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  • Writer's pictureRobin R Varghese, PT.

Struggling with weak pelvic floor muscles? We are here to help you!!!

Updated: Jul 17, 2023

Pelvic floor exercises

What are pelvic floor muscles?

  • The pelvic floor consists of muscles and connective tissues that support important organs in your pelvis, like your bladder, bowel (large intestine) and internal reproductive organs.

  • The pelvic floor muscles hold these organs in place while also providing the flexibility to assist with associated bodily functions

  • They form the base of a group of muscles known as your core.

  • It stretches from your pubic bone in the front of the body to the tailbone (coccyx) in the back.

  • The muscles extend outward on the right and left sides of the pelvis.

  • Several pelvic floor muscles intertwine to form a single sheet of layered muscle with openings (anus, urethra, vagina).

  • The main pelvic floor muscles are Levator ani and Coccygeus

The contraction of pelvic floor muscles during perineal exercises results in elevation of the urethra, vagina, and rectum, resulting in stabilization of the pelvic floor and resistance to downward movement.

Pelvic floor exercises can strengthen and increase neuromuscular control over the pelvic floor muscle and may reduce or eliminate symptoms associated with pelvic floor dysfunction.

Who should be doing pelvic floor exercises?

  • Urinary incontinence/frequency/urgency

  • Constipation

  • Pain in pelvic region, genitals, perineum, or rectum

  • Sexual dysfunction

  • Pelvic organ prolapse,

  • Chronic low back pain unexplained by other sources

Pelvic floor exercises involve the activation of the pelvic floor muscles.

  • As a first step, one must acquire ca comfortable position, relax all muscles, and focus on a steady breathing pattern

  • To activate the anterior pelvic floor muscles, replicate the action of stopping the flow of urine mid-stream.

  • To activate the posterior pelvic floor muscles, replicate the action of stopping passing gas.

  • To activate both the anterior and posterior pelvic floor muscles, combine the two above actions.

  • Only replicate, do not actually stop the flow of urine mid-stream as this will cause difficulty in emptying the bladder completely.


1. Pelvic tilt exercise

  • This exercise must be done correctly as this is the basic of pelvic floor exercises. Your Physical therapist is the right person who can teach you this correctly.

  • To do this exercise:

  • Lie down supine with your knees propped up.

  • Pull your naval in which will flatten your back against the floor.

  • Hold for 5 seconds and relax. Repeat this exercise.

  • As a progression, increase the hold time each session.

  • Make sure you breathe normally as you perform this exercise.

  • Also, remember that the movement during this exercise is very minimal and don’t push through your leg as that is an incorrect way to perform this.

2. Kegel Exercise

  • It consists of an isometric contraction of the pelvic floor muscles.

  • To do a Kegel exercise, follow these steps:

  • Start by holding your pelvic floor muscles in for 5 seconds. It is important to keeping breathing during this contraction.

  • After holding for 5 seconds, slowly and completely relax your muscles for 5 seconds.

  • Repeat this process 10 times, at least 3 times every day.

  • Your pelvic floor muscles may get fatigued during this exercise. If this happens, stop and do the exercise at a later time.

  • Don’t use your stomach, leg, or buttock muscles when doing this exercise.

  • As a progression, increase the duration of hold and rest periods of pelvic floor muscles. Start with 5 seconds, and slowly build up the time each week until you’re holding in and resting for 10 seconds.

3. Reverse Kegel exercise

  • The Reverse Kegel is a technique to mindfully relax pelvic floor muscles.

  • To perform a Reverse Kegel, follow these steps:

  • Start by gently contracting the pelvic floor to feel what tightening the muscles feels like.

  • Relax, and release the tension to feel the difference between tension and relaxation.

  • Then, try to visualize that the muscles between the pubic bone and tailbone lengthen by gently moving the pubic bone towards the ceiling (if you are lying on your back), and gently move your tailbone towards the surface you are lying on. Imagine that the pelvic floor muscles are getting longer as this happens creating more space in your pelvic floor.

  • During the above action, be sure to breath normally.

  • As you perform a Reverse Kegel, be sure you keep your pelvis and spine still. These can be performed in sitting and standing as well.

4. Hypopressive exercises

  • This involves a posture to be performed in different body positions like standing, kneeling, quadruped, sitting and supine, along with the with a hypopressive maneuver,

  • Here, an expiratory apnea or breath hold at end expiration is performed , while drawing-in their abdomen and opening their rib cage

5. Activation of the transversus abdominis (TrA)

  • TrA activation leads to increased pelvic floor muscle activity without directly training the pelvic floor musculature.

  • Activation of TrA has been shown to facilitate pelvic floor muscle activation and vice versa

  • Your Physical therapist will help you understand how to do this exercise before you progress the hold time. This can be a tricky exercise, but once you learn to activate the muscle, it is very simple.

The Kegel clock exercise, Pelvic tilt + ball squeeze incorporating hip flexors, etc. are a few more of the many pelvic floor exercises that one may benefit from.

Remember that you need the guidance of your physical therapist to learn and understand these exercises and their importance. Only once you get the proper training must you try them. This will help you in doing the right exercise the right way so that it can benefit your pelvic floor muscles.

At Valley Healing Hands, Brownsville, Texas, we provide the best physical therapy treatment for pelvic floor dysfunctions. Our Physical therapists will be happy to train you for all your pelvic floor related complaints with their expertise. Our patients are satisfied and happy with our services. You can check what they have to say about us and contact us here. Our patients love us and you too will!!!

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