How to Perform a Kegel Properly: A Pelvic Health Therapist’s Guide

If you have ever been told to "just do your Kegels" to fix urinary leakage, improve core stability, or support post-surgical recovery, chances are nobody actually explained how to do them correctly.

In fact, studies show that over half of people who attempt pelvic floor contractions perform them incorrectly—often bearing down, holding their breath, or squeezing their glutes instead of lifting the pelvic floor.

The pelvic floor is a hammock-like group of muscles sitting at the base of your pelvis. It supports your internal organs (bladder, bowel, and uterus or prostate), assists in spinal stability, and controls urinary, bowel, and sexual function.

Whether you are recovering from surgery or simply strengthening your core, mastering a proper pelvic floor contraction is essential for long-term health. Here is your step-by-step guide to tuning in and executing a flawless Kegel.

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Step 1: Tune Into Your Pelvic Floor (Biofeedback Tools)

Before you start squeezing, you need to establish a strong mind-muscle connection. Because you cannot directly see your pelvic floor, using visual or tactile biofeedback makes a massive difference:

• The Rolled Towel (Tactile Feedback): Roll up a hand towel and sit on it lengthwise so it rests directly against your perineum (the area between your pubic bone and tailbone). When you contract, you should feel your muscles lift away from the towel. When you relax, you should feel them gently drop back down onto the towel.

• The Handheld Mirror (Visual Feedback): Lie down in a comfortable position and hold a small mirror to observe your pelvic outlet. As you contract, you should see the vaginal opening or the base of the penis pull inward and upward. As you release, you should see the tissue return to its starting neutral position.

Step 2: How To Perform A Kegel Properly

Once you have established sensory awareness, follow this standard physical therapy protocol to perform a Kegel properly:

1. Find Your Starting Position: Begin by lying flat on your back with your knees bent and feet flat on the floor. This gravity-assisted position takes extra load off your pelvic floor while you learn the motion.

2. Set the Breath: Take a soft, deep breath in, letting your belly expand and allowing your pelvic floor muscles to fully relax.

3. Exhale and Lift: As you blow air out of your mouth, initiate the contraction by pulling UP and IN. Imagine you are trying to stop the passage of gas or hold back a stream of urine.

4. Hold Without Straining: Keep holding that upward lift for 3 to 5 seconds to start. DO NOT HOLD YOUR BREATH! Keep breathing naturally throughout the entire hold.

5. Completely Release: Slowly let go of the contraction and let the pelvic floor drop completely back down to rest. Always allow a full rest period between reps.

Common Kegel Mistakes To Avoid

• Squeezing your glutes, thighs or abdominals

• Holding your breath or bearing down (pushing out)

• Skipping the complete relaxation phase between reps

If you are navigating post-prostatectomy recovery or managing surgical scar tissue in the pelvic region, read our complete breakdown on pelvic floor physical therapy after prostatectomy.

Step 3: How to Progress Your Training

As your awareness and muscle endurance improve, challenge your pelvic floor by progressing your positions:

• Increase the Hold Time: Slowly build from 3–5 second holds up to 10-second holds while maintaining continuous, normal breathing.

• Change Your Posture: Move from lying down to sitting upright, and eventually to standing. Standing forces your pelvic floor muscles to work against full gravity and body weight.

• Integrate Functional Movement: Once you master standing contractions, practice engaging your pelvic floor right before coughing, sneezing, lifting heavy objects, or standing up from a chair.

For patients experiencing lower abdominal stiffness, fluid retention, or post-surgical swelling, explore our tips on 3 smart ways to speed up injury recovery.

Quality Over Quantity

When it comes to pelvic floor training, ten high-quality, controlled contractions with a full relaxation phase will do far more for your health than fifty rushed squeezes.

If you still struggle to feel the upward lift, experience pelvic pain, or continue to deal with unmanaged leakage, schedule an evaluation with a certified pelvic health physical therapist. Hands-on guidance can help you retrain your core safely and effectively.

Remember, at Rehab and Revive®, we heal smarter, not harder®.

When you try doing a Kegel, what is your biggest challenge?

• 0%I catch myself holding my breath every single time!
• 0%I honestly can't tell if I'm lifting or pushing.
• 0%My glutes and thighs always try to do all the work.
• 0%Using the rolled towel trick made it click for me.