Kegel Exercises: How to Contract Your Pelvic Floor
Kegel exercises are contractions that strengthen your pelvic floor muscles—the figure 8 muscle group that expands from the pubic bone to your tailbone. The pelvic floor is known for supporting organs like your uterus and bladder. It's also the first group of muscles to activate when you decide to "make a move."
A strong pelvic floor is important in your function before, during, and after pregnancy. We place a constant demand on our pelvic floor throughout the day as we lift kids, carry things, jump during a fitness class, and walk. What you do for your pelvic floor during pregnancy can also have lifelong implications. Because the pelvic floor is a figure 8 muscle, it is important to do Kegels that work the entire pelvic floor.
How to perform Kegels
A proper pelvic floor muscle contraction—or Kegel—tightens and lifts the pelvic floor, drawing in the muscles around the anal and vaginal openings. Using a mirror to look at your own anatomy can be helpful!
Start by lying down on your back (this is an easy position for the contraction).
Place your hand on the outside of your pelvic floor area with the heel of your hand at your pubic bone and fingers pointed backward toward your anus.
Contract your pelvic floor by pulling your tailbone UP and IN toward the belt line. You want to feel the sensation of these muscles pulling up and into the pelvic cavity. Imagine a string is attached to your tailbone, and draw that string up and in towards your belt line. When performing a contraction correctly, you should feel the area underneath your hand lift away.
During a contraction, you should NOT hold your breath, tighten your abdominals, squeeze your thighs together, tighten your butt, or bear down (this causes you to over-recruit the wrong muscles). You should feel a slight lift of your pelvic floor muscles between your tailbone and pubic bone.
After your contraction, relax your pelvic floor muscles. The most common mistake is not relaxing the pelvic floor fully between Kegels. You want to give yourself a healthy rest period between contractions. The pelvic floor needs to be able to relax and drop down to a resting position before you lift it into a contraction again!
At your 6-week postpartum follow-up with your doctor or midwife, don't be afraid to ask them to check your muscles to make sure that you're contracting your pelvic floor muscles correctly.
At Home Workouts For Each Week of Pregnancy
The Expecting and Empowered App Pregnancy Program was created for women looking to alleviate common aches and pains in pregnancy, as well as prepare your pelvic floor for labor and delivery. With 30 minute workouts for any fitness level - this app is a must have for all moms to be!
Helpful cues to perform Kegels correctly
Use your hand or sit on towels. This way, you can feel your pelvic floor rise off the surface.
Pull your pelvic floor muscles up and in while trying to squeeze your own (inserted) finger, a tampon, your partner's penis, etc.
Pretend that you are picking up a blueberry with your vagina.
Pretend you are stopping urine from coming out.
IMPORTANT NOTE: Do NOT practice Kegels while you're actually urinating. This is BAD advice given with good intentions. Performing Kegels when you pee can disrupt the ability to empty your bladder and cause a urinary tract infection.
Pretend you are trying to hold in gas. Try to feel the back of your pelvic floor contract.
Sit and lean forward to rest your elbows on your knees. Try to feel the front of your pelvic floor contract.
Why should you care about performing Kegels correctly?
The pelvic floor plays a role in incontinence. Nearly 42% of women experience stress urinary incontinence—leaking urine while lifting, running, jumping, coughing, laughing, or sneezing. Any leaking during pregnancy is NOT normal! If you experience leaking during your first pregnancy, your chances of being incontinent 15 years later DOUBLES. Like any other muscle, your pelvic floor muscles can weaken with age—this is why it's important to build strength NOW.
Some exercises can weaken the pelvic floor. Did you know that athletes typically have weaker pelvic floors compared to their non-athlete counterparts? This is because athletic demands on the body can often cause too much pressure on the pelvic floor—a muscle that most athletes don't even think to strengthen.
Running is a repetitive activity that places continual pressure on the pelvic floor- that said, be cautious if you return to running postpartum.
If you are a CrossFitter, powerlifter, etc., heavy lifting that places too much intra-abdominal pressure on a tight or weak pelvic floor can create long-lasting problems.
Kegels can help pelvic organ prolapse (POP). A weak pelvic floor can make prolapse worse, causing the pelvic organs (uterus/cervix, bladder/urethra, and rectum) to sag further into the vagina. The pelvic floor helps support your bladder, uterus, and rectum—so keeping your pelvic floor strong helps keep these internal organs inside your body where they belong.
Make sure you are exercising ALL OF THE PELVIC FLOOR
Performing Kegels in different positions is useful for different times during pregnancy and postpartum. Here are some of our favorite moves featured in the Expecting & Empowered App that help you contract the front and both sides.
Front of the pelvic floor: You can do Kegel exercises during standing ski jump, seated ski jump, and Down Dog. These exercises tip your pelvis forward, bringing attention to the front of your pelvis. Strengthening the front of the pelvic floor is very helpful for moms who still feel a bit of a dribble after peeing or who have a little leakage after standing.
Left and right sides: If you bring one leg out to the side (i.e., your right leg), you are making the left side of the pelvic floor do MORE. This is great if you display weakness on the left side and want it to catch up to the right. You can bring one leg to the side while sitting or on all four (quadruped). Then, do a pelvic floor contraction and try to move on the other side. Do you notice a difference? Is one side easier? If so, focus on doing Kegels on the HARD (not so easy side to do the contraction on) side. It's human nature to avoid stuff we are not good at, but it is much needed!
Kegels if you have prolapse
Cystocele Prolapse (anterior vaginal wall issues): Try doing Kegels in quadruped, lying on your belly, or sitting while leaning forward with elbows on your knees.
Rectocele Prolapse (posterior vaginal wall): Perform Kegels lying on your back, propping up your butt with pillows underneath it.
Kegels during pregnancy
Especially during the third trimester, doing Kegels in quadruped makes it easier to contract your muscles because the baby's weight is not on your pelvic floor. You can also do pelvic floor contraction exercises in a squat position. Even though this position adds more weight, it can help get you used to using your pelvic floor in an ideal position for laboring.
How do I know I’m doing Kegels correctly?
The key to contracting your pelvic floor is taking the time to learn! While you practice Kegels, use these tips to make sure you're turning on your pelvic floor:
Try using your hand to feel the outside of your pelvic floor (this makes it easier to identify a lift).
Try sitting on a bolster/ball for extra feedback so you can feel it.
Try squeezing during intercourse to see if you can create tension.
Try stacking your ribs over your hips as you do Kegels to see if the contraction improves.
Still need more help? See a Women's Health Physical Therapist! Your pelvic floor could be too tight, or you may need some biofeedback to help you figure out how to contract your pelvic floor. You can find a Women's Health PT in your area via APTA's pelvic health PT locator or Pelvic Rehab's pelvic rehab practitioner directory.
Sources
American College of Obstetricians and Gynecologists. (2023). Pelvic support problems.
Bordoni B, et al. (2023). Anatomy, abdomen and pelvis, pelvic floor. https://www.ncbi.nlm.nih.gov/books/NBK482200/
Culleton-Quinn E, et al. (2022). Elite female athletes’ experiences of symptoms of pelvic floor dysfunction: A systematic review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9477953/
Gao J, et al. (2021). Risk factors of postpartum stress urinary incontinence in primiparas. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8137028/
Gonzalez G, et al. (2020). Women's experience with stress urinary incontinence: Insights from social media analytics. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9354536/
National Institute of Diabetes and Digestive and Kidney Diseases. (2021). Kegel exercises. https://www.niddk.nih.gov/health-information/urologic-diseases/kegel-exercises