Pelvic floor exercises strengthen the group of muscles at the base of your pelvis that support your bladder, bowel, uterus, and rectum. These muscles control urinary and bowel continence, contribute to sexual function, and work as part of your deep core to stabilise your spine. When pelvic floor muscles weaken from pregnancy, childbirth, aging, or inactivity, problems like bladder leaking, pelvic pressure, and lower back pain often follow. Pelvic floor therapy addresses these problems through targeted exercise and hands-on treatment. The guide below walks you through five pelvic floor exercises step by step, explains how to do them correctly, and covers how often to train, how long results take, and when to see a physiotherapist for help.

What Are Signs of a Weak Pelvic Floor?

Signs of a weak pelvic floor include:

• Leaking urine when you cough, sneeze, laugh, or exercise (stress incontinence)
• A sudden, strong urge to urinate that is hard to defer (urge incontinence)
• A feeling of heaviness or pressure in the vaginal area
• Difficulty fully emptying your bladder or bowel
• Reduced sensation during intercourse
• Persistent lower back pain that does not respond to standard treatment

Pelvic floor weakness is far more common than most people realise. Data from the Canadian Medical Association Journal (CMAJ) shows that 29 to 34.5% of adult Canadian women experience urinary incontinence. A study published in Obstetrics and Gynecology using NHANES data found that approximately 25% of women in the United States report at least one pelvic floor disorder. Despite this prevalence, a McMaster University study found that only 55.8% of Canadian women with urinary incontinence sought medical advice, waiting an average of 14 months after symptoms began.

Recognising these signs early matters because pelvic floor muscles respond well to exercise when you start before symptoms become severe. Chiropractic care can complement pelvic floor exercise by addressing spinal alignment and sacroiliac joint issues that often accompany pelvic floor weakness.

What Are the 5 Best Pelvic Floor Exercises Step by Step?

The 5 best pelvic floor exercises step by step are Kegels (long hold contractions), quick flick Kegels, glute bridges with pelvic floor activation, pelvic tilts, and bird dogs. Each exercise targets the pelvic floor muscles from a different angle, and doing all five together builds strength, endurance, speed, and coordination across the entire deep core system. International clinical practice guidelines recommend pelvic floor muscle training as the first-line treatment for stress and mixed urinary incontinence with Level A evidence.

Before you begin any of these exercises, take a moment to find your pelvic floor muscles. Imagine you are trying to stop the flow of urine midstream or hold back gas. The muscles you feel lifting and squeezing inward are your pelvic floor muscles. Use this cue only once or twice as a test; do not practise on the toilet regularly, as interrupting urine flow can affect normal bladder function.

One important note: not every pelvic floor problem requires strengthening exercises. If your pelvic floor muscles are already too tight (hypertonic), doing Kegels can worsen your symptoms. A professional assessment from a registered physiotherapist determines whether your pelvic floor needs strengthening, relaxation, or better coordination. At our clinic in Markham, exercise rehabilitation programmes are always built on an assessment, never on guesswork.

Kegels (Long Hold Contractions)

Kegel exercises are the most widely studied pelvic floor exercise and the foundation of most pelvic floor training programmes. Kegels involve contracting the pelvic floor muscles, holding the contraction, then fully relaxing. A 2018 Cochrane review of 31 randomised controlled trials found that pelvic floor muscle training produced cure or significant improvement in approximately 70% of women with stress urinary incontinence.

1. Sit comfortably in a chair with your feet flat on the floor, or lie on your back with your knees bent. Keep your shoulders relaxed and your jaw unclenched.
2. Close the back passage as if you are stopping yourself from passing gas. Then squeeze and lift the front passage (around the urethra and vagina) upward and inward.
3. Hold the contraction for 3 to 5 seconds. Breathe normally throughout the hold; do not hold your breath.
4. Release the contraction slowly and fully. Feel the muscles let go completely. Rest for 5 seconds.
5. Repeat 10 times. This is one set. Aim for 3 sets per day.

As your pelvic floor muscles grow stronger, gradually increase the hold time from 3 seconds to 5, then to 8, and eventually to 10 seconds. The relaxation phase is equally important; pelvic floor muscles need to release fully between contractions to build functional strength.

Quick Flick Kegels

Quick flick Kegels train the fast-twitch muscle fibres of the pelvic floor. Fast-twitch fibres are the fibres that contract rapidly when you cough, sneeze, or laugh, preventing leaks during sudden pressure increases. Long holds alone do not train this speed response.

1. Start in the same comfortable position as the long hold Kegels.
2. Squeeze and lift the pelvic floor muscles as quickly and firmly as you can.
3. Release immediately. Do not hold the contraction.
4. Rest for 1 to 2 seconds between each flick.
5. Repeat 10 times. Perform after each set of long hold Kegels.

Quick flick Kegels also form the basis of the “knack” technique. The knack involves deliberately bracing your pelvic floor muscles just before you cough, sneeze, or lift something heavy. This pre-contraction protects against leaking during moments of sudden abdominal pressure and is one of the most practical skills pelvic floor training can teach you.

Glute Bridges With Pelvic Floor Activation

Glute bridges strengthen the gluteal muscles and hamstrings while simultaneously engaging the pelvic floor. Stronger glutes provide additional support to the pelvic floor from below, which is especially helpful for preventing leaking during position changes like getting up from a chair.

1. Lie on your back with your knees bent and feet flat on the floor, hip-width apart. Place your arms at your sides, palms facing down.
2. Exhale and contract your pelvic floor muscles (squeeze and lift).
3. Press through your heels and lift your hips toward the ceiling, keeping your pelvic floor engaged. Your body should form a straight line from your shoulders to your knees.
4. Hold the bridge for 5 to 10 seconds while breathing steadily.
5. Lower your hips slowly back to the floor, then release your pelvic floor contraction.
6. Repeat 10 to 15 times. Aim for 2 to 3 sets per day.

Pelvic Tilts

Pelvic tilts strengthen the lower abdominal muscles and improve the coordination between your abdominals and your pelvic floor. The transversus abdominis (the deepest abdominal muscle) works directly alongside the pelvic floor as part of the deep core canister, and training them together produces better results than training either in isolation.

1. Lie on your back with your knees bent and feet flat on the floor.
2. Inhale gently. On the exhale, tighten your lower abdominal muscles and press your lower back flat into the floor. You should feel a slight tilting of your pelvis.
3. Hold this position for 3 to 5 seconds while breathing normally.
4. Release and return to the starting position.
5. Repeat 10 to 15 times. Aim for 2 to 3 sets per day.

Bird Dog

The bird dog exercise activates the pelvic floor, the lower back stabilisers, and the deep abdominal muscles simultaneously. Research published in the AHRQ pelvic floor therapy handout from University Hospitals of Cleveland confirms that bracing these muscles during lifting, sneezing, and exercise both strengthens and protects the pelvic floor.

1. Start on your hands and knees with your wrists directly under your shoulders and your knees under your hips. Keep your back straight and your neck in a neutral position.
2. Engage your pelvic floor muscles and brace your abdominals gently.
3. Simultaneously extend your right arm forward and your left leg backward, keeping your hips and shoulders level. Do not let your pelvis rotate or your lower back arch.
4. Hold for 2 to 3 seconds.
5. Return to the starting position with control. Repeat on the opposite side (left arm, right leg). This counts as one repetition.
6. Perform 6 to 10 repetitions. Aim for 1 to 2 sets per day.

Exercise	Target Action	Starting Reps/Hold	Position	Level
Kegels (Long Hold)	Endurance (slow-twitch fibres)	10 reps, 3-5 sec hold	Lying, sitting, or standing	Beginner
Quick Flick Kegels	Speed (fast-twitch fibres)	10 reps, no hold	Lying, sitting, or standing	Beginner
Glute Bridge	Pelvic floor + glutes + core	10-15 reps, 5-10 sec hold	Lying on back	Beginner-Intermediate
Pelvic Tilt	Deep core + pelvic floor coordination	10-15 reps, 3-5 sec hold	Lying on back	Beginner
Bird Dog	Full core stabilisation + pelvic floor	6-10 reps, 2-3 sec hold	Hands and knees	Intermediate

Sources: Cleveland Clinic Kegel exercise guidelines; AHRQ Pelvic Floor Therapy Exercise Handout (University Hospitals of Cleveland); UT Health San Antonio MD Anderson Cancer Center; NHS Inform Scotland pelvic floor exercise programme.

How Do I Know If I Am Doing My Pelvic Floor Exercises Correctly?

You know you are doing your pelvic floor exercises correctly if you feel a distinct squeeze-and-lift sensation inside the pelvis without tightening your stomach, your buttocks, or your inner thighs. Your breathing should remain steady throughout. You should not feel pain, bearing down, or pressure pushing outward.

Getting the technique wrong is remarkably common. Research from Zanetti et al. found that approximately 30% of women cannot contract their pelvic floor muscles correctly even with instruction. A separate study cited in widely referenced postmenopausal health research found that up to 40% of women given only verbal Kegel instructions were unable to perform the contraction sufficiently. If your symptoms are not improving after 6 to 8 weeks of consistent practice, or if you are unsure whether you are using the right muscles, a registered physiotherapist with pelvic health training can assess your technique using internal examination or biofeedback technology.

An assessment provides a baseline measurement of your pelvic floor muscle tone, strength, and coordination. Pelvic floor treatment guided by a professional produces significantly better outcomes than unsupervised exercise alone, because a physiotherapist can identify whether you need strengthening, relaxation, or a combination of both.

Does Squeezing Buttocks Help the Pelvic Floor?

No, squeezing your buttocks does not help the pelvic floor. Squeezing the buttocks activates the gluteal muscles, not the pelvic floor muscles. While the glutes provide external support to the pelvis, they are a separate muscle group. Clenching the buttocks, inner thighs, or abdominals during Kegel exercises is one of the most common mistakes and means the pelvic floor itself is not being trained. The contraction should feel internal, like a lifting and drawing-in motion, not an external clenching.

What Is the Easiest Position to Do Pelvic Floor Exercises?

The easiest position to do pelvic floor exercises is lying on your back with your knees bent. Lying down removes the effect of gravity on the pelvic floor, making it easier to isolate and contract the correct muscles. Cleveland Clinic’s Kegel exercise guidelines confirm that people with weak pelvic muscles may want to start lying down before progressing.

Once you can perform pelvic floor contractions confidently while lying down, progress to sitting upright in a chair. Sitting adds some gravitational load but still provides support through the seat. After sitting becomes comfortable, progress to standing. Standing is the most challenging position because the pelvic floor must work against full gravitational pull. The final progression is performing pelvic floor contractions during functional activities like walking, bending, and lifting. This functional integration is what transfers exercise-room gains into real-life protection against leaking. For more on preparing for a physiotherapy session where your technique can be assessed, our practical guide covers everything you need.

How Many Times a Day Should You Do Pelvic Floor Exercises?

You should do pelvic floor exercises 3 times a day, performing 10 long hold contractions and 10 quick flick contractions per session. This frequency is consistent across Cleveland Clinic, NHS, and international clinical practice guidelines. Each session takes approximately 5 to 10 minutes.

A practical daily schedule works well when you tie your pelvic floor exercises to existing habits. Practise one set when you wake up in the morning, one set at midday, and one set before bed. Consistency matters more than volume. Research consistently shows that daily training of 3 sets of 10 to 15 contractions outperforms sporadic higher-volume sessions. The Canadian Urinary Bladder Survey found that 3.5 million Canadians are affected by urinary incontinence, yet most people who start pelvic floor exercises abandon them within weeks because they do not build the habit into a routine.

How Long Should You Be Able to Squeeze Your Pelvic Floor?

You should eventually be able to squeeze your pelvic floor for 10 seconds with a full relaxation between each contraction. Most people start at 2 to 3 seconds and work up gradually over several weeks. The NHS Inform Scotland pelvic floor exercise programme recommends starting at whatever hold time feels right for you and progressively building toward a 10-second hold with 5 seconds of relaxation between repetitions.

Hold duration matters because the pelvic floor contains both slow-twitch muscle fibres (which provide sustained support throughout the day) and fast-twitch fibres (which fire quickly during sudden pressure events). Long hold Kegels train the slow-twitch endurance fibres. Quick flick Kegels train the fast-twitch speed fibres. Training both types produces the most complete pelvic floor strengthening.

How Long Will It Take to Strengthen Your Pelvic Floor With Exercises?

It takes approximately 4 to 6 weeks of consistent daily pelvic floor exercises to notice initial improvement, and 8 to 12 weeks to achieve significant measurable results. Cleveland Clinic states that most people notice changes after 6 to 8 weeks. A systematic review by Bø and Hilde published in 2013 found that optimal clinical results required a minimum of 15 to 20 weeks of consistent daily training, with most measurable improvement occurring in the 8 to 12 week window.

A randomised controlled trial published in the journal Medicine in 2025 found that regular pelvic floor exercise produced positive effects on all sexual health subdimensions within 6 weeks. A separate study published in Healthcare in 2025 demonstrated that a 10-week combined exercise programme significantly improved both fast-twitch and slow-twitch pelvic floor muscle fibre strength in postpartum women. These findings reinforce that pelvic floor muscles respond to progressive training in the same way other skeletal muscles do: gradually, measurably, and reliably, if the programme is followed consistently.

If you are not seeing improvement after 8 to 12 weeks of consistent practice, seek a professional assessment. Pelvic floor physiotherapy guided by a registered physiotherapist can identify technique errors, determine whether your muscles need relaxation instead of strengthening, and adjust your programme to match your specific findings.

What Happens If I Do 100 Kegels a Day?

Doing 100 Kegels a day is likely too many and can lead to pelvic floor muscle fatigue, soreness, or hypertonic dysfunction (muscles that are chronically tight and unable to relax properly). Overtraining the pelvic floor is similar to overtraining any other muscle group; the muscles need time to recover between sessions to grow stronger. Cleveland Clinic specifically notes that doing too many Kegels, or doing Kegels when you do not need to, can cause your muscles to become too tense or tight.

Hypertonic pelvic floor muscles cause symptoms that can mimic weakness, including urinary urgency, difficulty emptying the bladder, pelvic pain, and pain during intercourse. The recommended target of 30 total Kegels per day (10 per set, 3 sets) with full relaxation between each contraction is supported by clinical evidence and avoids the overtraining trap.

What Happens If You Don’t Exercise Your Pelvic Floor?

If you do not exercise your pelvic floor, the muscles weaken progressively over time, especially after events that stretch or strain them like pregnancy, childbirth, or pelvic surgery. Weakening pelvic floor muscles lead to worsening incontinence, increasing prolapse risk, reduced core stability, and lower sexual satisfaction. Data from the American College of Obstetricians and Gynecologists (ACOG) shows that women have a 13% lifetime risk of undergoing surgery for pelvic organ prolapse, and the demand for prolapse surgery is expected to increase by approximately 50% by 2050. Many of these surgeries could be prevented or delayed by consistent pelvic floor muscle training started early.

Can You Do Pelvic Floor Exercises While Pregnant?

Yes, you can do pelvic floor exercises while pregnant, and research supports starting them during pregnancy. A 2024 meta-analysis published in Acta Obstetricia et Gynecologica Scandinavica confirmed that pelvic floor muscle training during pregnancy reduces the risk of urinary incontinence and severe perineal tears during delivery. Women who performed pelvic floor muscle training between weeks 20 and 36 of pregnancy also experienced less pregnancy-related lower back and pelvic girdle pain.

Prenatal pelvic floor exercises follow the same basic technique as the exercises described above, adjusted for comfort as pregnancy progresses. Lying-down exercises work well in early pregnancy. Side-lying or seated positions become more comfortable in the second and third trimesters. Pregnancy chiropractic care can work alongside pelvic floor exercises during the prenatal and postnatal periods to support pelvic alignment and comfort.

Should Men Do Pelvic Floor Exercises?

Yes, men should do pelvic floor exercises, especially after prostate surgery, for chronic pelvic pain, or for urinary incontinence. Pelvic floor muscles play the same role in men as in women, supporting the bladder and bowel, contributing to continence, and influencing sexual function. Research indicates that urinary incontinence can affect up to 80% of patients after radical prostatectomy, and pelvic floor muscle training is the recommended first-line rehabilitation for post-prostatectomy incontinence. Our guide to pelvic floor exercises for men covers the male-specific application of these exercises in detail.

Cleveland Clinic confirms that Kegel exercises for men can help improve incontinence, manage prostate-related symptoms, and increase sexual pleasure. The technique is the same: find the pelvic floor muscles, squeeze and lift, hold, relax, and repeat. Men locate the muscles by imagining they are stopping the flow of urine or holding back gas.

Frequently Asked Questions

What Is the Best Exercise to Strengthen the Pelvic Floor?

The best exercise to strengthen the pelvic floor is the Kegel exercise performed with correct technique. Kegels directly target the pelvic floor muscles through controlled contraction and relaxation. A 2018 Cochrane review found that supervised Kegel training produced cure or significant improvement in approximately 70% of women with stress urinary incontinence. For maximum benefit, combine Kegels with functional exercises like glute bridges, pelvic tilts, and bird dogs to strengthen the entire deep core system.

What Position Relaxes the Pelvic Floor?

The position that relaxes the pelvic floor most effectively is the “happy baby” pose: lying on your back, drawing your knees toward your chest, and holding the outside edges of your feet with your hands while gently opening your knees wider than your torso. Deep diaphragmatic breathing in this position encourages the pelvic floor to lengthen and release. Child’s pose (kneeling with your forehead on the floor and arms extended) also promotes pelvic floor relaxation. These positions are especially helpful for people with hypertonic (too-tight) pelvic floor muscles.

Does Massaging Your Pelvic Floor Help?

Yes, massaging the pelvic floor can help, particularly for people with hypertonic pelvic floor muscles, scar tissue from childbirth or surgery, or chronic pelvic pain. Pelvic floor massage (including internal myofascial release and trigger point therapy) is a clinical technique performed by a registered physiotherapist with pelvic health training. Massage therapy addresses surface muscle tension, while pelvic floor physiotherapy targets the deeper internal muscles through specialised manual techniques.

What Can Be Mistaken for Pelvic Floor Dysfunction?

Conditions that can be mistaken for pelvic floor dysfunction include urinary tract infections (UTIs), overactive bladder syndrome, interstitial cystitis, endometriosis, irritable bowel syndrome (IBS), hip joint pathology, and sacroiliac joint dysfunction. These conditions share overlapping symptoms like pelvic pain, urinary urgency, and bowel irregularity. A thorough clinical assessment is the only reliable way to distinguish pelvic floor dysfunction from these other conditions.

Can Pelvic Floor Exercises Stop Bladder Leaking?

Yes, pelvic floor exercises can stop or significantly reduce bladder leaking. Pelvic floor muscle training is the recommended first-line treatment for stress and mixed urinary incontinence with Level A evidence from international clinical practice guidelines. The 2018 Cochrane review confirmed that women who completed supervised pelvic floor muscle training were significantly more likely to report cure of urinary incontinence compared to those who did not train. Results depend on consistency, correct technique, and the severity of the underlying weakness.

What Is the Difference Between Kegels and Pelvic Floor Exercises?

Kegels are one type of pelvic floor exercise. Pelvic floor exercises is the broader term that includes Kegels alongside other movements that engage and strengthen the pelvic floor, such as glute bridges, pelvic tilts, bird dogs, squats, and clamshells. A complete pelvic floor physiotherapy programme combines Kegels with these functional exercises to train the pelvic floor as part of the whole deep core system, not in isolation.

The Takeaway

Pelvic floor exercises are simple to learn, require no equipment, and produce measurable results within weeks when performed consistently and correctly. The five exercises in this guide cover endurance, speed, glute support, core coordination, and full-body stabilisation, giving your pelvic floor the comprehensive training it needs to support you through daily life. Research from a University of North Carolina study found that 1 in 5 women will undergo surgery for incontinence or prolapse by age 80. Much of that surgical burden is preventable with consistent pelvic floor muscle training started early and maintained over time.

If you are unsure whether you are doing the exercises correctly, or if your symptoms are not improving after 8 to 12 weeks of consistent practice, a professional assessment can make the difference. At KC Rehab, our registered physiotherapist assesses your pelvic floor in a private treatment room, confirms your technique, and builds a programme that fits your body and your goals. Call us at 905-205-1668 or book online to schedule your initial assessment.