Pelvic floor exercises for women

What does the pelvic floor do?

Read information about how your pelvic floor works.

It supports your pelvic organs and abdominal contents especially when standing or when there is an increase in pressure in your abdomen (intra-abdominal pressure) with activities such as lifting, bending and straining.
It helps keep the bladder and bowel openings closed to prevent unwanted leakage. The muscles need to work gently most of the time and also be able to work harder when your intra-abdominal pressure increases i.e. when you cough, sneeze, lift or exert yourself.
It is used to control wind and when ‘holding on’ with your bowels.
It can help improve sensation during sexual intercourse.

Why should I exercise my pelvic floor muscles?

Read advice on the benefits of pelvic floor self care.

All women need to do pelvic floor exercises and up to a third of all women experience a problem with their pelvic floor muscles at some time in their life. Your pelvic floor muscles need to be strong but they also need to work in the right way at the right time.

Symptoms you may be experiencing could include:

Urinary leaking with activities such as coughing, laughing,
sneezing, lifting and jumping
A sudden need to rush to the toilet or leaking on the way to the
toilet
A need to go to the toilet too frequently in the day and/or the night
Leakage of faeces or difficulty controlling wind
A feeling of heaviness, dragging or something ‘coming down’
inside your vagina
A reduced or lack of sensation during intercourse.

5 minute pelvic health self care

Read below for 5 minute activities that can be completed every day to improve your pelvic floor.

It is recommended that you do daily pelvic floor exercises throughout pregnancy and after birth. This will help to prevent symptoms.

Your pelvic floor exercises or ‘Kegels’ can be performed in any position. Find one which is comfortable for you. You may find lying or sitting easier if your muscles feel weak and try standing when they are stronger.

Imagine that you are trying to stop yourself passing wind and urine at the same time. You can also think of squeezing in the vagina. You should you feel your pelvic floor muscles ‘squeeze and lift’ inside. Don’t hold your breath or clench your buttocks. You may feel a gentle tightening in your tummy.

Long squeezes: Squeeze and lift your pelvic muscles, hold and release. Repeat the long squeezes, with a rest between each, until you feel that your muscles are tired.

Short squeezes: Quickly squeeze and release the muscles. Always let the muscles fully relax before the next squeeze.

How often should I do the exercises? Aim to repeat this programme three times a day. Build up to 10 long squeezes and 10 short squeezes. You may need to start with little and often until the muscles get stronger.

How to do pelvic floor exercises

Learn how to perform pelvic floor exercises.

A pelvic floor contraction is performed by closing and drawing up your front and back passages. Imagine you are trying to stop wind and at the same time trying to stop your flow of urine. It should be a sensation of ‘tighten and lift’.

You should:

Continue to breath normally.
Keep your buttocks and legs relaxed though you may feel a
gentle tightening of your tummy.
Always let the muscles fully relax at the end of a contraction.
You need to practice long contractions as well as short ones.

Long contractions

Short contractions

https://youtu.be/kME0N1YToDk

Exercises

Learn exercises to help support your pelvic floor muscles.

Aim to do these exercises 3 times a day but start with a small amount and build up gradually as you feel able.
The exercises should not make you feel uncomfortable or cause you to leak.
Aim for quality rather than quantity
Gradually build up your hold times and repeat times as the exercises become easier until you reach the maximums stated.
You may find it easier to do your exercises lying or sitting to start with. Sitting leaning forwards can be helpful to start with.
Do try the exercises in a standing position as soon as you feel able to do so - initially you could try leaning forwards onto a worktop/ table top or leaning back against a wall. When standing, turning your toes inwards or your heels inwards can help activate the front and back portion of your pelvic floor muscles respectively (see pictures on the next page).
It can take 2-3 weeks to improve the brain-muscle connections allowing better coordination of your pelvic floor muscles.
It can take about 4 to 6 months to improve the strength of your pelvic floor muscles. You will need to always do some amount of the exercises to maintain their improvement.

Sitting leaning forwards

Standing leaning forwards

Leaning back against a wall

Standing turning toes inwards

Standing turning heels inwards

Top Tips

Read our top tips for remembering to do the exercises!

It is very easy to forget to do your pelvic floor exercises. Some tricks
to trigger your memory are:

Put a reminder on your phone
Try one of the pelvic floor exerciser apps that are available
Do them after emptying your bladder whilst still sitting on the toilet or standing by it
Use coloured stickers or reminder notes around the house/place of work
Use the advert break between television programmes.

Other ways to help your pelvic floor

Learn other ways to help support your pelvic floor.

Tighten your pelvic floor muscles prior and during any activity that increased the intra-abdominal pressure i.e. coughing, sneezing, lifting, carrying and bending.

You could also try:

Check you can breathe easily throughout your activity or exercise and that you are not holding your breath. This could include times when you are lifting something or when getting out of a chair.
If your symptoms feel worse with certain activities or exercise, consider lower impact activities and shorter bursts of activity whilst you improve your pelvic floor function.
Maintain a healthy body weight.
Avoid constipation - eat adequate fibre (15-30g per day) and drink adequate fluids (1.5-2 litres per day though more in hot weather, after exercise, during air travel and when you are ill). Many people find symptoms can be worse when they are
constipated as additional pressure is placed on the pelvic floor.

Need more help?

Consider self referring using the link below:

If you have a new injury or problem, please look at the self help information in our advice pages. We will often complete the same exercises and share information in clinic appointments.

If you still need some more help you can self refer into our service. Please note that the NHS is currently experiencing longer than normal waits, for more information visit our waiting times page.

Click the link below for self-referal

Click here to refer yourself to physiotherapy