How to do Pelvic Floor Exercises – Self Examination Guide

pelvic floor examination

Learn how to do pelvic floor exercises correctly with this Pelvic Floor Physiotherapist self examination guide.

Two self examination techniques are described below to help women find and feel their pelvic floor muscles working with the correct technique:

  1. How to do pelvic floor exercises using external self examination; and
  2. How to do pelvic floor exercises using internal self examination.

Please note: physiotherapist video instructions in both these techniques are also freely available by accessing our complimentary pelvic floor exercises video on the upper right side of your screen now

In the interests of cultural sensitivity for all our readers worldwide, and to avoid any unnecessary offence  we suggest that if you feel uncomfortable with the idea of touching your genital region, that you refer instead to our library of free articles and videos on pelvic floor exercises rather than reading this article. The following information is intended to provide women with  information they may require but often are unable to access.

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Inside Out eBook and exercise video pack helps you:

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  • Understand unsafe exercises to avoid
  • Choose pelvic floor safe exercises
  • Strengthen your pelvic floor
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  • Improve your bone health

How to do Pelvic Floor Exercises Correctly?

Correct pelvic floor exercises involve lifting and squeezing all the pelvic openings together (i.e. anus, vagina and urethra or opening to the urine tube). Ideally you should feel a lifting and squeezing sensation in and around the area where you sit.

Try not to feel disheartened if this is difficult to feel, especially when first starting out, some women feel only a small flicker of movement or nothing at all. Many women find they have more sensation of correct pelvic floor muscle exercise when they start this technique by lifting and squeezing in and around the anus (as if trying to stop wind from escaping).

Technique 1: How to do Pelvic Floor Exercises (External Examination)

This technique is ideal for feeling how to do pelvic floor exercises, particularly if you feel uncomfortable with internal self examination (outlined next).

How to do pelvic floor exercises

Diagram 1: How to feel pelvic floor exercises

Position: Lay on your side with a pillow between your legs and your knees slightly bent. With clean hands, use your index and third fingers to locate the area of skin between your vaginal opening and your anus. This area of skin is called the perineum shown in Diagram 1.

Your perineum can be felt through your underwear or by directly placing your fingers on your skin. Reach your arm either in front or behind your body to access your perineum.


  • Step 1 – Have a small cough and feel your perineum push down or bulge out slightly against your fingers. This is the exact opposite of what you should feel with correct pelvic floor exercise.
  • Step 2 – Try to lift and squeeze your pelvic openings with your fingers touching your perineum. You should feel the skin under your fingers move inward, rather than bulging outward as it did when you coughed.  Try to maintain the lift and squeeze of your pelvic floor muscles as you breathe normally for up to 10 seconds.
  • Step 3 – Fully relax your pelvic floor muscles. You may feel your perineum lower down slightly and it should return to its original resting position. Take a rest and recover fully before your next attempt. Wash your hands when you finish your session.

Technique 2: How to do Pelvic Floor Exercise (Internal Examination)

This is an excellent technique for feeling your pelvic floor muscles working correctly.

Avoid this technique:

  • During pregnancy;
  • During the first 6 weeks following childbirth;
  • With active pelvic infection; and
  • During early recovery from gynaecological surgery.

Position: As for Technique 1. Wash your hands before you commence and position yourself lying on your side rather than on your back.

Step 1: Use a small amount of lubricant if required and insert either your index finger or your index and third fingers to a depth of approximately 2cm.

There are two groups of pelvic floor muscles that you may be able to feel working within your vagina as you perform your pelvic floor exercises. Refer to Diagram 2 to help you find and feel your pelvic floor muscles within your vagina.

how to do pelvic floor exercises

Diagram 2: How to feel pelvic floor muscles

Step 2: Feel the back wall of your vagina at a depth of 1-2cm as you use the correct technique for activating your pelvic floor muscles already discussed (i.e. lift and squeeze all your pelvic openings). As you lift and squeeze your anus, you should feel the back wall of your vagina move your finger inwards and slightly forward.  You may need to try a couple of times and move your finger a little to get the best position for feeling these muscles. These pelvic floor muscles are your Puborectalis or PR muscles. These are often the easiest of the pelvic floor muscles to self examine.

Step 3: Move one or two fingers a little further into your vagina to approximately 2-3 cm and feel one of the side walls of your vagina. Once again lift and squeeze your pelvic openings. This time you should feel the side wall under your finger move your finger inwards as if squeezing your finger and upwards. If your pelvic floor muscles are in good condition you may even feel both side walls of your vagina squeezing inwards against your finger at the same time. These are your Pubococcygeus pelvic floor muscles and are commonly known as the PC muscles.

Step 4: Try to maintain the lift and squeeze of your pelvic floor muscles while feeling your pelvic floor muscles.

Step 5: Fully relax your pelvic floor muscles back to their original resting position. Wash your hands thoroughly when you have completed your session immediately following internal examination.

Regardless of the technique you choose to use, remember that learning how to do pelvic floor exercises correctly takes time involving regular practice and perseverance. With practice using the techniques described above, you will become much more familiar with the feeling of correct pelvic floor exercise. As your confidence and strength improve, you will learn to activate your pelvic floor muscles without having to self examine. Then you can use these techniques to occasionally monitor pelvic floor muscles becoming stronger.

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We Welcome Your Comments


  1. Hi Michelle. Greetings from a member of your increasing fan base in India. I am a 40 year old male who underwent a hemerroidectomy a few years back. It went bad and led to an anal fissure post which I have had constant tightenesss and spasm in the anus. Sitting is a nightmare and I also have constant pain in the left lower back sacroiliac region. Have tried a bunch of stuff including acupuncture. Would be grateful if you could recommend a few exercises etc. that may help me release the tightness and spasm in the anus. Much appreciated and thanks for this super website!

    • Michelle Kenway says

      Hi Sam

      Yes thank you Sam what’s going on there in India??

      Thanks for contacting me about this important issue – I understand what you are telling me about the discomfort, yes sitting must be a nightmare for you. This really needs a full article which I will aim to write up for you in the near future Sam.

      First and foremost the diagnosis of muscle spasm needs to be made by a doctor as anal/pelvic floor spasm can be caused by a range of medical issues, yes a history of fissure and hemorrrhiodectomy are both potential contributing factors but be certain about the cause. You are probably aware that the spasm can be caused by the anal sphincter and/or levator muscle spasm (they can coexist).

      There are really a number of things to do to ease this issue and relieve long term.
      * Learn diaphragmatic breathing – this helps to relax the pelvic floor muscles here’s a diaphragmatic breathing link for more information
      * Lower abdominal bulging, when the lower abdomen bulges forward the anal sphincter relaxes – you can see this technique on this bowel emptying video
      * Learning to relax and release the anal sphincter and pelvic floor muscles voluntarily – this pelvic floor muscle tension CD for men is an excellent self management resource for this issue
      * Avoid Kegel or pelvic floor exercises while spasm exists
      * Avoid heavy lifting and prolonged standing/sitting wherever possible
      * Sitting can sit be relieved by getting off the anus when sitting – a couple of wedges made from rolled towels or thick foam placed lengthways under and inline with the thighs help to raise the buttocks and relieve sitting pressure. Note to avoid rubber cushion rings that make things worse
      * Correct bowel emptying technique is paramount
      * Keeping the stool soft with stool softener foods is also vital
      * Returning to pelvic floor strengthening only when the pelvic floor muscles can be voluntarily relaxed
      * Obviously avoiding high impact/heavy lifting exercises
      * Appropriate medication from your doctor

      Hope this helps out Sam – keep an eye out in upcoming newsletters for more and your qns always most welcome
      Kindest regards

      • Dear Michelle, thank you for taking time out to share such detailed recommendations. Much much appreciated. I will start implementing these right away and share my progress in the near future. Your site shares such important topics that it amazes me that not enough physicians and experts tend to these when we meet them face to face in their clinics! Here’s wishing you all the happiness and success.

  2. Stephen Tomlinson says

    Are you able to help us men with what exercises help to , hopefully, regain control of the bladder? Please keep it simple.
    I did purchase the DVD you recommended. “Pelvic Floor Exercises for Men” which I have endevoured to use. Do you have any further suggestions that may help? Secifically for men. Thank you.

    • Michelle Kenway says

      Hi Stephen
      Sure what would you like to know in particular – the DVD does a great job helping men understand how to locate their pelvic floor muscles, is this the issue you are having or is it more to do with the quantity of exercise you need to do. Just let me know so I can keep it simple.

      • Stephen Tomlinson says

        Thank you Michelle for your caring reply. I am endeavouring to do the exercises as shown in the video 3 times,ie each time 3 sets of 10, daily. Whilst this has helped me gain better control with my over active bladder I feel there is more I could be doing. Are there other recommended exercises or should I increase the number of times with the exercises I am doing now? I apprecite very much your help and your caring attitude, thank you.

        • Michelle Kenway says

          Hi Stephen
          This is a good question – I do think the mistake that some people make is to do too much exercise (when these exercises were first introduced the advice was typically to do hundreds of Kegels and we now know that this advice is incorrect as it resulted on over-fatigue at times and worsening symptoms. I think a good way to approach strength progression is to think gym resistance training – to strengthen the muscle the contraction needs to induce fatigue (but not over-fatigue). So in other words to strengthen, you need to activate really strongly, rest and recover before your next exercise. You can also progress by; standing (pelvic floor lifts against gravity, contracting for longer if you can up to 15 seconds). Also add 10 strong brisk reps once a day for the fast twitch pelvic floor muscle fibres. I would be inclined to think about adding another set during the day if you are really not seeing a training effect rather than increasing the number of reps per set if this makes sense, so that you can still activate strongly – this is key. In women we can try vaginal weights and other devices however not so with men to the best of my knowledge.

          Does this give you the information you are after? Just let me know if there is anything more, it’s no problem.

  3. Supposedly estrogen plays a part in the weakening of pelvic floor muscles. Is there a natural product that could be applied to the skin, or a safe internal supplement that women over 50 could take to stave off some of the problems associated with lowered estrogen levels?
    Thank you,

    • Re: Oestrogen and Pelvic Floor Muscles

      Hi Darien

      This is an excellent question. Yes you are correct, oestrogen receptors have been found in the pelvic floor muscles. We also know that when a woman’s oestrogen levels decline, the pelvic floor tissues weaken, thin and become less supportive for the pelvic organs. We also know that the pelvic floor tissues becomes less vascular (reduced blood supply). This is one reason why pelvic floor dysfunction with prolapse/incontinence in particular often presents during menopause along with the decline of oestrogen.
      Some specialists prescribe vaginal oestrogen to help thicken the tissues floor tissues. Vaginal oestrogen comes in a cream or vaginal pessary (tablet) form. Many women use this type of oestrogen topically as it doesn’t have the systemic effects that oral forms of HRT have. The individual’s suitability for vaginal oestrogen needs to be discussed with the treating doctor or gynaecologist.

      Unfortunately vaginal oestrogen isn’t a miracle cure for pelvic floor problems, however it can be a really useful adjunct to pelvic floor exercise (or kegel exercises).

      There may well be natural topical oestrogen products available however I am not familiar with them. Just as there are a range of natural HRT medications available that can be purchased over the counter without script. It is always wise to discuss such natural HRT medications with your treating doctor before use.
      Thanks for your question Darien, Michelle

  4. Thank you for giving the most concise information about just where these muscles intersect areas we are most troubled by when we have pelvic floor problems. I am six months past a major pelvic floor repair and total hysterectomy. I bought your book before the surgery and have shared it with my friends and my surgeon. Though I still have a ways to go before I feel strong in those areas I feel protected from further damage by reading your book and articles. As a former dance teacher I appreciate knowing exactly how to access these muscles with anatomical precision. Thank you for clarifying –everything !

    • Hi Elaine
      Thanks so much for taking the time to post your comment. I wrote this article because I have received so many emails from women having difficulty feeling their pelvic floor muscles. It is such a challenge to know that you are doing your exercises with the correct action. I am really glad to hear that article it has clarify things for you.