Pelvic Floor Exercise Guide

Why Exercise Your Pelvic Floor?

The pelvic floor muscles form a supportive platform between the pubic bone and tailbone. They support the bladder, uterus, and rectum, and play an important role in continence and sexual function. Like any muscles, they can be strengthened through regular exercise.

When pelvic floor muscles are strong, they keep the urethra closed and support the pelvic organs effectively:

When pelvic floor muscles become weakened, they can no longer provide adequate support, which may lead to incontinence:

Finding Your Pelvic Floor Muscles

Before you can exercise these muscles, you need to identify them correctly:

1. Sit or lie comfortably and relax your thighs, buttocks, and abdomen
2. Squeeze the muscles you would use to stop the flow of urine midstream
3. You should feel a "lifting and squeezing" sensation inside the pelvis
4. Try to avoid tightening your buttocks, thighs, or abdomen — focus only on the pelvic floor muscles
5. Do not hold your breath — breathe normally throughout

Note: The "stop urine test" is only for identifying the muscles. Do not practice exercises while actually urinating, as this can interfere with normal bladder emptying.

The Exercise Program

Slow Contractions (Endurance)

1. Squeeze and lift your pelvic floor muscles
2. Hold for up to 10 seconds (start with whatever you can manage and build up)
3. Relax completely for 10 seconds
4. Repeat 10 times

Quick Contractions (Power)

1. Squeeze and lift quickly with a strong contraction
2. Relax immediately
3. Repeat 10 times

Frequency

• Perform 3 sets of the above exercises each day
• Aim for at least 3 months of regular practice before assessing improvement

Tips for Success

• Be consistent — set reminders or link exercises to daily activities (e.g., after meals)
• Quality over quantity — a good, full contraction is better than many weak ones
• Progress gradually — increase hold times and repetitions as you get stronger
• Practice in different positions — sitting, standing, and lying down
• Use "the knack" — consciously contract your pelvic floor muscles before coughing, sneezing, lifting, or laughing

When to Seek Professional Guidance

A pelvic floor physiotherapist can:

• Confirm you are performing the exercises correctly
• Develop a personalized program
• Use biofeedback tools to help you learn proper technique
• Monitor progress and adjust the program

Expected Results

Up to 75% of women with stress urinary incontinence show improvement with supervised pelvic floor exercises. Maximum benefit typically occurs after 3-6 months of regular practice. Continued maintenance exercises are recommended long-term to sustain the benefits.

Illustrations courtesy of the International Urogynecological Association (IUGA) Patient Information Leaflets.