Need to Strengthen Your Pelvic Floor Muscles? These Are the Exercises Pelvic Floor Physical Therapists Recommend

Learn the benefits of strengthening the pelvic floor, how physical therapy can help, and how pelvic exercises can help avoid pelvic injuries.

Published Date: Apr 27, 2023
Woman-laying-on-yoga-mat-doing-bridges-at-home

Need to Strengthen Your Pelvic Floor Muscles? These Are the Exercises Pelvic Floor Physical Therapists Recommend

Learn the benefits of strengthening the pelvic floor, how physical therapy can help, and how pelvic exercises can help avoid pelvic injuries.

Published Date: Apr 27, 2023
Woman-laying-on-yoga-mat-doing-bridges-at-home

Need to Strengthen Your Pelvic Floor Muscles? These Are the Exercises Pelvic Floor Physical Therapists Recommend

Learn the benefits of strengthening the pelvic floor, how physical therapy can help, and how pelvic exercises can help avoid pelvic injuries.

Published Date: Apr 27, 2023
Woman-laying-on-yoga-mat-doing-bridges-at-home

Need to Strengthen Your Pelvic Floor Muscles? These Are the Exercises Pelvic Floor Physical Therapists Recommend

Learn the benefits of strengthening the pelvic floor, how physical therapy can help, and how pelvic exercises can help avoid pelvic injuries.

Published Date: Apr 27, 2023
Woman-laying-on-yoga-mat-doing-bridges-at-home
Table of Contents

Doing regular strength training? Good for you. But there’s one surprising area your strength training sessions might be neglecting: your pelvic floor. 

Your pelvic floor muscles are actually a part of your core, which includes your diaphragm, abdominals, and spinal muscles. Together, these muscles are important for balance, flexibility, and stability. And they’re all connected, so problems with one area can lead to symptoms in another. Since your pelvic floor supports your bladder, bowel, and sexual organs, strengthening this part of your core can help improve your bladder and bowel control and may even improve your sexual health. 

Read on to learn about your pelvic floor, the benefits of pelvic floor physical therapy, and the best pelvic floor strengthening exercises for women and men. 

Our Hinge Health Experts

Kandis Daroski, PT, DPT
Pelvic Health Physical Therapist and Clinical Reviewer
Dr. Daroski is a pelvic health physical therapist who provides clinical expertise for the Hinge Health Women's Pelvic Health Program.
Tamara Grisales, MD
Expert Physician in Urogynecology and Medical Reviewer
Dr. Grisales is a board-certified urogynecologist and surgeon and oversees the Women's Pelvic Health program at Hinge Health.

What Is Your Pelvic Floor?

Not so familiar with your pelvic floor? It’s made up of layers of muscles, ligaments, and fascia (or connective tissue) that stretch like a hammock from your pubic bone in front of your body back to your tailbone. These structures make up the bottom or “floor” of the bowl-shaped pelvis (in both women and men). They support your pelvic organs, play a role in bladder and bowel control, sexual response, and help stabilize your body during movements like walking and standing.

Just like your biceps or quads can weaken with inactivity, your pelvic floor muscles can change or weaken due to many different factors. Some common reasons for pelvic floor muscle weakness in both men and women include: chronic coughing or sneezing, genetics, obesity, health conditions like diabetes or overactive bladder, and more. 

Female Pelvic Floor

The muscles of the female pelvic floor can also change or weaken due to pregnancy and childbirth, menopause, pelvic surgeries, and more. 

Male Pelvic Floor

Prostate cancer surgery and other treatments can also lead to pelvic floor muscle weakness in men. 

The Pelvic Floor and Your Core: A ‘Soda Can’ Analogy

Your pelvic floor muscles are one part of a larger group of muscles known as your core. Think of your core as a pressurized container not unlike a soda can — with the surfaces of the can representing different structures:

  • Diaphragm muscles (top of the can) contract rhythmically as you breathe. 

  • Abdominal muscles (front and sides of the can) support your trunk and hold your organs in place. 

  • Spinal muscles (back and sides of the can) support your spine and help you maintain your posture. 

  • Pelvic floor muscles (bottom of the can) support your organs and play a role in urination, bowel movements, sexual function, pregnancy, childbirth, and more.

When all of the structures are healthy and working well together, the can is strong and sturdy. (Think about squeezing a sealed soda can.) But what happens when you open a soda can? The contents can leak out. The bottom can sink down. The sides can be squeezed or dented, throwing off the can’s balance and structural integrity. 

The same things can happen with the system of muscles that make up your core. When one part is injured, weak, or tight, other areas are affected. That’s why problems with any part of your core can lead to pelvic floor disorders (PFDs) with common symptoms that are pretty hard to ignore — pelvic pain, urinary or fecal incontinence (leaking urine or feces), sexual problems, and more.

Physical Therapy and Pelvic Floor Strengthening

Since your pelvic floor is made up of layers of muscles, ligaments, and fascia (or connective tissue) — just like the structures in your ankles, shoulders, knees, and hips — pelvic floor problems are musculoskeletal problems. That’s why pelvic floor exercises and physical therapy to strengthen your pelvic floor makes sense.

Because your pelvic floor muscles support your bladder, bowel, and reproductive organs, strengthening these muscles can help improve your bowel and bladder control (i.e., not leaking urine or feces), prevent and treat some types of pelvic pain, and may also improve your sexual response

Pelvic floor physical therapy is a comprehensive treatment that may include education, behavioral and lifestyle strategies, movement and exercise, and manual therapy. You can see a physical therapist (PT) in person or use a program like Hinge Health to access a PT who specializes in pelvic health via telehealth video visit.

Depending on your symptoms, a pelvic floor physical therapist may recommend:

  • Pelvic floor exercises and pelvic training devices

  • Whole-body exercises to strengthen areas that support your pelvic floor 

  • Stress management techniques

  • Nutritional changes

  • Sleep strategies

Benefits of Pelvic Floor Exercises

Pelvic floor exercises and physical therapy can bring the following benefits:

  • Improved bladder control, fewer bladder leaks, and less post-void dribbling

  • Improved bowel control and reduced bowel incontinence

  • Prevention and relief for pelvic organ prolapse symptoms in women

  • Improved sexual response and function, including arousal, orgasm, and satisfaction in women; improved erection quality and less premature ejaculation in men

  • Better support for your body during everyday movements like standing, walking, and running

Pelvic Floor Muscle Strengthening vs. Relaxing: What’s the Difference?

Some pelvic health issues are due to an overly tight pelvic floor instead of pelvic floor muscle weakness. These conditions benefit from exercises that focus on relaxing the pelvic floor rather than strengthening it. Some signs of a tight pelvic floor include:

  • Pain in the perineal or vulvar region

  • Difficulty starting a stream of urine

  • Slow urine stream

  • Urinary urgency and frequency (feeling like you need to pee right after you go)

  • Constipation or “skinny poops” (pencil-thin bowel movements from pelvic muscles that don’t relax)

  • Pain with intercourse or tampon insertion in women

  • Chronic abdominal clenching and pain

  • Tailbone pain

Overdoing pelvic floor strengthening exercises can actually make some pelvic symptoms worse, especially if you have tight pelvic floor muscles. So it's a good idea to see a doctor or pelvic floor physical therapist if you have concerns.

Best Exercises to Strengthen Your Pelvic Floor

There are many different exercises to strengthen your pelvic floor. These exercises are most effective when you coordinate them with your breathing. The general rule for breathing with pelvic floor exercises is to inhale during the “rest” portion of the exercise and exhale during the “hardest” part when the muscle is contracting. The following exercises recommended by Hinge Health pelvic floor physical therapists are a great way to keep your pelvic floor muscles strong and healthy.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Tap into pain relief. Anytime, anywhere with our app.

Get exercises from a licensed physical therapist and more to relieve your pain. All right from your phone. At $0 cost to you.
Start your app tour

Hooklying Kegels are one of the best ways to strengthen your pelvic floor muscles, improve bowel and bladder control, and provide support to organs in the pelvis. To begin:

  • On a yoga mat, lie comfortably on your back with your knees bent and your feet flat on the floor. Inhale slowly. Note: Use a seated or side-lying position if you are in your second or third trimester of pregnancy.

  • Slowly exhale while you contract your pelvic floor muscles and hold for three to five seconds. It might feel like your muscles are being gently pulled up and into your body as you hold this position. You are using the muscles you would use to stop the flow of urine or prevent yourself from passing gas.

  • Inhale as you slowly release the contraction and relax your muscles for 10 seconds. 

  • Complete 10 repetitions three times a day. 

  • Increase the hold time to 10 seconds as you get stronger.

You should be able to feel your pelvic floor muscles working with each repetition. And even though you won’t see changes in your muscular strength like you might when strengthening other muscles (such as your biceps), remember to trust the process and know you’re making progress.

Bridge

Bridge

Bridge

Bridge

The bridge exercise helps strengthen your pelvic floor, hips, butt, and leg muscles. To begin:

  • On a yoga mat, lie comfortably on your back with your knees bent and your feet flat on the floor. 

  • Inhale and then slowly exhale while you push through your feet to raise your hips off the floor. Make a straight line with your torso and thighs. Focus on squeezing your pelvic floor and butt muscles as you hold this position.

  • Inhale and relax your hips back to the floor as you release your pelvic floor and butt muscles.

  • Perform 10 repetitions.

As you do each rep you might feel your pelvic floor, butt, hip, and leg muscles working. The glutes are the biggest muscle in the body, making the bridge a great exercise for sports like running and daily activities like walking and hiking.

Squat

Squat

Squat

Squat

Squats improve strength in your pelvic floor, leg, and butt muscles and overall balance. To begin:

  • Stand with your feet comfortably apart.

  • Exhale as you reach your hips back while bending your knees like you’re sitting in a chair.

  • Hold the squat position as you focus on squeezing your thigh and hip muscles. Continue exhaling. 

  • Push through your feet to straighten your knees and return to standing. Inhale

As you do each rep, you might feel your thigh, butt, and hip muscles working. This is a great exercise for activities like picking up heavy objects from the floor, going up and down stairs, and preparing for long active days like when you travel. 

Internal Hip Rotation

Internal Hip Rotation

Internal Hip Rotation

Internal Hip Rotation

Internal hip rotation helps to increase mobility and strength in your hip and pelvic floor muscles. To begin:

  • Sit comfortably in a chair and inhale.

  • Slowly exhale while sliding one foot off the floor and rotating it away from your other foot. Your thigh and knee should remain in the same position while your foot rotates to the side.

  • Inhale and relax your foot back to the floor.

As you do each repetition, you might feel your hip and pelvic floor muscles working. This is a great exercise for daily activities like sitting at a desk and getting in and out of a car.

Seated Abdominal Bracing

Seated Abdominal Bracing

Seated Abdominal Bracing

Seated Abdominal Bracing

Seated abdominal bracing helps strengthen your pelvic floor and other core muscles and improves stability. To begin:

  • Sit upright in a chair with your feet flat on the floor and inhale slowly. 

  • Exhale slowly while squeezing your abdominal muscles. 

  • Inhale slowly as you relax your abdominals. 

As you do each repetition, you might feel your core muscles working. Seated abdominal bracing helps build stability through your core to help with activities like lifting heavy objects, carrying groceries, or playing sports.

What to Avoid During Pelvic Floor Exercises

Some of the most common mistakes people make with pelvic floor strengthening exercises include:

  • Contracting other nearby muscles while performing a Kegel exercise. Focus on contracting only the pelvic floor muscles while keeping the muscles of your stomach, thighs, and buttocks relaxed.

  • Holding your breath. Breath holding increases the pressure in your abdomen and can stress your pelvic floor and lead to pelvic floor dysfunction. 

  • A full bladder. Like holding your breath, a full bladder increases the stress on your pelvic floor. It also increases the pressure on your urethral sphincters that control the flow of urine from your bladder. Empty your bladder before performing pelvic floor strengthening exercises.

  • Overdoing it. Your pelvic floor muscles can be overtaxed. This can make it difficult to relax your pelvic floor to urinate or have a bowel movement and can lead to other pelvic symptoms. 

  • Pain. Stop if you feel pain in your abdomen, back, or hips while performing pelvic floor exercises. If you’re doing them correctly, pelvic floor exercises shouldn’t hurt.

When to See a Doctor

See your doctor if you experience pain with pelvic floor exercises. Pelvic pain could be a sign that you’re doing exercises incorrectly or overdoing them. Pain could also be a sign of another health condition, like an overactive or tight pelvic floor or a urinary tract infection.

PT Tip: Remember ‘It’s Not Just Kegels’

Kegel exercises can be an important part of a pelvic floor strengthening program, but they shouldn’t be your whole program. Kegels involve consciously contracting or squeezing your pelvic floor muscles like you do when you’re trying to stop the flow of urine. 

“If you’re thinking that pelvic floor muscle strengthening is just Kegel exercises, think again,” says Kandis Daroski, PT, DPT, a physical therapist at Hinge Health. “A well-rounded pelvic floor exercise plan addresses all the body areas that may contribute to your symptoms,” she adds. “It will include exercises that strengthen other parts of your core, including your abdominal, hip, glute, and back muscles.” 

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

$0 Cost to you

Looking for pain relief? Check if your employer or health plan covers our program

Join more than 800K members and over 1,700 companies that trust Hinge Health to get relief.

References

  1. Ramalingam, K., & Monga, A. (2015). Obesity and pelvic floor dysfunction. Best practice & research. Clinical obstetrics & gynaecology, 29(4), 541–547. doi:10.1016/j.bpobgyn.2015.02.002

  2. Cho, S. T., & Kim, K. H. (2021). Pelvic floor muscle exercise and training for coping with urinary incontinence. Journal of exercise rehabilitation, 17(6), 379–387. doi:10.12965/jer.2142666.333 

  3. Dumoulin, C., Hay-Smith, E. J., & Mac Habée-Séguin, G. (2014). Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. The Cochrane database of systematic reviews, (5), CD005654. doi:10.1002/14651858.CD005654.pub3

  4. Grimes, W. R., & Stratton, M. (2021b). Pelvic Floor Dysfunction. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559246/ 

  5. Huang, Y. C., & Chang, K. V. (2022). Kegel Exercises. In StatPearls. StatPearls Publishing. 

  6. Khosravi, A., Riazi, H., Simbar, M., & Montazeri, A. (2022). Effectiveness of Kegel exercise and lubricant gel for improving sexual function in menopausal women: A randomized trial. European journal of obstetrics, gynecology, and reproductive biology, 274, 106–112. doi:10.1016/j.ejogrb.2022.05.022 

  7. Massery, M (2013. Soda pop can model [Video]. YouTube. https://www.youtube.com/watch?v=IeiKhMmjDGc

  8. Myers, C., & Smith, M. (2019). Pelvic floor muscle training improves erectile dysfunction and premature ejaculation: a systematic review. Physiotherapy, 105(2), 235–243. doi:10.1016/j.physio.2019.01.002 

  9. Siegel A. L. (2014). Pelvic floor muscle training in males: practical applications. Urology, 84(1), 1–7. doi:10.1016/j.urology.2014.03.016 

  10. Wallace, S. L., Miller, L. D., & Mishra, K. (2019). Pelvic floor physical therapy in the treatment of pelvic floor dysfunction in women. Current Opinion in Obstetrics and Gynecology, 31(6), 485–493.doi:10.1097/gco.0000000000000584 

  11. Williams, A. M. M., Sato-Klemm, M., Deegan, E. G., Eginyan, G., & Lam, T. (2022). Characterizing Pelvic Floor Muscle Activity During Walking and Jogging in Continent Adults: A Cross-Sectional Study. Frontiers in human neuroscience, 16, 912839. doi:10.3389/fnhum.2022.912839