Pelvic floor exercises are not limited to repeatedly squeezing the muscles as hard as you can. A balanced pelvic floor needs to contract, respond quickly, coordinate with breathing and movement and relax completely afterwards.
The exercises that are right for you depend on whether your pelvic floor muscles are weak, overactive, poorly coordinated or a combination of these. If you have pain, difficulty emptying your bladder or bowel or symptoms that worsen when you squeeze, strengthening exercises may not be the right place to start.
Quick answer: To perform a Kegel, gently close and lift the muscles around the anus and urethra — and around the vaginal opening if you have one — while continuing to breathe. Hold the lift comfortably, then let the muscles soften completely. You should feel an inward and upward movement rather than pushing down.
If you would like more background first, read our guide to what the pelvic floor is and how it works.
Key takeaways
- Kegels are one type of pelvic floor exercise, not the whole picture.
- A healthy pelvic floor needs strength, endurance, coordination and the ability to relax.
- Slow holds train endurance while quick contractions train a rapid response.
- “The Knack” teaches you to contract before a cough, sneeze, jump or lift.
- More squeezing is not always better. Pain, urinary urgency, constipation, emptying difficulties and painful penetration may indicate that relaxation and assessment should come first.
- Correct technique matters more than completing a high number of repetitions.
- Pelvic floor trainers are optional aids and do not replace learning how to contract and relax correctly.
Are Kegels and pelvic floor exercises the same thing?
Not quite. A Kegel is a voluntary contraction of the pelvic floor muscles followed by a full release. Pelvic floor muscle training is broader and may include:
- slow contractions for strength and endurance
- quick contractions for speed and responsiveness
- coordination with breathing and movement
- contracting before a cough, sneeze, lift or jump
- bladder-training strategies
- relaxation or down-training
The pelvic floor works with the diaphragm, abdominal muscles and back muscles to manage pressure and support the pelvic organs. It needs to respond when you cough, laugh, run, lift, use the toilet or breathe. Keeping it clenched all day is not the goal.
Do you need to strengthen or relax your pelvic floor?
This is the most important question to consider before beginning pelvic floor exercises.
Leaking urine when you cough, sneeze or exercise, difficulty controlling wind and pelvic heaviness may be associated with muscle weakness, reduced endurance or poor coordination. A strengthening programme may help some people with these symptoms.
Pelvic floor muscles can also be tight or overactive. Possible signs include:
- pelvic, vulval, vaginal, penile, testicular or rectal pain
- pain during or after penetration
- difficulty starting urination or fully emptying the bladder
- constipation, straining or difficulty emptying the bowel
- urinary urgency, frequency or pain
- pain during or after Kegel exercises
- difficulty feeling the muscles release after a contraction
Weakness and overactivity can occur together, so symptoms alone cannot tell you exactly what the muscles are doing. If you have pain, bladder or bowel emptying difficulties, a vaginal bulge, symptoms after surgery or symptoms that worsen with Kegels, see a pelvic health physiotherapist, continence nurse or GP before beginning a strengthening programme.
Our guides to pelvic floor relaxation, vaginismus and painful intercourse explain when tension or difficulty relaxing may be contributing.
How do you find and contract your pelvic floor muscles?
Begin lying down or sitting in a supported position. Relax your jaw, shoulders, abdomen, buttocks and thighs, then breathe normally.
Gently imagine:
- stopping yourself from passing wind
- closing the muscles around the anus and urethra, then drawing them inward and upward
- if you have a vagina, gently closing and lifting around the vaginal opening
- if you have a penis, drawing the penis slightly inwards and lifting the testicles
You are looking for an internal closing and lifting sensation, not a downward push. Your buttocks and thighs should remain mostly relaxed and you should be able to breathe throughout.
After every contraction, let the muscles soften completely. The release is part of the exercise, not simply the pause before the next squeeze.
Should you stop your urine stream to find the muscles?
You may gently try to slow or stop the stream once to help identify the muscles. Do not make this part of your exercise routine. Regularly interrupting urination can interfere with normal bladder emptying.
If you still cannot feel an inward lift or you feel yourself bearing down, ask a pelvic health physiotherapist or continence nurse to check your technique.
A general beginner pelvic floor strengthening routine
If you do not have pelvic pain, difficulty emptying your bladder or bowel or symptoms that worsen when you squeeze, this general routine may be a useful starting point.
- Find a comfortable position lying down or sitting with support.
- Gently squeeze and lift your pelvic floor muscles.
- Hold for 3 seconds while breathing normally.
- Release completely and rest for at least 3 seconds.
- Repeat 3–5 times.
- Add 3–5 quick contractions, fully releasing after each one.
- Practise up to 3 sets spread across the day.
As your control improves, gradually work towards holding for 5–8 seconds and completing 8–10 slow contractions followed by 8–10 quick contractions. Progress from lying to sitting, standing and relevant daily activities.
This is general guidance, not an individual prescription. Your ideal position, contraction length, rest time and number of repetitions may be different. Stop when the muscles become tired, the contraction becomes weaker or you can no longer relax fully.
What are the different types of pelvic floor exercises?
Different exercises train different functions. A personalised programme may include several of the following.
1. Slow holds for strength and endurance
Slow contractions help the pelvic floor sustain support over time. This can be useful during standing, walking, exercise and everyday activities.
- Gently squeeze and lift your pelvic floor.
- Keep breathing and avoid gripping your buttocks or thighs.
- Hold for as long as you can maintain a clear, comfortable lift.
- Release completely and rest for at least as long as you held.
- Stop the set when you can no longer lift and release with good control.
2. Quick contractions for speed and power
Quick contractions, sometimes called “quick flicks”, train the muscles to respond rapidly when pressure rises suddenly.
- Squeeze and lift the pelvic floor quickly.
- Let go completely.
- Begin with 3–5 repetitions, allowing a clear release between each one.
- Gradually build towards 8–10 good-quality repetitions.
A quick contraction should still include a definite lift followed by a definite release. It is not a repeated partial clench.
3. Functional bracing: “The Knack”
The Knack is a practical technique rather than a traditional exercise set. It involves gently contracting the pelvic floor immediately before and during an activity that increases pressure through the abdomen.
Try a gentle squeeze and lift just before you:
- cough or sneeze
- laugh
- lift a child, shopping bag or gym weight
- stand from a chair
- jump or land
Keep breathing and release once the effort has passed. The aim is a well-timed response, not continuous tension throughout the day.
4. Urge-control contractions
Pelvic floor contractions may be used as part of bladder training to help settle a sudden urinary urge.
If urgency strikes, stop moving, breathe slowly and avoid rushing to the toilet. A small number of quick, controlled contractions may help the bladder settle. Once the urge eases, walk to the toilet at a normal pace.
Urgency can have several causes. Seek medical advice if it is new, painful, accompanied by blood in your urine, fever or other symptoms or affecting your daily life.
5. Pelvic floor relaxation and down-training
Some pelvic floors need help letting go before they need more strengthening. Down-training aims to reduce unnecessary tension and improve the ability to lengthen and relax. It is sometimes called a “reverse Kegel”, although it should be a gentle release rather than a forceful push.
- Lie or sit in a comfortable, supported position.
- Place your hands around your lower ribs or lower abdomen.
- Breathe in slowly and allow your ribs and abdomen to expand.
- Imagine the sit bones widening and the muscles around the urethra, vagina or penis and anus softening.
- Breathe out easily without automatically squeezing.
- Continue for 5–10 relaxed breaths.
Do not bear down or strain. The movement may feel very subtle. If you have pelvic pain, vaginismus, painful penetration or persistent difficulty relaxing, individual guidance is preferable to trying to force the muscles to release.
6. Breathing, core coordination and movement
The pelvic floor, diaphragm and deep abdominal muscles normally work together. As you breathe in, the diaphragm moves down and the pelvic floor can gently lengthen. As you breathe out or perform an effort, the pelvic floor can recoil and contribute to support.
Once you can contract and relax in a supported position, practise that control while sitting, standing and moving. A physiotherapist may progress training into walking, squats, lifting, jumping or sport according to your needs.
Yoga, Pilates, bridges and squats can support mobility, strength and breathing. However, they are not automatically pelvic floor exercises and do not replace specific pelvic floor muscle training when it has been recommended.
How can you tell if you are doing Kegels correctly?
| Signs of a controlled contraction | Signs to adjust your technique |
|---|---|
| You feel an inward and upward lift | You feel pushing, bulging or downward pressure |
| You can continue breathing | You hold your breath or brace forcefully |
| Your buttocks and thighs remain mostly relaxed | Your buttocks, thighs or upper abdomen take over |
| You can release completely after each contraction | The muscles remain clenched or become harder to release |
| The exercise feels controlled and pain-free | You develop pain, cramping, urinary urgency or pressure |
It is normal for the lower abdominal muscles to respond gently because the deep core and pelvic floor work together. A forceful abdominal brace, breath hold or visible gripping of the buttocks can take the focus away from the intended movement.
Because the pelvic floor is hidden, technique can be difficult to judge. A pelvic health physiotherapist or continence nurse can assess both contraction and relaxation and tailor a programme to your symptoms.
Common pelvic floor exercise mistakes
Doing Kegels without knowing what your muscles need
Repeated strengthening can aggravate symptoms if the muscles are already overactive, painful or unable to release.
Holding your breath
Breath-holding increases abdominal pressure and makes coordination more difficult. Keep your breathing easy throughout each exercise.
Pushing down instead of lifting
Straining or bearing down is the opposite of the intended movement during a strengthening contraction. Seek help with your technique if you cannot feel an upward lift.
Skipping the relaxation phase
The muscles need to return to rest between contractions. If the release becomes smaller as the set continues, stop and rest.
Doing too many repetitions
Pelvic floor muscles can fatigue. More is not necessarily better, particularly when contractions become weaker or other muscles begin taking over.
Only exercising while lying down
Lying down is often the easiest place to learn. As control improves, progress to sitting, standing and the activities in which you need the muscles to respond.
Expecting an immediate change
Awareness and coordination may improve before strength does. Some people notice changes within several weeks, but a structured strengthening programme is commonly continued for at least three months. Persistent symptoms deserve assessment rather than simply adding more Kegels.
Do pelvic floor exercises work?
Pelvic floor muscle training has good evidence as a conservative treatment for urinary incontinence. A Cochrane review found that women who completed pelvic floor muscle training were more likely to report improvement or cure than those receiving no treatment or an inactive treatment.
Stress and mixed urinary incontinence
Supervised pelvic floor muscle training for at least three months is recommended as a first-line treatment for stress or mixed urinary incontinence. The programme should be adjusted to the person’s ability, symptoms and goals.
If leakage affects your daily life, read what to do about light bladder leakage and speak with a GP, continence nurse or pelvic health physiotherapist.
Pelvic organ prolapse
Supervised pelvic floor muscle training may reduce symptoms and improve support for some people with mild to moderate pelvic organ prolapse. It does not guarantee that an existing prolapse will disappear and a heavier strengthening device is not automatically more effective.
Other pelvic floor symptoms
Results vary according to the cause of the symptoms, technique, consistency and whether the programme matches what the muscles need. Kegels are not a universal treatment for pelvic pain, sexual difficulties, urinary urgency, constipation or bladder and bowel emptying problems.
Can pelvic floor trainers help?
Pelvic floor trainers are optional aids, not a requirement for effective exercise. They work in different ways:
- Weighted balls, beads or cones add resistance but do not confirm that you are contracting correctly.
- Sensor-guided trainers use vibration or another signal to guide or adapt a routine.
- App-based biofeedback trainers use sensors to display information about contractions and progress.
- Electrical stimulation devices activate muscles using an electrical current and may be recommended in specific circumstances.
An app-controlled vibrating product is not automatically a biofeedback device. These product types are not interchangeable and internal trainers will not suit every body or condition.
Read our guide to choosing a Kegel trainer or pelvic floor exerciser to compare the different device types, or explore our range of pelvic floor trainers.
When should you see a pelvic health professional?
Speak with a pelvic health physiotherapist, continence nurse or GP if:
- you cannot feel your pelvic floor contract or relax
- you have pelvic, genital, bladder, bowel or lower abdominal pain
- Kegels cause pain or make your symptoms worse
- you have difficulty urinating or emptying your bowel
- you notice a vaginal bulge, heaviness or dragging sensation
- you have persistent bladder or bowel leakage
- you have recently given birth or had pelvic, gynaecological, urological or colorectal surgery
- you are unsure whether strengthening or relaxation is appropriate
- your symptoms are not improving despite consistent, correctly performed exercises
You can use our directory to find a pelvic health physiotherapist in Australia.
The National Continence Helpline also provides free and confidential advice on 1800 33 00 66.
Frequently asked questions
Should you do Kegel exercises every day?
Many strengthening programmes involve daily practice, but the right frequency depends on your muscle function and symptoms. Rest and full relaxation between contractions are essential. Stop and seek advice if the exercises cause pain or worsen urgency, constipation or emptying difficulties.
Can Kegel exercises make pelvic floor problems worse?
Yes. Repeated strengthening may aggravate symptoms when the pelvic floor is already overactive or painful, or when the exercises are performed by pushing down, holding the breath or never fully releasing.
Should you practise Kegels while urinating?
No. You may try slowing or stopping the stream once to help identify the muscles, but it should not become an exercise. Regularly interrupting urination can interfere with normal bladder function.
What is the best position for pelvic floor exercises?
The best starting position is one in which you can clearly feel the muscles lift and release without gripping your buttocks or thighs. Lying down or supported sitting is often easiest. Progress to standing and movement as your control improves.
Can men do pelvic floor exercises?
Yes. Everyone has a pelvic floor. Training may be used to support bladder and bowel control, sexual function and recovery after prostate treatment. The right programme still depends on whether the muscles need strength, coordination, endurance or relaxation.
Can you do pelvic floor exercises during pregnancy or after birth?
Pelvic floor muscle training is commonly used during pregnancy and after birth, but the programme should suit the pregnancy, birth experience, symptoms and healing. Ask your midwife, obstetrician, GP or pelvic health physiotherapist when and how to begin, particularly after a complicated birth, significant tearing or surgery.
Can pelvic floor exercises fix prolapse?
Pelvic floor muscle training may reduce symptoms and improve support for some people with pelvic organ prolapse, but it does not guarantee that the prolapse will disappear. Assessment can also help you understand other options such as lifestyle changes, a vaginal pessary or surgery where appropriate.
How long do pelvic floor exercises take to work?
Some people notice better awareness or control within several weeks. Building strength and changing symptoms often takes three months or longer. Progress depends on correct technique, consistency and whether the exercises address the underlying problem.
The bottom line
Pelvic floor health is not about achieving the strongest possible squeeze. These muscles need strength, endurance, speed, coordination and the ability to relax completely.
Begin with a gentle inward lift, keep breathing and release fully after every contraction. Use slow holds for endurance, quick contractions for responsiveness and The Knack before activities that increase pressure.
Most importantly, match the exercise to what your pelvic floor actually needs. If you have pain, emptying difficulties, a vaginal bulge or symptoms that worsen with Kegels, seek professional guidance before doing more strengthening.
Related reading
- The Pelvic Floor and a Guide to Kegel Exercises
- How to Choose a Kegel Trainer or Pelvic Floor Exerciser
- Overactive Pelvic Floor: Hypertonicity and How to Find Relief
- Pelvic Floor Relaxation Techniques
- Pelvic Organ Prolapse: Types, Symptoms and Treatments
- What to Do About Light Bladder Leakage
This article provides general information and is not a substitute for individual medical advice, diagnosis or treatment. Speak with a qualified healthcare professional about symptoms or exercises that are appropriate for you.
Sources
- Continence Health Australia, Pelvic floor exercises for women
- Continence Health Australia, Pelvic floor exercises for men
- Continence Health Australia, Bladder training
- Better Health Channel, Pelvic floor
- Pelvic Floor First, Activating your pelvic floor
- Cochrane, Pelvic floor muscle training for urinary incontinence in women
- Cochrane, Conservative management of pelvic organ prolapse in women
- National Institute for Health and Care Excellence, Urinary incontinence and pelvic organ prolapse in women: management