Pelvic Floor Exercises – Pelvic Floor Physio Proven Workout Formula

Pelvic floor exercises

Pelvic floor exercises are exercises to improve pelvic floor muscle strength and fitness.

This Pelvic Floor Physiotherapist information teaches you the proven guidelines for how to exercise for better strength and control of pelvic floor muscles with:

  • Pelvic floor daily strength exercise guidelines;
  • Pelvic floor exercises for quick control (for cough and sneeze);
  • How long until you notice improvements; and
  • How to do pelvic floor exercises;
  • How to progress pelvic floor exercise for additional challenge.

Pelvic floor exercises PDF Download this pelvic floor exercises guide as a PDF by scrolling down.

How to do Pelvic Floor Exercises? pelvic floor exercises

To train pelvic floor muscles you need to practice lifting and squeezing your pelvic floor openings because this is what these muscles do – lift and squeeze your pelvic floor openings.

It is vital to know correct technique for pelvic floor muscle exercises before commencing your exercises.

The pelvic floor muscles are shown above. You can see that the pelvic floor muscles wrap around and support the three pelvic openings (the vagina, anus and urethra or urine tube).

Lift inside and squeeze all three pelvic openings together for correct pelvic floor exercises, then relax them back to resting

When to do Pelvic Floor Exercises?

Pelvic exercises should be performed regularly life-long. There are times and events in a woman’s life when they become even more important for pelvic floor health:

  • During pregnancy and after childbirth;
  • Preparation for incontinence, hysterectomy or pelvic organ prolapse surgery;
  • Before and after pelvic surgery for prolapse, incontinence, or hysterectomy; and
  • With menopause and beyond.

A. Pelvic Floor Muscle Strength Exercises – Why Bother?

Regular pelvic floor strength exercises can help build:

  • Pelvic floor strength, thickness and firmness for better pelvic floor support.
  • Pelvic floor endurance or ability to contract for longer periods of time.

If your pelvic floor is strong and working well, it can help you:

  • Decrease prolapse symptoms
  • Improve bladder control
  • Improve bowel control
  • Recover pelvic floor strength after pelvic surgery

Pelvic Floor Exercise Strength Training Guidelines pelvic floor exercisew

  • Make each pelvic floor muscle contraction as strong as possible
  • Maintain every contraction for 3-10 seconds
  • Repeat 8-12 strong contractions in a row to fatigue (this is one full set of exercise)
  • Rest your pelvic floor muscles until recovered 1-2 minutes between each effort
  • Perform 1-3 sets of pelvic floor exercise every day
  • Adhere to the correct pelvic floor exercise technique
  • Perform full pelvic floor muscle action lifting your pelvic floor as high as you are able to with each attempt
  • Perform pelvic floor exercises in a controlled manner for the lift and the lower down.

How to Progress Pelvic Floor Strength Exercises

  • Increase the duration or length of each pelvic floor muscle contraction
  • Increase the strength and effort you use with each pelvic floor muscle contraction
  • Decrease the rest time between consecutive pelvic floor exercises when possible
  • Consider using vaginal weights to progressively increase resistance to the pelvic floor muscles
  • Progress the positions to increase the challenge of lifting the pelvic floor muscles against gravity from lying down to sitting and standing positions.

How Long for Pelvic Floor Exercises to Work?

There are initial rapid gains with pelvic floor exercises even over the first month of training; however the ACSM recommends strength training periods of 15-20 weeks as a minimum. This is because effective pelvic floor training requires increasing overload to promote muscle changes, meaning that women need to work harder over time to continuously improve. Studies show that for weak pelvic floor muscles, pelvic floor muscle strength increases over 6 months of training (Bo et al 1990).

2. Pelvic floor Exercises for Quick Control

These exercises help train pelvic floor muscles to work effectively for bladder control and support when you cough and sneeze

How to train pelvic floor muscles for quick control

  • Contract your pelvic floor muscles quickly and strongly using the correct pelvic floor exercise technique for 2 seconds and relax over two seconds.
  • Rest briefly and repeat these strong moderate speed pelvic floor contractions for 8-10 times in a row.
  • Lift your pelvic floor as high as you can with each successive attempt
  • Perform pelvic floor exercises in a controlled manner for the lift and the relax
  • When you feel confident and can contract 10 times in a row you are ready to progress your power exercises.

How to progress pelvic floor quick control exercises

  • Contract your pelvic floor muscles as strongly as possible, hold the contraction and add 3-4 fast contractions on top of the strong hold
  • Rest and repeat for up to 5 times in a row
  • Lift your pelvic floor as high as you can with each attempt and then relax  your muscles and rest briefly between each attempt
  • Ensure that you fully relax your pelvic floor muscles back to their original resting position when you have completed your pelvic exercises.

Pelvic floor exercises PDFDownload print friendly Pelvic Floor Exercise Training Guidelines PDF



with Pelvic Floor Physiotherapist
Michelle Kenway

Learn how to strengthen and train your pelvic floor with expert guidance in the privacy of your home, on the bus, wherever you can listen to your audio.

Pelvic Floor Exercises Daily Workout brings Physiotherapy training and motivation to your your fingertips.




  1. hi.can u plz suggest me exercises for 23 yr old female having neurogenic bladder (spina bifida).thanks

    • Neurogenic Bladder

      Hi Harshil

      Since neurogenic bladder or lack of bladder control can be caused a variety of neurological problems, it is essential that treatment is very specific to the actual problem involved. In some individuals the muscles controlling the emptying of the bladder are unable to contract, in others the muscles are unable to relax with appropriate timing. Neurogenic bladder conditions needs to be fully assessed and appropriately treated by a continence health professional.

      I am sorry I am unable to be of further assistance with your question.
      All the best

      • Nancy Westbrook says:

        Hello Michelle I recently underwent total prolapse surgery with the Uterus and Cervix removed and the bladder and bowel stitched back into their proper places. cysto-cele/rectocele. If I might suggest to the above Lady named Harshil that she looks for a Euro-gynecologist in her area. He of course specializes in the very thing she is concerned about. I of course do not have Harshil’s e-mail but would hope that you can email her for me.. Thank you.
        Michelle I am so excited to get started on your book and Video after my post-op healing. My surgery was 3 weeks ago and am still spotting and there is quite a bit of tenderness when I over do it. I only wish I had know about you several years ago because perhaps I could have avoided prolapse all together. As a matter of fact I had never heard of a physiotherapist before or if I had I never put 2 and 2 together. Dumb because I’ve exercised my whole adult life. Im very much into holistic medicine herbs vitamins and clean eating, but I never realized how very important it was and is to throughly exercise the pelvic floor DAILY. I’m 48 a mother of three and am looking forward to my new post-op lifestyle. But when can I begin my aerobics safely.

        • Michelle Kenway says:

          Hi Nancy
          Thank you for the information for Harshil, I will foward your comment to her to ensure she receives your message.Nancy what kind of aerobics do you plan to commence? Your internal healing will take at least 3 months so this will not be a time to commence any high impact exercise. Ultimately your ability to do aerobic exercise that involves impact depends upon the support provided by your pelvic floor for your repair.

          You will be able to commence the Inside Out DVD exercises when you have approval from your surgeon to return to general exercises – this is usually around 6-8 weeks post op for most women after prolapse surgery. I would suggest starting with no weights and doing just a set of each exercise, see how your body feels, have a day or two rest and repeat this for a week when starting back. This way you can gradually return to exercise and avoid injury while you familiarise yourself with the basic strength exercises.

          All the best Nancy

    • Harshil,
      I too have a neurogenic bladder and would love to compare things that I have learned over the years ..I have had a neurogenic bladder for 17 years…


  2. Hi,
    I first found your videos on Youtube and they were one of the better ones on Pelvic Floor exercises.  Thank you for posting them!
    I just started pelvic exercises and I'm not sure if I'm doing this correctly.  I feel a slight tension in my tailbone as if the area is tightening and sometimes there's a slight pain.  Is this normal?  Should I feel anything in my tailbone at all?

    Thank you,


    • Coccyx pain with pelvic floor exercises

      Hi Jade

      Thanks so much for your kind feedback.

      Perhaps if I explain a little of the anatomy of the pelvic floor muscles you may understand a little better. The pelvic floor muscles sling like a hammock from the pubic bone at the front to the tailbone at the back. When these muscles contract the tailbone is an anchor point for the muscles and they will create a pulling tension on the tailbone.

      For most women the tailbone sensation with a pelvic floor muscle contraction is not painful. If there has been a past problem with the coccyx (lower part of the tailbone, such as a fall onto the tailbone or a strain/fracture during vaginal delivery then the pelvic floor muscle contraction can potentially cause discomfort. Then when the pelvic floor muscles contract forcefully or strongly discomfort can result from the tensioning of the tailbone. Some women in this situation need to perform their pelvic floor exercises in antigravity positions such as lying down, or using very gentle pelvic floor contractions.

      If coccyx discomfort during pelvic floor exercises is an ongoing problem for you, then see a pelvic floor physiotherapist or check with your medical practitioner. A history, physical examination and an X-ray if required should help to determine the cause of your discomfort.

      I hope this assists you with your pelvic floor exercises Jade.


  3. I'm so thankful for the detailed information!  This was very helpful.  I really enjoy your website and learning more about how to stay fit in areas I never thought about before.
    Thanks so greatly!

  4. Bernadette Holden says:

    Hi Michelle
    Thank you for your terrific website. I have just purchased your book and this will be great to help me discuss my needs with my Clinical Pilates physiotherapist. I have had a prolapse repair which was not successful and think that I'm heading for another one. My specialist has told me that the muscle detached from the pubic bone during childbirth, [levator avulsive damage]. Does this mean that pelvic floor exercises will not improve the muscles. Thanks from Bridget

    • Pelvic floor muscle detachment, prolapse and exercise

      Hi Bridget

      Thanks for this great question! For the information of other women reading this ‘levator avulsion’ basically means that the pelvic floor muscle becomes detached or tears off the pelvic bone and this happens during childbirth in some women. You can well imagine the effect this has on decreasing the support for the pelvic organs. For some women this will mean that pelvic floor exercises won’t be effective depending on the degree of avulsion in other words depending upon how much pelvic floor muscle and which muscle(s) have been torn off the bone. Often women have damage to one side of their pelvic floor so that pelvic floor exercises may still have benefit for the remaining muscles but not to the extent they would if the pelvic floor was completely intact.

      Regarding a failed prolapse repair, detached levator and exercise – this combination obviously increases the risk of further pelvic floor injury with the wrong kind of exercise. There are a number of measures that can be taken to improve pelvic support and reduce the risk of injury and allow for ongoing exercise:
      seek an appointment with a pelvic floor physiotherapist. She will assess just how much pelvic floor muscle is intact, and be able to provide an accurate risk assessment in tems of exercise (and other factors which may also be impacting upon your pelvic floor without you being aware of them) in addition to prescribing appropriate pelvic floor exercise for you
      discuss the possibility of a pessary for improved pelvic floor support with your physiotherapist and with your gynaecologist. A pessary is a discreet device worn within the vagina and can be of tremendous benefit in improving pelvic floor support, particulalry when pelvic floor muscle support is lacking and/or when prolapse is present. There is now a vast range of vaginal pessaries available, some are even made to use as required on a daily basis whereas others are fitted for longer term wear.
      adhere to pelvic floor safe exercise principles always and become as educated as possible in terms of appriate and inappropriate exercises for your condition (and educate your instructor too). It sounds as though you are already doing this.
      stay strong and fit – some women unfortunately cease exercise altogether with a prolapse when in fact the stronger the individiual the less pressure on the pelvic floor in everyday living.

      Thanks again for raising this issue Bridget, I hope this gives you some future direction and helps you to keep your pelvic floor safe exercise routine going

  5. I just was told that I have to have a rectocele procedure and that I have a minor prolapsed bladder.  My doctor told me I would be needing a vaginal hysterectomy within the next five years to fix my bladder issues before all of this happened.  I am only 30 years old and I work out 6 days a week, with heavy amounts of weights.  I have had two vaginal deliveries 2 and 4 years ago.  Do you think there is any ways of me getting around have surgical procedures by doing kegals????  Also do you think there is anyway I will be able to keep working out and lifting the way I do now?????

    • Bladder prolapse, rectocoele and exercise

      Hi Danielle

      In the case of a minor prolapse of the bladder and recotocoele such as yours Kegels or pelvic floor exercises will usually help to reduce symptoms and improve overall pelvic floor support. A prolapse cannot be reversed however it can often be better supported and protected. As you become older your pelvic floor will naturally become less supportive with menopause and beyond and often this is the time that pelvic floor problems such as prolapse really present themselves.

      Young women can protect the pelvic floor and reduce the likelihood of pelvic floor injury including progression of prolapse with:
      – regular effective and ongoing kegel exercises or pelvic floor exercises (lifelong)
      -minimising the strain on her pelvic floor with; pelvic floor safe exercise, never straining to use the bowels, minimising heavy unsupported lifting and physical work, minimising strain on the pelvic floor with unsupported coughing/asthma/hay fever etc
      -consider a pessary for pelvic floor support, especially with exercise

      I strongly suggest that your heavy weights program be designed to be pelvic floor safe and suited to your female body and your prolapse. There are quite a range of heavy weighted exercises possible using techniques and positions that will avoid strain on the pelvic floor refer to and Inside Out strength training DVD (pelvic floor safe)

      Best of luck Danielle

  6. Hi Michelle
    A couple of questions.
    I find it hard to contract the vagina and anus at the same time. Sometimes I find it hard to contract the anus, although I probably am- I just don't feel the same amount of lift as from the front- can you advise?
    The second question is that I had a prolapse repair 20 years ago for a mild uterine and bladder prolapse.  I've been okay although sometimes I feel a slight slackness in the front wall which reminds me to do my exercises.  I have now been taking HRT for 4 years and am post menopause. I am concerned that when I stop HRT my pelvic floor will deteriorate.  Is this likely and will local HRT- vaginal- help to keep it toned even if I stop systemic HRT? I don't mean rely on that instead of exercise, but HRT generally helps my irritable bladder.
    Thank you.

    • Hi Glynis
      Women frequently report feeling different amounts of sensation in the various pelvic openings, for example many find it difficult to feel their pelvic floor muscles in and around the vagina especially having once had traumatic vaginal delivery. Have you tried isolated contractions in and around the anus? Other indications can be whether or not you can voluntarily stop wind or defer the strong urge to use your bowels for a short time should you need to. If you are unsure you can also use a finger on the anus during a squeeze and lift to check what happens. You should feel a lift and squeeze. Alternatively you could use a mirror to see whether the anus puckers up as you contract this area. If you remain unsure and concerned you may wish to see a women’s health physiotherapist as there are treatment techniques to assist with the management of pelvic floor muscles around the rectum.

      As for HRT, local oestrogen can be an excellent option for women for pelvic floor management. It delivers the oestrogen locally rather than through the system. The cream form can provide lubrication for women with vaginal dryness and the pessary form is great if you wish to avoid increased discharge (although there may be a small amount).
      Hope this helps Glynis

  7. Hi Michele,

    I am a 56 yr old women who had a hysterectomy 2 yrs ago, been diagnosed with a bladder prolapse and pelvic floor tension. My question is should I do kegels? If so how often and how long to hold? If not what can I do to strengthen the floor. I would like to get back into some exercise as I have put on weight and have been inactive since being diagnosed. I would like to get back to feeling like myself active and on the go with lots of energy which I have seemed to have lost.

    Any info to get my life improved will be appreciated.


    • Michelle Kenway says:

      Hi Barb
      Yes this is a challenge isn’t it – you need to strengthen your pelvic floor to support your prolapse but you are hampered by the fact you have increased pelvic floor muscle tension.

      First and foremost I would suggest you see a Pelvic Floor Physio who can treat your pelvic floor tension. In the early stages of management of pelvic floor tension, pelvic floor strength exercises or Kegels are not advisable as they can worsen the whole situation by worsening the pelvic floor spasm. You need to be taught how to relax your pelvic floor muscles first, then gradually introduced to appropriate kegel exercises over time. This is a condition that is usually treated with appropriate management and Pelvic Floor Physical Therapy intervention, try to seek the assistance of a Physical Therapist who has experience in treating Pelvic pain.

      This pelvic floor muscle tension article may also help you with some further information in pelvic floor tension management and kegels, I hope this assists you and points you in a helpful direction.

      Hope this helps you along Barb

  8. Hello Michelle
    I am 61 years old and had a hysterectomy when I was 36. I was never given any information about pelvic floorexercises either before or after my operation and as a result I have suffered on and off ever since. I did go and see my GP who referred me to hospital where the consultant said that he could operate to tighten everything up but I may be so tight that I might have to self catheterise. So obviously I declined. I continue to do my pelvic floor exercises with some limited success. Most of the time if I’m home I don’t have too much trouble, however on the days that I go to work I have a twenty minute walk to the station and by the time I get there I have to change my pad as I have leaked. I don’t wake in the night or have problems getting to loo when I wake. I don’t know if I have any kind of prolapse and would like to see a physiotherapist who specialises in pelvic floor but know that my GP would not be able to help me. I live in the UK and wonder if the therapist would see me without a GP referral. I have just purchased your book Inside Out and am waiting for it’s delivery. Many thanks Angela.

    • Michelle Kenway says:

      Hi Angela
      I am not sure whether pelvic floor physios in the UK are primary contact practitioners that do not require a medical referral – maybe one of our readers from the UK can clarify this. In Australia this is the case, however in the US a medical referral is required which makes accessing pelvic floor physiotherapy a little difficult at times. If you phone the UK Physiotherapy association they should be able to provide you with this information as well as where you can locally access pelvic floor physiotherapy – maybe through one of the larger hospitals physiotherapy outpatient clinics.

      I would also be inclined to seek an appointment with a Urogynaecologist – these specialists have the dual qualification of urologist and gynaecologist. I would think your circumstances warrant a urodynamics investigation to determine why the leakage is occurring and then appropriate surgical recommendation made after that if it is warranted at all. The TVT used for stress urinary incontinence (leakage when walking) is these days a simple procedure and often performed if pelvic floor exercises have been unsuccessful in treating the condition. Yes occasionally the tape can be too tight but this is not usually the case at all and a urologist or Urogynaecologist who is experienced in performing this procedure should be able to get the tensioning of the tape correct.

      So the first step here is to access pelvic floor rehabilitation, and then specialist treatment and appropriate investigations if pelvic floor physio is unsuccessful. Internationally pelvic floor rehabilitation is now recommended as the first line of intervention with a problem such as yours.

      I hope this information is helpful Angela – always keen to hear how you go.
      Best of luck

  9. Michelle, does your Inside Out workout DVD require any equipment?

    • Michelle Kenway says:

      Hi Micki
      Since Inside Out strength is a whole body strength training program, it is desirable to use some dumbbell weight for resistance. Some of the exercises can involve an exercise ball however this is optional and depends on whether you choose the beginner or maore advanced exercise options for each exercise.

  10. Hi Michelle
    Thanks for your really helpful website. 4 months ago I had a hysterectomy & since recovering I have been diagnosed with coccydinia. I have been seeing a Chiropractor who has been doing some internal manipulation, including releasing of the surrounding ligaments as well gently pulling the coccyx itself back. I just wanted to check, if I do pelvic floor strengthening exercises following my hysterectomy, could I be pulling the coccyx in the wrong position & cause more pain or would pelvic floor strengthening actually be of help with coccyx pain?

    Thanks so much, Gill

    • Michelle Kenway says:

      Hi Gill

      This is a great question – in my experience some women do find that doing pelvic floor exercises can aggravate coccydynia. This is because the pelvic floor muscles attach to the coccyx so there can be a tractioning effect on the coccyx with strong pelvic floor exercises. My approach has been to start with just a few very gentle couple of second exercises on the first day, focused more around the urethra/vagina than the rectum and then nothing more waiting to see how the coccyx reacts. Some women find that they can gradually progress their exercises over time while others may find that their coccyx becomes too aggravated. Different women will respond differently so you are wise to take a measured approach – and yes this is tricky bearing in mind the value of strengthening your pelvic floor after hysterectomy. A Pelvic Floor Physio may be able to assist you in this regard if you find you have difficulty.

      All the best

  11. Hi Michelle, I would like to know am the only woman who can’t contract the pelvic floor for more than a millisecond at time, so there is no way I could even hold a contraction for a few seconds or even up to 10 seconds? Is there anyway to improve on this? Would a physio who specialises in the pelvic floor be able to help me?

    • Michelle Kenway says:

      Hi Natalie

      You are definitely not the only woman who can’t maintain a pelvic floor contraction – I can’t tell you the stats on this but in my work most women I have seen on average have been just the same. It can be incredibly difficult to do even know where the muscles are let alone and activate let alone maintain a contraction.

      The way to improve is with practice and maintained holds starting lying down, moving to sitting and then standing.

      Yes a pelvic floor physio will be able to help you with this. I am soon to release a dedicated pelvic floor exercise training CD for beginners to listen to at home – this will be announced in the next newsletter if you are interested, for updates just pop your name on the newsletter list on the home page of the site. You can also find a pelvic floor physio by phoning the Continence Foundation of Australia

      Finally it is possible to train your pelvic floor muscles just like other muscles – I have seen this many times so hang in there

      All the best


  1. […] forefront of non-surgical treatment for prolapsed vagina. This involves prescription of progressive pelvic floor exercises to improve pelvic floor muscle support. Pelvic exercises are often prescribed before and after […]

  2. […] Pelvic floor exercises- Regular daily pelvic floor exercises will optimise the condition of pelvic floor support in order to withstand the pressure associated with a variety of fitness exercises. A strong well supported pelvic floor will better withstand the pressure and impact associated with running when compared with a weak dysfunctional pelvic floor. Commitment to regular ongoing pelvic exercises is an essential to ensuring and optimising long-term pelvic floor support. […]

  3. […] pelvic floor muscles surround the entrance to the vagina, and also attach to the clitoris. Regular pelvic floor exercises can help a woman’s sexual arousal and ability to achieve orgasm. Kegel exercises will also […]

  4. […] exercises or pelvic floor exercises describe the repeated action of the pelvic floor muscles contracting. These exercises are usually […]

  5. […] 5: Correct pelvic floor exercises involve lifting and squeezing the pelvic floor openings together (i.e. anus, vagina and urethra or […]

  6. […] exercises are specifically for the pelvic floor muscles and are known as pelvic floor exercises. Pelvic floor exercises strengthen and help to restore the pelvic floor […]

  7. […] to regular pelvic floor exercises / Kegel exercises which help act as bladder control exercise. If your pelvic floor muscles are […]

  8. […] What I can do is shout from the roof tops to consider all your options before surgery and do your pelvic floor exercises and keep them going under the guidance of a professional physiotherapist. Be patient because your […]

  9. […] how should you workout for better pelvic floor strength? With regular pelvic floor exercises. Certain life events and stages in a woman’s life play havoc with a woman’s pelvic floor […]

  10. […] regular pelvic floor exercises to keep your pelvic floor in good shape regardless of the […]