You can strengthen and lengthen your pelvic floor muscles with exercises, including quick flick Kegels and heel slides. Treating underlying conditions and changing certain habits may also help.
If you can’t sneeze, laugh, or cough without leaking a little urine, you’re not alone. Problems with the pelvic floor are common and can happen to anyone.
The good news? Incorporating specific exercises (aka pelvic floor muscle training) into your overall fitness routine
Here’s an easy-to-understand guide to what the pelvic floor is, what it does, how to find these muscles, and tips regarding when to see a professional. Plus, it provides five exercises to help strengthen your pelvic floor that you can start doing right away!
You can activate the pelvic floor anytime, anywhere. But it’s also beneficial to incorporate specific exercises that strengthen and target the pelvic floor muscles.
One way to design a program is to categorize the exercises for those who have hypotonic pelvic floor muscles versus those who have hypertonic pelvic floor muscles.
Hypotonic means you have low tone pelvic floor issues and need to strengthen and improve endurance and power. Hypertonic means your pelvic floor muscles are too tight or overactive and need to lengthen and relax the muscles.
Exercises for hypotonic pelvic floor muscles
To target hypotonic pelvic floor issues, Marcy Crouch, PT, DPT, WCS, a board certified clinical specialist in women’s health, recommends these 3 exercises:
Quick flick Kegels
Crouch says the quick flick Kegel requires quick contractions of your pelvic floor to help activate the muscles faster and stronger to stop leaks upon sneezing or coughing.
- Begin by lying on the floor with your knees bent and feet flat on the floor. As this exercise becomes easier, try sitting or standing while performing it.
- Find your pelvic floor muscles using the tips described above.
- Exhale, pull your navel to your spine, and quickly contract and release your pelvic floor muscles. Aim to contract for 1 second before releasing.
- Maintain steady breathing throughout.
- Repeat the quick flick 10 times, then rest for 10 seconds. Do 2–3 sets.
Heel slides encourage pelvic floor contractions while targeting the deep abdominal muscles.
- Begin by lying on the floor with your knees bent and pelvis in a neutral position.
- Inhale into the rib cage, then exhale through the mouth, letting your ribs naturally compress.
- Draw your pelvic floor up, lock in your core, and slide your right heel away from you. Only go as far as you can without losing your connection to your deep core.
- Find the bottom position, then inhale and bring your leg back to starting position.
- Do 10 slides up and back and then repeat with the other leg.
Marches (also called toe taps)
Like heel slides, the marching exercise increases core stability and encourages pelvic floor contractions.
- Begin by lying on the floor with your knees bent and pelvis in a neutral position.
- Inhale into your rib cage, then exhale through your mouth, letting your ribs naturally compress.
- Draw your pelvic floor up and lock in your core.
- Slowly lift one leg up to a tabletop position.
- Slowly lower this leg to the starting position.
- Repeat the movement, alternating legs. You should not feel any pain in your lower back. It’s important that your deep core stays engaged throughout the entire exercise.
- Alternate legs for 12–20 times total.
Exercises for hypertonic pelvic floor muscles
Hypertonic exercises may provide some relaxation and lengthening for someone who has short or tight pelvic floor muscles.
Crouch says the goal is to lengthen and relax the hypertonic muscles, so contractions are more effective and the muscles can work effectively. “We have to make sure the muscle can do what we need it to do, so lengthening is just as important as strengthening,” she says.
Here are 2 exercises that she recommends:
Happy Baby Pose
The Happy Baby Pose is a great addition to a pelvic floor routine when stretching and releasing are the goal.
- Begin by lying on the floor with your knees bent.
- Bring your knees toward your belly at a 90-degree angle, with the soles of your feet facing up.
- Grab and hold the outside or inside of your feet.
- Open your knees until they’re slightly wider than your torso. Then, bring your feet up toward your armpits. Make sure your ankles are over your knees.
- Flex your heels and push your feet into your hands. You can stay in this position for several breaths or gently rock from side to side.
- Begin by lying flat on the floor on a yoga or exercise mat. You can also perform the exercise in a seated position.
- Do a few seconds of progressive relaxation. Focus on releasing the tension in your body.
- Once relaxed, put one hand on your stomach and the other on your chest.
- Inhale through your nose to expand your stomach — your chest should stay relatively still. Then, breathe in for 2–3 seconds and exhale slowly.
- Repeat several times while keeping one hand on the chest and one on the stomach.
Crouch also recommends adding lunges and squats to a pelvic floor routine. “Everyday exercise like lunging and Swiss ball squats can be great ways to add in pelvic floor strengthening,” she says.
When performing these moves, Crouch says to think about contracting the pelvic floor before you go down into the lunge or squat, re-engaging at the bottom, and then contracting again as you drive up to standing.
Quick flick Kegels, marches, heel slides, Happy Baby Pose, and diaphragmatic breathing are five exercises that help relax and condition the pelvic floor muscles.
Like other muscles in your body, the pelvic floor operates best when the muscles are strong and able to release fully after a full contraction. Strengthening the pelvic floor
Improved pelvic floor function may also improve quality of life.
For example, if you have pelvic floor prolapse, strengthening the pelvic floor muscles
- including urinary leakage
- pelvic pressure
- lower back pain
A pelvic floor strengthening program
Some research supports the connection between male sexual function and pelvic floor function. Specifically, researchers cite how pelvic floor physical therapy can potentially improve erectile dysfunction and ejaculation problems.
Moreover, regularly squeezing or contracting the pelvic floor muscles
Finally, the American Urological Association recommends pelvic floor muscle training as part of a treatment plan for overactive bladder. The goal of this therapy is to inhibit involuntary bladder contractions and decrease incontinence.
Strengthening the pelvic floor muscles can reduce incontinence, improve sexual health, decrease symptoms of pelvic floor prolapse, and help treat overactive bladder.
The pelvic floor comprises muscles and connective tissues. These soft tissues attach to your pelvis, and more specifically, to the bones at the bottom of the pelvis.
In all people, the pelvic organs include the urethra, bladder, intestines, and rectum. If you have a vagina, the pelvic floor also consists of the uterus, cervix, and vagina.
One of the simplest ways to find the pelvic floor is to stop or slow urine flow while going to the bathroom. If you can do this successfully at least a few times, you’ve found your pelvic floor.
Another good way to activate the pelvic floor muscles, says Crouch, is this:
- Lie down with your knees bent and feet flat on the floor. Inhale.
- Exhale gently, draw in your lower abdominal muscles, and squeeze in the muscles around the urethra like you’re trying to stop gas or urine. People with a vagina can also focus on lifting or squeezing the muscles around the vagina.
- Hold for 1–2 seconds, then let everything go. You should feel the pelvic floor muscles release and drop.
One way to find the pelvic floor muscles while standing is to imagine you need to pass gas but don’t want to let it out.
If you’re trying to hold it in, there’s a good chance you’ll squeeze your rectum and anus. The muscles you activate are those comprising the pelvic floor, especially if you feel a pulling sensation at your anus.
How to effectively engage the pelvic floor muscles
When engaging the pelvic floor, it’s important to remember that these muscles span the distance across the bottom of your pelvis. So, if you’re contracting only the muscles that control the flow of urine but not the rectal muscles, you aren’t getting a full contraction.
For the most effective contraction, engage both areas — the muscles that would stop gas and urine simultaneously.
Likewise, engaging the pelvic floor muscles
This is especially important to remember when you’re an active individual or looking to increase your core strength for functional purposes.
Still, learning to release or relax the contraction of these muscles is just as important for optimal pelvic floor function. Once you’re able to feel the sensation of contraction in these muscles, check in with yourself occasionally: Are these muscles always turned on, even just a little?
One way to think about it is to imagine your pelvic floor muscles as an elevator. When you’re sitting at your desk or standing and doing dishes, take note of where the elevator has come to a stop. Is it at the bottom floor? At the third floor? Or all the way at the tenth?
Learning to let the elevator rest at the bottom is important, too, as excess tension in these muscles can cause pain.
There are several ways to find the pelvic floor muscles, including stopping urine midstream and trying to prevent gas from leaving your body. It’s important to learn how to both contract and relax these muscles.
Chronic issues with the pelvic floor can be caused by both hypotonic muscles (pelvic muscles that are too lax or weak) or hypertonic muscles (pelvic floor muscles that are too tight or overactive).
Sometimes, these conditions are referred to as relaxing pelvic floor dysfunction and nonrelaxing pelvic floor dysfunction.
Pelvic floor dysfunction can also happen on a continuum, with both hypotonic and hypertonic issues. This often comes as a surprise to people who assume their pelvic floor issues are caused by inactive muscles.
But here’s the deal: Not everyone should be doing Kegels.
The pelvic floor comprises skeletal muscle. “That means it can have the same kind of injuries, weakness, or trauma like any other muscle in your body,” says Crouch. “It can also become “tight” or chronically contracted — think a muscle spasm in your calf.”
If the muscles are in spasm, contracted, or too tight, Crouch says doing Kegels can worsen the problem — pain, leaking, constipation, or sexual dysfunction. In other words, if your pelvic floor is hypertonic, it’s best to avoid Kegels until you consult a pelvic floor physical therapist.
Pelvic floor muscles can be hypotonic (too weak or lax) or hypertonic (too tight).
For a lot of people, adding pelvic floor exercises to their daily routine is a simple way to strengthen these muscles and maintain overall pelvic health.
But for many others, seeking help from a doctor or a physical therapist trained in pelvic floor issues is a necessary intervention. This is especially true if you’re having bowel or bladder control problems.
Here are some signs to watch for that may indicate it’s time to see a professional:
- leaking urine or stool
- problems with having a bowel movement
- pressure or discomfort in the pelvis
- seeing or feeling a bulge protruding out of the vagina or anus
- pain while urinating
- difficulty emptying the bladder or bowels completely
Remember, it’s always OK to call your doctor, even if you feel your symptoms are not that severe. Finding the right treatment for your situation can help you feel better and prevent any further damage to the pelvic floor area.
Call your doctor if you’re experiencing bladder control issues, pain or discomfort, or symptoms related to pelvic floor prolapse.
What does the pelvic floor do?
The pelvic floor muscles are critical to daily functions. They
Plus, they help stabilize your hips and trunk, especially when walking and standing.
Do people of all genders have these muscles?
Yes, people of all genders have these muscles. In people with a penis, the pelvic floor muscles support the bladder and bowel, preventing leakage of stool and urine. They also help with sexual health, including function and sensation.
Diagnoses of pelvic floor disorders in men may include:
- chronic prostatitis
- pudendal neuralgia
- genitofemoral neuralgia
How do I know if my pelvic floor is weak?
When the pelvic floor muscles are weak or malfunctioning, they lose the ability to fully support the pelvic organs, causing pelvic floor disorders. These disorders can include:
Symptoms of pelvic floor dysfunction include:
- pelvic pressure or fullness
- the frequent urge to urinate or painful urination
- urinary leakage
- urinary incontinence
- lower back pain
- constipation, difficulties with bowel movements, or bowel leakage
- difficulty emptying the bladder
- pain with sexual intercourse
- pain in the pelvic region or genitals
- pelvic muscle spasms
How long does it take to strengthen the pelvic floor?
The amount of time it takes to strengthen the pelvic floor with exercise will depend on a variety of factors, including any underlying conditions and how often you exercise the muscles. In
It’s important to discuss any exercise program with a doctor. They can help identify exercises that are right for you, including how often to do them and how long it may take before you see results.
Adding pelvic floor strengthening exercises to your day is an excellent way to give these muscles a workout and boost your overall health. Remember to focus on form and function and engage the muscles each time you do an exercise.
If you’re new to these exercises or want extra help, consider consulting a pelvic floor physical therapist. They can recommend specific exercises and ensure you’re doing them correctly.
Finally, if your symptoms interfere with daily activities or seem to be getting worse, make an appointment with your doctor.