strength and coordination
* return to impact too quickly
* stiffness or tension through the pelvic floor
* fatigue and load
* core and hip strength
* running technique

And yes, pelvic floor exercises can help, but they’re only one piece of the puzzle.

You shouldn’t have to give up running because of leaking.

With the right assessment, rehab and graded return to impact, many women can get back to running confidently again.

If this is something you’re struggling with, please know you’re not alone and support is available 🤍

Save this post for later or send it to a running friend who needs to hear this.

31/05/2026