Everyone with a pelvic floor should be doing the “10:10:3” daily…. Are You?

Today I want to explain to you what the 10:10:3 is and why we should all be doing it every day…. For the rest of our lives. I am often asked what this is and why its important so here is your answer.

The 10:10:3 is a daily protocol for training your pelvic floor that has been proven to improve or completely resolve/cure the symptoms of pelvic floor disfunction in most women in as little as six to twelve weeks.

In fact this simple set of exercises is recommended by NICE as a first call of treatment for women dealing with stress incontinence, urge incontinence (also called overactive bladder) or pelvic organ prolapse, because it is so effective in the majority of cases.

This simple to remember descriptor of 10:10:3 describes the following

- engage, lift & hold the pelvic floor for 10 seconds
- Perform a quick pelvic floor lift and release 10 times.
- Repeat these two exercises 3 times a day.

So what does this mean?

The 10 second hold trains the deeper layer of the pelvic floor. This layer of the pelvic floor makes up approximately 2/3 of the pelvic floor, these are slower twitch/endurance muscle fibres and are responsible for supporting the pelvic organs. So engaging them fully and holding for a count of ten builds strength and endurance into these fibres.

The 10 quick lifts trains the outer lower layer of the pelvic floor. These muscles make up approximately one a third of the pelvic floor and help with sphincteric control…. This means they help to stop you peeing when you cough, sneeze, laugh etc. As these are fast twitch fibres they need to be trained by quickly engaging and releasing them.

And then you should be repeating both of these exercises 3 times every day.

Most women I work with usually have difficulty with these to begin with and may only manage a hold for 4 or 5 seconds or 4 or 5 quick lifts. This is fairly normal and improves with practice.

I would also like point out that pelvic floor function can be very variable as your pelvic floor function will be affected by fatigue or where you are in your menstrual cycle, if you have a bad cough or are a sneezy hay fever sufferer.... so you may find you can hold for 10 at the beginning of the day but by the end of the day you are struggling to hold for 3 or 4 seconds…. This is common, don't be discouraged be kind to your self and do what you can do well. You should find that with regular practice your pelvic floor will improve.

This is also a good way to assess what you should be doing today. If you have been struggling to get back to running without leaking and were planning a long run today. However, you were up all night last night with the children or with hot flushes for example and this morning you can barely manage a 4 second hold compared to your usual morning easy 10 seconds or more….. this may no be the day to go for the monster run…. This may be the day to go for a walk and focus on mindfulness and relaxation instead.

And some women will take longer that the six to twelve weeks and some will need more assistance from women’s health physiotherapists of other health care professionals. However given how un-intrusive the 10:10:3 is, its crazy that we don’t all know what it is and we’re not all doing it daily.

I would like to mention at this point that there is a common misconception that the pelvic floor should be a strong and tight as is humanly possible. With an increasing number of pelvic floor training courses hitting the market and pushing us to Herculean displays of pelvic floor strength. While in some cases this will be fine if a woman just need to improve the strength or endurance of her pelvic floor these courses may be fine. However, If there are more complex issues especially if a woman is not recruiting her pelvic floor correctly this gung-ho approach may exacerbate any disfunction and symptoms.

The pelvic floor is like any other muscular structure within the body. While it needs to be strong to support our pelvic organs and to withstand increases in intra-abdominal pressure from sneezing etc our pelvic floor also needs to be flexible and have the ability to stretch and release.

Make sure you are releasing the pelvic floor fully between each repetition, I sometimes find that a woman who claims to only be able to perform 3 or 4 quick lifts despite practicing daily is not incapable of performing more reps….

If you are not releasing after each repetition by the third or forth repetition your pelvic floor will be fully engaged and unable to lift any more. This is often misread as being incapable of performing a full set while the problem is not releasing fully.… like a flag being hauled up to the top of a mast….. once its reached the top there is nowhere else to go you have to release it to be able to pull it up again. This is more common that you would think and if this sound like you then you can still do the 10:10:3 but focus on the release phase of the exercise and practice some diaphragmatic breathing to help.

So how should you do the 10:10:3?

Find a position that you are best able to feel your pelvic floor engagement. That may be lying on your side, on your back with your knees bent in or seated with your feet flat on the floor.

Maintaining neutral alignment think about drawing up the pelvic floor as if pulling the sitz bones, pubic bone and tailbone towards each other and upwards.

While you may feel the muscle tone in your your lower abdominals increase a little you shouldn’t feel a huge amount of movement. The pelvic floor doesn’t move any bones it just lifts your bladder and draws your urethra forwards a few millimetres…. If you feel your abdominals crunch, your butt clench or your inner thighs squeeze you’ve probably overdone it…. Click on the video to see me talk you through this.

And before you think well I don’t have any issues so I don’t need to bother… we all know that our heart needs to be exercised every day so why would we assume our pelvic floor is any different.

Research has shown that if we stop exercising our pelvic floor we loose between 5 and 10% of the strength and endurance in your pelvic floor every week this loss increases once we hit menopause.

I am passionate about helping women with pelvic floor dysfunction wether that is incontinence, pelvic organ prolapse or chronic pelvic pain.

If you would like to work with me I do offer One-2-One training either Online or in Person I also have an online “Adore Your Pelvic Floor” course that will not only give you the practical skills to heal your body but the education and knowledge you need to feel empowered to make educated decisions for yourself so you are able to live your best life.

This course is split into two halves. The first is a comprehensive educational program that will give you a deep understanding of the anatomy of the pelvic floor, how it functions, what can go wrong and how to effectively train your pelvic floor.

This runs alongside a 16 week pelvic floor conditioning program that will take you from the basics of pelvic floor recruitment through to impact and loaded exercise…. in other words get you back to running, jumping, dancing and anything else you want to do so you can live your best life.

If you would like to work with me One-2-One fiona@fionacarterpilates.com

If you would like to access my Online Adore Your Pelvic Floor Course https://fiona-s-school-a743.thinkific.com/courses/adore-your-pelvic-floor-with-fiona-carter

If you would like to train to become an Adore Your Pelvic Floor Coach https://adoreyourpelvicfloor.co.uk/courses/teacher-education-classes/

This Blog is not meant to be used as a treatment programme. While I hope you find the information I have shared interesting it is based on what I have found useful in my teaching over the years and the best and most current research.

However, you should always seek the guidance of medical professionals in treating any condition. As a Pilates teacher I am not qualified to diagnose any condition. I would recommend seeking the advice of a good Physiotherapist or your General Practitioner. I would also recommend training with a Pilates Teacher who has completed a in depth training in the field. Pilates courses can vary vastly from short online or two day courses to three/four year in-depth full time apprenticeships. don’t be afraid to ask questions about your teachers training and experience. If you would like to train with me as a Pilates Teacher or as a Pelvic Floor Coach Or find an Adore Your Pelvic Floor programme in your area. Get in touch I'd Love 💗 to hear from you.


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