How To Do Pelvic Floor Exercises For Women

Know how to do pelvic floor exercises for women starting out. These pelvic floor exercises are science-based proven to improve pelvic floor strength, endurance and control.

This Pelvic Floor Physiotherapist-guided video shows women how to do pelvic floor exercises correctly with:

• Pelvic floor exercises in 3 simple steps
• Best starting positions for beginners
• How to progress training for stronger pelvic floor muscles

Pelvic Floor Exercises For Women – Beginner Guided Video

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Where Are The Pelvic Floor Muscles Located ?

In women, the pelvic floor muscles sit at the base of the pelvis, shown in red in the anatomical model below.

You can see how the pelvic floor muscles wrap around the three pelvic openings; the anus, vagina and urethra (sits in front of the vagina).

Pelvic Floor Exercises For Women – 3 Simple Steps

The correct action when doing pelvic floor exercises for women involves squeezing and lifting inwards using the pelvic floor muscles that wrap around and sit inside the pelvic openings. These muscles are then released and relaxed back to resting position.

Step 1 – Anus

• Squeeze and lift inwards contracting the pelvic floor muscles that wrap around the anus (shown below).
• This action is similar to squeezing the anus closed as if preventing gas from passing.
• Relax these muscles after contracting them and allow them to briefly rest.
• Keep the buttock muscles relaxed throughout this entire exercise.

Step 2 – Vagina

• Squeeze and lift the pelvic floor muscles in and around the vagina (shown below).
• This action is similar to resisting withdrawing a tampon using the pelvic floor muscles.
• Relax and rest these muscles after contracting them.
• Keep the upper abdominal muscles relaxed throughout. It’s quite normal to feel the pelvic floor muscles around the anus to contract at the same time and to feel the lower abdominal muscles tense slightly¹.

Step 3 – Urethra

• Squeeze and lift the pelvic floor muscles around the urethra (urine tube).
• Relax and rest these muscles after contracting them.
• Breathe normally throughout this exercise and avoid holding your breath.
• It’s quite normal to feel the pelvic floor muscles around the vagina and anus contract at the same time.

Correct Pelvic Floor Exercises – Combine Steps 1-3

• Pelvic floor exercises for women combine steps 1-3 by squeezing and lifting inwards around the anus, vagina and urethra together
• The pelvic floor muscles are then relaxed back to resting position to allow muscle recovery before attempting the next exercise.

The 3 Best Positions For Pelvic Floor Exercises

Progressing pelvic floor exercise positions involves adopting pelvic exercise positions that progressively increase the resistance force of gravity acting on the pelvic floor muscles ².

1. Lying Down

The best position for beginners to start their pelvic floor exercises is usually lying down. This position avoids lifting the pelvic floor muscles and the weight of the pelvic contents up against gravity which occurs in upright positions.

Suitable lying down pelvic floor exercise positions include:

• lying on the back with knees bent (shown below)
• sidelying
• lying prone on the belly

2. Sitting Upright

Progressing pelvic floor exercises from lying down often involves doing pelvic floor exercises sitting. When using this position sit away from the back of the chair to optimize pelvic floor muscle action.

Pelvic floor exercises performed sitting on the arm of a chair³ or a towel roll (shown below) can improve feedback about whether the pelvic floor muscles are contracting and relaxing. A towel roll pressing into the pelvic floor can also provide a reference point to lift the muscles away from.

3. Standing Tall

Advanced pelvic floor exercises are usually performed in standing position.

When standing upright, the pelvic floor muscles are required to work harder lifting against the opposing downward force of gravity.

Standing is also the best functional training position for pelvic floor exercises; this is the position the pelvic floor muscles usually need to work when women are active and upright during the course of the day.

Women who are at beginners and intermediate level are also encouraged to work towards doing their pelvic floor exercises standing upright as soon as they feel confident to do so.

References

¹ Sapsford RR, Hodges PW, Richardson CA, Cooper DH, Markwell SJ, Jull GA. Co-activation of the abdominal and pelvic floor muscles during voluntary exercises. Neurourol Urodyn. 2001;20(1):31-42. doi: 10.1002/1520-6777(2001)20:1<31::aid-nau5>3.0.co;2-p. PMID: 11135380.

² Bø, K., Talseth, T., & Holme, I. (1999). Single blind, randomised controlled trial of pelvic floor exercises, electrical stimulation, vaginal cones, and no treatment in management of genuine stress incontinence in women. Bmj, 318(7182), 487-493. https://www.bmj.com/content/318/7182/487.short

³ Bø, Kari & Mørkved, Siv & Aschehoug, Arve. Chapter 6. (2104) Pelvic floor and exercise science. In Bo, K., Berghmans, B., Morkved, S., & Van Kampen, M. Evidence-based physical therapy for the pelvic floor: bridging science and clinical practice. Elsevier health sciences. 10.1016/B978-0-7020-4443-4.00006-6.