Master Your Pelvic Floor Exercises: A Physical Therapist's Detailed Guide to Understanding, Activating and Strengthening the Right Muscles

Dr. Yvonne Huang
Aug 2
3 min read

three women in workout clothes stretching

The pelvic floor. It’s a phrase you might hear often in the world of physical therapy, especially concerning women's health, but what exactly is it, and why is it so important? I’m Dr. Yvonne Huang, a physical therapist specializing in lymphatic drainage and pelvic rehabilitation here at Rehab and Revive, and I want to shed some light on this crucial group of muscles. I’ll guide you through finding and strengthening them with simple Kegel exercises.

What is the Pelvic Floor?

Imagine a natural hammock-like support at the base of your pelvis – that's your pelvic floor! It's a group of muscles that essentially "close off" the pelvic outlet, providing vital support for your abdominal organs. But its role extends far beyond just support. The pelvic floor plays a key part in:

Urination: Controlling the flow and preventing leakage.
Bowel Movement: Aids in proper elimination.
Sexual Function: Contributing to sensation and satisfaction.
Postural Support: Working with your core muscles for overall stability.

Understanding and engaging these muscles can significantly improve various aspects of your health and well-being.

Finding Your Pelvic Floor and Mastering Kegels

I always emphasize that mastering Kegel exercises starts with proper awareness. Here's my step-by-step guide to finding your pelvic floor and practicing these essential exercises:

Step 1: Lie Down and Breathe (Diaphragmatic Breathing)

Position: Lie on your back with your knees bent. You can use pillows for comfort. The goal is to be relaxed.
Focus: Begin with diaphragmatic breathing. As you inhale, allow your belly to rise. As you exhale, your belly should gently fall.
Pelvic Floor Connection: Now, pay attention to your pelvic floor – the area from your pubic bone to your tailbone, between your sit bones. As you breathe in, you'll feel a subtle downward push on your pelvic floor, like a balloon inflating. As you exhale, it will naturally draw inward, like the balloon deflating. This subtle movement is key to recognizing your pelvic floor muscles.

Step 2: The "Zipper" Kegel (Long Holds)

Visualization: Imagine a zipper running from your tailbone all the way up to your lower abdomen.
Action: Gently "pull" that zipper up, squeezing and lifting in stages:
- Start from your tailbone.
- Move towards your anus.
- Continue to your vaginal opening (if applicable) and urethra.
- Finish by feeling a gentle lift towards your lower abdomen.
Hold: Once you've "zipped it all the way up," hold this gentle contraction for 10 seconds.
Remember to Breathe: This is crucial! Do not hold your breath during the contraction. Continue your regular breathing.
Relaxation: The relaxation phase is just as important as the contraction. Slowly "unzip" the muscles, relaxing them little by little. Don't just let go abruptly. Control the release until you feel your tailbone area fully open.

Common Mistakes to Avoid:

Clenching your buttocks: Your glutes should remain relaxed.
Squeezing your knees: This is not a pelvic floor exercise.
Holding your breath: Always maintain steady breathing.

Step 3: Quick Flick Kegels

Action: This is a rapid squeeze and release. Think of it as a "quick flick" of your pelvic floor muscles.
Full Relaxation: The most important aspect of quick flicks is to ensure complete relaxation between each flick. If you don't relax fully, your muscles can become chronically tight.

My Recommended Practice:

Long Holds: 10-second hold, 10 repetitions.
Quick Flicks: 10 quick flicks.
Frequency: Perform these sets three times a day.

Progressing Your Practice

Once you feel comfortable and confident performing Kegels while lying down, you can progress to more challenging positions:

Sitting Position:

Posture: Sit upright with your feet flat on the floor. Avoid slouching.
Awareness: In a relaxed sitting position, you should feel your pelvic floor gently touching the surface you are sitting on.
Execution: Apply the same "zipper" and "quick flick" techniques.
Emphasis on Relaxation: In sitting, the controlled relaxation phase (eccentric training) is even more important for strengthening. Slowly release the muscles until you feel them touching the surface again.

Standing Position:

Once you've mastered Kegels in sitting, you can progress to standing. This is the most challenging position as you are working against gravity.

Important Precaution: Do NOT Practice Pelvic Floor Exercises While Urinating!

I strongly advise against practicing Kegel exercises while urinating. This can disrupt your body's natural urination cycle, potentially leading to further problems. Instead, set aside dedicated time for your Kegel practice.

By consistently incorporating these exercises into your routine, you can build a stronger, more functional pelvic floor, leading to improved bladder and bowel control, enhanced sexual health, and better overall core stability.

If you've experienced pelvic floor issues, have you ever considered seeing a specialized physical therapist?