How to Do Pelvic Floor Exercises

Fifty percent of women can correctly identify which muscles to activate to build pelvic strength and tone; the rest of us need extra help. Here's how to do pelvic floor exercises (kegels) the right way.

How to Do Pelvic Floor Exercises

We all know that Kegels or pelvic floor exercises are the exercise for urinary health, but it turns out that having a strong back and core is key too. Learn all the workout moves you need to help control urine leaks.

Kegel Exercises

Kegel Exercises

Kegel exercises, which involve contracting and releasing the pelvic floor muscle, are ideal for stopping leaks. Kegels, in which you contract and release the pelvic muscles, are the most effective way to stop leaks. Kegels can be compared with the pressure you apply to your bladder to try to stop it from flowing.

Kegels can be compared to dental floss for the pelvis of a woman, says Dr. Romanzi. He is the author of Plumbing and renovations: A vagina and pelvic floor primer, published by Beauty Call Books in 2008. They’re an excellent starting point for anybody with bladder problems.

Also Read: Kegel Exercise Know-How

Luckily, you can really strengthen these muscles and start seeing positive results with minimal work—just 10 or so controlled contractions, three times a day.

Doing Kegels Correctly

Only about 50 percent of women can correctly identify which muscles to activate to build pelvic strength and tone.

To ensure you’re contracting the right muscles, insert a finger into your vagina and squeeze as if you were trying to stop a urine flow. You should feel your finger lifted and compressed.

If you’re not confident that you’re working the right muscles, consider seeing your OB/GYN or a physical therapist with special training in incontinence. She can use techniques like biofeedback or electrical stimulation to help you locate the proper muscles.

Another Option: There’s a Food and Drug Administration-approved over-the-counter pelvic muscle strengthener called the Myself Trainer. It identifies the muscles you need to strengthen and guides you through a five-minute exercise session, providing resistance and telling you when to contract and relax. It also displays the strength of your contractions on a small monitor.

The American Urogynecologic Society (AUS) recommends the following Kegel exercise routine:

  1. Lie down with your knees bent. (As you get used to the movement, you can do this while sitting and standing.)
  2. Slowly and steadily squeeze the pelvic muscles for 3 seconds. Then relax. Repetition of 10 repetitions three times per day will help you to strengthen your slow-twitch muscle fibers that maintain the general support. Add 10 squeezes after each set. It works on the fast-twitch muscle fibers, which are activated when there is a sudden increase in pressure.
  3. You can increase your hold for contraction by one second every week until you reach a 10-second squeeze.
  4. Rest and breathe between contractions.

Start Using Weights

Strength-training is not just for sculpted arms: If you’re having difficulty isolating the correct muscles for Kegels, inserting a cone-shaped vaginal weight can help. The weight requires you to contract the proper pelvic floor muscles in order to keep the weight in place. (Vaginal weights are available without a prescription at drugstores or online at stores like, $56, or, $90.)

Work your Abs and Back

How well your pelvic muscle works is affected by many factors, including posture, gait, and back strength. Sebastian states that more and more studies show our core and pelvic muscles are working together. Your abs and your adductors (hip muscles) attach directly to the pubic bones. Muscle fibers from the hip connect to the pelvic floor. All of them help to activate each other. Women who do Kegels in a large group are not getting the results they want.

Take Vivian Tisevich, 58, of Canton, OH: She had tried pelvic floor exercises, as well as biofeedback, medication and even surgery to combat her overactive bladder, with little success. But when a back injury sent her to physical therapy, “the exercises I was given to tighten my core and my transverse abdominal muscles really helped me with my Kegels. This is what’s keeping me dry,” she says.

What’s important is engaging the crucial core muscles, which strengthens your abs, back and hips at the same time. “Once you learn to activate these muscles together, you can incorporate this into your regular gym program or exercise activities—walking, running or biking,” Sebastian explains.

She advises the following simple regimen: Start with two sets of Kegels. If you like, use a pillow to elevate your hips to avoid working against gravity as your pull your pelvic floor muscles up and in. Then, do these three exercises:

Pelvic Floor Exercise 1: Inner-thigh squeeze

Inner-thigh squeeze

While lying on your back with your knees bent, very lightly squeeze a ball or pillow between your knees to work your adductors. Inhale, and as you exhale, draw your pelvic floor up and in while keeping your tailbone on the floor. You may feel the pelvic floor contract more strongly in this position. Hold this muscle contraction for 10 counts while breathing normally. Relax completely. Repeat 10 times.

Pelvic Floor Exercise 2: Ab pull

Ab pull

To work your deep ab muscles (transverse abdominals), inhale, and on your exhale pull your pelvic floor up and in while squeezing a ball or pillow between your knees. Then flatten your lower abs, keeping your tailbone on the floor. Hold this contraction for ten counts. Relax completely. Repeat 10 times.

Pelvic Floor Exercises 3: Hip flexors

Hip flexors

Inhale, and as you exhale, pull your pelvic floor up and in, while flattening your lower abs. Hold this contraction and breathe normally. Lift your hips up to create a “bridge,” then slowly open and close your knees 10 times. Lower your hips and relax completely. Repeat two to three times for a total of 20 to 30 hip rotations.