Eye Strain and the Pelvic Floor: Could There Be a Connection?
Try this with me.
Sit comfortably and allow your jaw to remain relaxed. Keep breathing rather than deliberately holding your breath.
Now gently scrunch your eyes.
What do you notice elsewhere in your body?
Perhaps your ribs tighten. You may feel your lower abdomen respond, your breath pause slightly or your pelvic floor contract or lift.
Now gradually increase the eye scrunch and then slowly release it.
For me, the response was unmistakable. As I scrunched my eyes, my pelvic floor tightened. The stronger the eye contraction became, the more clearly I could feel the pelvic-floor response.
It was directly comparable in my body.
As the effort around my eyes increased, so did the sensation of lift through my pelvic floor.
That immediately raised a much bigger question.
Could sustained eye strain, squinting and facial tension influence the way some people hold tension through their ribs, abdomen and pelvic floor?
The answer is not yet a simple yes or no, it never is! But it did seem a fascinating area to explore.
Meet your orbicularis oculi
The orbicularis oculi is the circular muscle surrounding each eye. It helps us blink, gently close the eyelids and squeeze or scrunch the eyes more firmly.
We may recruit it more strongly when concentrating on small print, staring at a screen, squinting through glare, trying to focus when tired or grimacing during effort, stress or discomfort.
Research into computer-related eye strain has found not totally unsurprisingly that demanding visual tasks and glare can increase activity in the orbicularis oculi. This means that eye strain is not simply a sensation inside the eyeball. It can include measurable muscular effort around the eyes.
That does not prove that working at a computer tightens the pelvic floor. It does, however, give us a useful starting point.
If the muscles around the eyes are working harder, what else may be joining in?
Is there an eye-to-pelvic-floor connection?
There is a movement approach I discovered as I dove deeper known as the Paula Method that proposes that contractions of circular muscles around the eyes, mouth and other parts of the body may influence the pelvic floor. Now this peaked my interest!
The concept is perhaps not as unfamiliar as it first sounds. In pelvic-health and bowel-emptying practice, people are already commonly encouraged to soften the jaw, round the lips and breathe out with a long “ooooh” or “moo” sound.
NHS bowel guidance sometimes calls this “moo to poo.” The cue is used to discourage breath-holding and forceful straining, allow the abdomen and waist to expand and help the pelvic floor soften during bowel emptying.
Research into voicing also suggests that making a sound on the exhale can alter pelvic-floor behaviour. Ultrasound research has found that ordinary voicing sounds that create a vibration in your throat like mmm or zzz creates lengthening through the pelvic floor, while louder shouting produces a greater downward strain. Vocalisation during labour has also been associated with reduced severity of some perineal tears.
What has not yet been clearly demonstrated is that making an O shape with the lips directly relaxes the anal sphincter through a unique mouth-to-anus reflex. The effect may come from the whole strategy: an open glottis, prolonged exhalation, less breath-holding, expansion through the abdominal wall and reduced gripping through the pelvic outlet.
Even so, the fact that these mouth shapes and sounds are already used to influence bowel emptying and pelvic-floor release makes the Paula Method’s focus on circular muscles feel rather less unusual.
Researchers have explored this idea using pelvic-floor electromyography, or EMG. Some studies have investigated whether contracting circular muscles can produce measurable activity in the pelvic floor, while clinical trials have explored whether circular-muscle exercises may help women experiencing urinary incontinence.
The findings are interesting but, as with so many studies, they are still considered inconclusive.
The research does not yet allow me to say, with studies backing me, that scrunching the eyes reliably activates the pelvic floor in every person. Nor can I claim that eye exercises should replace established pelvic-floor rehabilitation.
If you have read any of my previous blogs, you will already know that I firmly believe all of these methods and body connections matter when they are brought together, helping us to see the whole picture.
However, the fact that the average response across a study group may be inconsistent does not mean that no individual experiences a clear response.
In my own body, the connection was immediate, repeatable and graded. As the eye contraction became stronger, the pelvic-floor response felt stronger too.
Some people may experience exactly the same thing. Others may feel their ribs tighten or their breath pause without noticing anything in the pelvis. Some may feel no wider response at all.
The most useful question may therefore be:
“What does your nervous system do when your eyes work harder?”
It may be coordination rather than a single direct pathway
The pelvic floor does not work alone at the bottom of the body.
It participates in breathing, pressure management, postural control, balance and whole-body movement. Its activity changes depending on what the diaphragm, abdominal wall, spine, rib cage and limbs are doing.
When you squeeze your eyes tightly, the nervous system may not treat this as an isolated facial action.
Your breath may briefly pause. The ribs may become more rigid. The throat and tongue may become more active. The abdominal wall may tighten, and the pelvic floor may join the wider strategy.
This is sometimes described as motor overflow, where effort in one area spreads into additional muscles.
It may also represent a familiar protective pattern. Your nervous system may have learned to connect visual concentration, facial tension, restricted breathing and pelvic-floor gripping as part of one coordinated response.
However, after trying all of the experiments below, I found that the pelvic-floor engagement remained even when I continued breathing, allowed my ribs to expand and made sure I was not gripping through my jaw, throat or abdomen.
I could also feel a clear engagement through my lower abdominal wall.
That does not prove there is a direct anatomical pathway between the muscles around the eyes and the pelvic floor, but it does suggest that, in my body, the response was not simply caused by breath-holding, rib rigidity or a general bracing strategy.
The connection still appeared to be neurological, functional and whole-body, but it was more specific and repeatable than I initially expected.
Try it for yourself
The eye-scrunch experiment
Sit or lie somewhere comfortable. Allow your jaw to soften, keep your teeth slightly apart and let your tongue rest.
Close your eyes normally and notice what you feel through the ribs, abdomen and pelvic floor.
Now scrunch your eyes gently for two or three seconds.
Release them slowly.
Notice whether your pelvic floor tightened, lifted or closed. Did the lower abdomen draw inward? Did the ribs become firmer? Did the breath pause?
Repeat the movement once or twice, rather than turning it into a strenuous exercise.
The aim is not to make your pelvic floor contract.
The aim is to notice what it already does.
This is an awareness experiment, not a strengthening prescription.
Turn up the dial
Imagine your eye contraction has five levels.
Begin at level one, where the eyes are only slightly more active than they would be during normal closure.
Gradually increase the effort towards level five, without squeezing painfully or straining.
Notice whether the response elsewhere in the body changes with the intensity of the eye contraction.
Does your pelvic floor lift more as the eye squeeze becomes stronger? Do your ribs become progressively more fixed? Does your breath become smaller?
Then reduce the effort gradually.
Notice whether the pelvic floor releases at the same rate as the eyes.
A graded response may suggest that your nervous system is scaling the wider muscular strategy according to the amount of facial effort.
Keep the ribs responsive
Try the eye scrunch again, but this time maintain an easy breath into the side and back ribs.
Do not force a large breath or deliberately push the ribs out. Simply see whether they can remain responsive while the eyes contract.
You may find that the pelvic-floor response remains, becomes smaller or changes quality.
You may also discover that it is difficult to scrunch strongly without restricting the breath.
That is useful information.
It shows you how your eyes, ribs, diaphragm and pelvic floor may currently be organised together.
Keep the jaw relaxed
Allow the mouth to remain slightly open and keep the teeth apart.
Scrunch the eyes while allowing the jaw to stay loose.
If you still feel the pelvic floor respond, it suggests that the effect is not simply caused by clenching the teeth.
You may still notice activity through the tongue, throat, ribs or abdomen, so remain curious about the whole pattern rather than trying to identify one single muscle as the culprit.
Add the tongue
With the jaw still relaxed, scrunch the eyes and allow the tongue to extend gently out of the mouth.
First, let it hang out with as little effort as possible.
Then reach the tongue forwards slightly more actively.
Notice whether the pelvic-floor response changes.
For me, the further the tongue extended from the scrunched face, the stronger the pelvic-floor lift felt, even though the jaw remained relaxed.
This may reflect increased effort through the tongue, floor of the mouth, throat and broader postural system.
It is an interesting personal response, but it is not yet an established pelvic-floor exercise.
Scrunch and melt
Gently scrunch the eyes and face for two seconds.
Then release slowly.
Allow the forehead to widen, the skin around the eyes to soften and the jaw to unhook.
Let the tongue settle.
Feel the throat soften and allow the ribs to become mobile again.
Notice what happens through the abdomen and pelvic floor.
For some people, the most valuable part of this exercise will not be the contraction.
It will be the contrast between gripping and letting go.
What might this have to do with the nervous system?
Facial tension can form part of a wider effort, concentration or protective response.
Think about the face you make when lifting something challenging, trying not to cry, struggling to read a screen, anticipating pain or pushing through exhaustion.
The eyes, face, throat, breath, ribs, abdominal wall and pelvic floor may all become involved in the same moment.
A brief, deliberate scrunch followed by a slow release may give the nervous system useful sensory information.
It can help you recognise what tension feels like and, just as importantly, what release feels like.
For someone with pelvic-floor overactivity, pain, urgency or difficulty relaxing, this second part may be far more important than repeatedly practising the contraction.
“The aim is not always to make the pelvic floor work harder. Sometimes it is to help it stop working when it does not need to.”
What about digital eye strain?
Many of us spend hours looking at phones, laptops and tablets.
During visually demanding work, we may blink less freely, narrow the eyes, bring the head forwards, grip around the forehead and temples or become increasingly fixed through the ribs and breath.
Research has shown increased orbicularis oculi activity during demanding computer tasks and in conditions involving direct glare.
We do not yet have evidence showing that digital eye strain directly causes pelvic-floor dysfunction.
However, if you personally notice that eye effort produces rib, abdominal or pelvic-floor tension, it is reasonable to consider visual strain as one possible contributor within your wider movement pattern.
Not the sole cause.
Not the whole story.
One possible piece of a much bigger puzzle.
A gentle eye-release practice
After prolonged screen work, take your gaze away from the screen and look towards the furthest comfortable point you can see.
Rather than staring intensely at one object, allow your gaze to soften and take in the wider environment.
Notice what is above, below and to either side of you.
This broadening of peripheral vision can feel very different from the narrow, concentrated gaze we use for reading and screens.
Next, warm your hands by rubbing them together and lightly cup them over your closed eyes.
Do not press on the eyeballs.
Allow the warmth and darkness to settle around the eyes while you continue breathing comfortably.
When you remove your hands, blink lightly several times.
Think of the eyelids gliding rather than snapping shut.
You can then allow the eyes to look slowly upwards, to one side, downwards and across to the other side while keeping the head still.
Keep the movement small and comfortable.
Finish with one gentle scrunch of the eyes.
Notice what happens through the ribs and pelvic floor.
Then release the eyes, jaw, tongue, throat, ribs, abdomen and pelvic floor together.
Why eye work should not stand alone
Pelvic-floor symptoms rarely come down to one weak muscle, one tense muscle or one missing exercise.
The pelvic floor works as part of a larger system involving breathing, rib-cage mobility, spinal organisation, hip movement, foot contact, strength, load sharing, connective tissue, movement confidence and nervous-system state.
This is why I would not present eye scrunching as a replacement for comprehensive pelvic-floor rehabilitation. I don’t personally believe isolation of any part of us helps our health and our pelvic floor. Recovery and better pelvic floor and general health is all about combination and connection, including person to person connections.
However it is a useful awareness tool within a broader programme.
Hypopressives: exploring posture and breath
Hypopressives are a part of what I recommend because they combine body awareness, postural organisation, breath work and purposeful movement.
They help us explore how the jaw, ribs, diaphragm, abdominal wall and pelvic floor coordinate, rather than treating the pelvic floor as a muscle that simply needs to squeeze harder.
For someone whose eye tension is accompanied by rib gripping or breath restriction, restoring movement and variability through the rib cage may be particularly relevant.
You can learn more about my approach to [Hypopressives here].
TRE® and release work
TRE®, or Tension and Trauma Releasing Exercises, uses the body’s natural tremor response within a carefully regulated and supported process.
Persistent eye, jaw, throat, diaphragm, abdominal or pelvic-floor tension may sometimes form part of a wider protective holding strategy.
Release work is not about forcing muscles to relax.
It is about helping the nervous system develop enough safety, awareness and capacity to choose a different response.
Gentle eye releases, peripheral vision, orienting and supported rest can all sit naturally alongside this work.
You can read more about [TRE® sessions here].
Personal training and whole-body strength
Sometimes the pelvic floor is gripping because the rest of the body is not sharing load effectively.
Progressive personal training can help improve hip and leg strength, balance, impact tolerance, respiratory coordination and confidence under load.
The goal is not to remove effort from movement.
It is to give the body more than one way to organise that effort.
You can find out more about [personal training with me here].
Pelvic-floor muscle training
Pelvic-floor muscle training remains an evidence-based treatment for many people experiencing urinary incontinence and some other pelvic-floor symptoms.
However, the exercises need to suit the person.
Not everyone needs more squeezing.
Some people need improved awareness. Others need better timing, endurance or reflexive support. Some need help learning to release an overactive pelvic floor.
For many people, the most effective approach may combine appropriate pelvic-floor muscle training with breath work, nervous-system support, whole-body movement and progressive strength training.
What this little experiment teaches us
Your eyes are not floating separately from the rest of your body.
Neither is your pelvic floor.
When we begin to pay close attention, we often find connections between areas that traditional exercise programmes have treated as unrelated.
The science around eye contraction and pelvic-floor activity remains emerging and mixed.
We cannot yet claim that eye scrunching activates every pelvic floor or that it should be used as a standalone treatment.
But that does not invalidate a repeatable response within your own body.
You may scrunch your eyes and feel nothing in the pelvis.
You may feel the ribs tighten.
You may notice the breath pause.
Or you may feel the pelvic floor lift immediately.
The experiment is not about proving that one response is correct.
It is about discovering how your nervous system has currently connected your eyes, face, breath, ribs, abdomen and pelvic floor.
Once you can feel a pattern, you have more opportunity to change it.
“Your pelvic floor is not an isolated muscle. It is part of your breathing, movement, pressure and nervous-system story.”
Begin exploring your whole-body pattern
Pelvic-floor symptoms are rarely explained by one muscle or one exercise.
My work brings together pelvic-floor education, Hypopressives, breath and postural work, nervous-system support, release practices and progressive strength training. The aim is not simply to make your pelvic floor squeeze harder. It is to understand why it is responding as it does and help your whole body develop more choices.
Important note
These exercises are intended for gentle awareness and education. They are not a diagnosis or a replacement for individual medical or pelvic-health assessment.
Stop and seek professional guidance if you experience eye pain, significant headaches, dizziness, visual changes, pelvic pain, worsening pelvic heaviness, difficulty emptying your bladder or bowel, or any other concerning symptoms.
Anyone with a known eye condition, recent eye surgery or retinal concerns should seek advice from an appropriate eye-care professional before attempting unfamiliar eye exercises.
Further Reading and Research
The following resources offer different perspectives on circular-muscle exercise, eye strain and pelvic-floor rehabilitation. Some are scientific studies, while the Paula Method website describes the method from the perspective of its own professional association.
The principles of the Paula Method
The Paula Method Association — “The Principles”
This page explains the method’s theory that voluntary circular muscles around areas including the eyes, mouth, urethra and anus can create wider chain reactions throughout the body. It also emphasises the balance between contraction and release and describes individual responses to eyelid exercises.
This is the Paula Method organisation’s own account of its philosophy and practice, rather than independent scientific evidence.
Read the principles of the Paula Method
Circular-muscle contraction and pelvic-floor EMG
Resende APM, Zanetti MRD, Petricelli CD, Castro RA, Alexandre SM and Nakamura MU. Effects of the Paula method in electromyographic activation of the pelvic floor: a comparative study. International Urogynecology Journal. 2011;22:677–680.
This study used surface EMG to examine pelvic-floor activity during circular-muscle contractions involving muscles around the eyes, mouth and fingers. It included 34 healthy women who had not given birth.
The researchers did not find a statistically significant increase in average pelvic-floor activity during the circular-muscle contractions. Combining the circular-muscle exercise with a deliberate pelvic-floor contraction did not improve the pelvic-floor contraction either.
This is important counter-evidence and one reason the immediate eye-to-pelvic-floor response should not be presented as universal.
Paula exercises and stress urinary incontinence
Liebergall-Wischnitzer M and colleagues. Paula method of circular muscle exercises for urinary stress incontinence—a clinical trial. International Urogynecology Journal. 2005;16:345–351.
This pilot clinical trial compared a programme of Paula circular-muscle exercises with conventional pelvic-floor training for women experiencing stress urinary incontinence. Both groups demonstrated changes in urinary leakage, although the trial was relatively small and its findings require cautious interpretation.
Randomised trial of Paula exercises and pelvic-floor training
Liebergall-Wischnitzer M and colleagues. Randomized trial of circular muscle versus pelvic floor training for stress urinary incontinence in women. Journal of Women’s Health. 2009;18(3):377–385.
This larger randomised trial assigned 245 women with stress urinary incontinence to 12 weeks of either Paula circular-muscle exercises or pelvic-floor muscle training.
Both groups improved. The study reported a higher cure rate in the Paula group, but it did not demonstrate the predefined statistical equivalence between the treatments and had a dropout rate of approximately 27%.
The trial suggests that a complete Paula programme may benefit some women, but it does not prove that eye scrunching alone directly strengthens the pelvic floor.
Longer-term follow-up
Liebergall-Wischnitzer M and colleagues. Long-term efficacy of Paula method as compared with pelvic floor muscle training for stress urinary incontinence in women: a six-month follow-up. Journal of Wound, Ostomy and Continence Nursing. 2013;40(1):90–96.
At six months, both intervention groups had experienced reductions in the frequency of urinary incontinence, with similar long-term adherence reported across the two approaches.
Sexual function and quality of life
Liebergall-Wischnitzer M and colleagues. Sexual function and quality of life of women with stress urinary incontinence: a randomized controlled trial comparing the Paula method to pelvic-floor muscle training. Journal of Sexual Medicine. 2012;9(6):1613–1623.
This study reported improvements in sexual function and quality of life in women completing either the Paula Method or pelvic-floor muscle training.
Review of alternative exercise methods
Bø K and Herbert RD. There is not yet strong evidence that exercise regimens other than pelvic floor muscle training can reduce stress urinary incontinence in women: a systematic review. Journal of Physiotherapy. 2013;59(3):159–168.
This review concluded that the available evidence was not strong enough to recommend alternative exercise systems in place of specific pelvic-floor muscle training.
This does not mean that whole-body or circular-muscle exercises have no value. It means their effectiveness and mechanisms had not been demonstrated with enough consistent, high-quality research to replace established pelvic-floor rehabilitation.
Orbicularis oculi activity during visually demanding computer work
Thorud HMS and colleagues. Eye-related pain induced by visually demanding computer work. Clinical and Experimental Optometry. 2012.
The researchers investigated discomfort, muscle activity and blood flow in the orbicularis oculi during visually demanding computer work. The study supports the idea that eye strain can include increased muscular activity and discomfort around the eyes.
It did not measure the pelvic floor.
Direct glare and eye-muscle activity
Mork R and colleagues. Effect of direct glare on orbicularis oculi and trapezius muscle activity. Applied Ergonomics. 2016.
This study found that direct glare during computer reading increased reported eye strain and orbicularis oculi contraction.
Again, it did not measure pelvic-floor activity, but it helps demonstrate that visual conditions can alter muscular effort around the eyes.
Research Disclaimer
The research around circular-muscle exercises and pelvic-floor function is limited and mixed. Studies of the complete Paula Method have reported improvements in urinary symptoms, but one small EMG investigation did not find that circular-muscle contractions consistently increased pelvic-floor activity in healthy nulliparous women.
Research into digital eye strain confirms that demanding visual work and glare can increase activity around the eyes, but studies have not yet tested whether prolonged eye strain causes pelvic-floor tension or dysfunction.
The exercises in this article are therefore offered as gentle awareness experiments rather than established treatment protocols. They are best used within an individualised, whole-person approach that may include pelvic-health assessment, appropriate pelvic-floor muscle training, Hypopressives, release work and progressive strength training.
