The pelvic floor is a set of muscles that supports pelvic organs, such as the bladder and bowel. These muscles aid urinary control, continence, and sexual function.
Both men and women can experience pelvic floor weakness over time. As with other muscles, people can perform exercises to strengthen the pelvic floor, enhancing bowel and bladder control.
Pelvic floor exercises offer women many benefits, including a lower risk of vaginal prolapse, better bowel and bladder control, and improved recovery after childbirth.
They can also benefit men by speeding recovery after prostate surgery, reducing the risk of rectal prolapse, and improving bowel and bladder control.
Anyone who has recently had surgery or given birth must talk to a doctor before beginning an exercise program for the pelvic floor to ensure that they can safely begin working these muscles again.
Kegel exercises focus on tightening and holding the muscles that control urine flow. This exercise is suitable for men and women.
A Kegel exercise consists of the following steps:
- Sit in a comfortable position, close the eyes, and visualize the muscles that can stop urine flow.
- Tighten these muscles as much as possible.
- Hold this position for 3–5 seconds. It should feel as though the muscles are lifting up as a result of the squeezing.
- Release the muscles and rest for several seconds.
- Repeat up to 10 times.
People can vary this exercise by performing it while standing, lying down, or crouching on all fours.
This exercise is a rapid "squeeze and release" movement that builds the ability of the pelvic floor muscles to respond quickly.
To perform this exercise, a person should:
- Sit in a comfortable position.
- Picture the pelvic floor muscles.
- Squeeze the muscles as quickly as possible and release without attempting to sustain a contraction.
- Rest for 3–5 seconds.
- Repeat the movement 10–20 times.
- Repeat the exercise twice later in the day.
While bridges primarily strengthen the buttocks, they also help work the pelvic floor.
People can do a bridge using these steps:
- Lie down on the back, bend the knees, and place the feet flat on the floor about hip-width apart. Let the arms fall to the sides with the palms facing downward.
- Contract the buttocks and pelvic floor to lift the buttocks several inches off the ground.
- Hold this position for 3–8 seconds.
- Relax the buttocks and pelvic floor muscles to lower the buttocks to the ground.
- Repeat up to 10 times.
- Rest, then perform up to 2 additional sets.
As the strength of the pelvic floor increases, many people will find that they can do more repetitions.
Along with the bridge, squats can promote a stronger pelvic floor and buttocks.
To perform a squat, a person should:
- Stand with the feet hip-width apart, keeping them flat on the floor.
- Bend at the knees to bring the buttocks toward the floor, going only as low as is comfortable. Keep the back straight and leaning slightly forward. The knees should be in line with the toes.
- Focus on tightening the buttocks and pelvic floor while returning to a standing position.
- Repeat this exercise to do a total of 10 repetitions.
- Rest before performing any additional sets.
Not all squats target the pelvic floor. Wide-legged or deep squats may make it difficult to retain a pelvic floor contraction. When strengthening the pelvic floor, narrow and shallow squats tend to be more beneficial.
People may have difficulty targeting their pelvic floor specifically to perform the exercises. Specialized physical therapists known as pelvic floor therapists can help a person identify their pelvic floor using different feedback devices.
One example is a biofeedback device that involves placing sticky electrodes on key areas of a person's body and asking them to contract their pelvic floor muscles. The electrodes send signals to a computer that can identify when they are contracting the correct muscles.
Sometimes, a person may have nerve damage that prevents them from contracting their pelvic floor muscles on their own.
Where this is the case, a pelvic floor therapist may offer pelvic stimulation therapy, which can help produce muscle contractions.
Some exercises may be too difficult for a person with a very weak pelvic floor. Performing the exercises may further weaken their muscles and lead to more problems with incontinence.
Until a person has done several months of pelvic floor work, they should avoid the following exercises:
- situps with straight legs in the air
- lifting heavy weights for minimal repetitions
- double leg lifts
- running, jumping, and other high-impact activities
One common misconception about pelvic floor exercises is that it is beneficial to try to stop urinating midstream to test pelvic floor muscle control. This is not an effective practice as it could result in incomplete emptying of the bladder.
Incomplete emptying can increase the risk of urinary tract infections (UTIs) and other urinary disorders.
A person should talk to their pelvic floor therapist, doctor, or physical therapist about whether there are any specific exercises they should avoid after surgery or childbirth.
In addition to practicing pelvic floor exercises on a daily basis, everyday activities can help strengthen the pelvic floor. These include walking, standing up straight, and sitting properly.
Both men and women can also tighten and squeeze the pelvic floor muscles each time they sneeze, cough, or lift something heavy. These activities help strengthen the pelvic floor further and prevent incontinence.