Pelvic floor exercises strengthen the muscles that hold urine in, so you may leak less when you sneeze, laugh or lift. This guide covers finding the right muscles, five moves to start, and why core strength rehab matters too.
What are pelvic floor exercises?
Pelvic floor exercises are repeated squeezes and releases of the muscles under your bladder, uterus and bowel. MedlinePlus recommends them for women with stress incontinence and for men with it, most often after prostate surgery. Use them to strengthen the pelvic floor muscles the way you'd train any other muscle.
I'm Dr. Ivan Bracic, DC, founder of Novaré Injury Care and Rehab in Fort Myers. I've cared for more than 30,000 patients across Illinois and Florida. With bladder leaks, my goal is to rebuild strength and control so you can laugh, travel and exercise with less worry.
You're far from alone. Per the NIH's NIDDK, researchers estimate about half of all women experience urinary incontinence. The same source says as many as 1 in 3 men over 65 may lose urine by accident.
Why your bladder leaks when you sneeze or laugh
Your bladder leaks when a sneeze or laugh pushes on it harder than your pelvic floor can hold. Per NIDDK, this is stress incontinence, and coughing or physical activity can trigger it too. Check when your leaks happen, since that pattern helps a provider tell which type you have.
The usual cause is a pelvic floor that has weakened or stretched. Per NIDDK, women are more likely to develop leaks during and after pregnancy, childbirth and menopause. Cleveland Clinic adds aging, a chronic cough, straining from constipation and extra weight as other strains.
Many women first notice leaks after having a baby and assume they come with motherhood. Leaks are common, and pelvic floor training gives you something concrete to do about them. If they're hard to talk about, I want you to feel respected, listened to and taken seriously.
Are bladder leaks a normal part of getting older?
No, leaks are common with age, but they aren't something to accept. Per NIDDK, incontinence is not a routine part of being a woman or getting older. Treat leaks as a muscle problem you can work on, not as a fact of life.
Many of my patients tell me they've worn pads ever since their first child. I recommend getting checked when you first notice leaks, rather than years later.
The NIH's aging institute, NIA, advises trying the simplest and safest treatments first, and lists pelvic muscle exercises among the options.
Pelvic floor exercises for women after childbirth and menopause
Pregnancy and childbirth stretch the structures of the pelvic floor to make room for a baby. After birth, those muscles need rebuilding like any others, so start gently once your own provider says you can.
Leaks can also begin later in life. NIA says stress incontinence is the most common type in younger and middle-aged women, and it may begin around menopause.
Men can benefit too. The NIDDK says strengthening these muscles may help men leak less often, especially dribbling after urination.
How to find your pelvic floor muscles
Finding the right muscles comes first. Use these four steps, drawn from Cleveland Clinic and MedlinePlus guidance.
- Imagine holding in gas. Squeeze the muscles you'd use to stop passing gas and stop the flow of urine. You should feel a lift and squeeze inside.
- Try the stop test once. Midway through peeing, slow the flow to feel those muscles. Cleveland Clinic warns that stopping your pee often can lead to infection.
- Keep everything else loose. Your belly, buttocks and thighs should stay relaxed, per MedlinePlus. If they tighten, ease off and squeeze more gently.
- Keep breathing. Breathe normally as you squeeze, since holding your breath tightens other muscles. Counting out loud can help.
5 pelvic floor exercises to build bladder control
These are the five moves I recommend starting with. Cleveland Clinic suggests lying down at first if your muscles are weak.
- Slow Kegel holds. Squeeze and lift, hold for 3 seconds, then relax for 3 seconds. Repeat 10 times, morning and night, building toward 5-second holds.
- Quick squeezes. Squeeze and lift for 1 second, then let go completely. Repeat up to 10 times to train a fast response.
- Bridges. Lie on your back with knees bent. Breathe out, squeeze your pelvic floor and glutes, and lift your hips. Lower slowly.
- Sit-to-stand squats. Sit back toward a firm seat and stand up, squeezing your pelvic floor as you rise. Hold a counter for balance if you need it.
- Squeeze before you sneeze. Tighten your pelvic floor just before you sneeze, cough, laugh, lift or stand up. MSKCC suggests a Kegel before these moments to help keep urine in.
Do Kegels work for stress incontinence?
Yes, for many people, when they squeeze the right muscles and keep at it. NIDDK reports that women who received pelvic floor muscle training had fewer leaks per day than women who didn't. Give them a fair trial before you decide they don't work.
The trouble is how Kegels are often done. Almost everyone with leaks is told to do them, but Pelvic Floor First notes it's common to tighten too many outside muscles.
Your pelvic floor is like any other muscle. It needs proper activation, repetition and consistency, and a few squeezes at a red light won't do it.
How often to train your pelvic floor and when leaks may ease
Train most days in short sessions, and expect a few weeks before you notice a change. MedlinePlus suggests 10 repetitions, 3 to 5 times a day, with most people noticing some improvement after 4 to 6 weeks. Plan on up to 3 months before you judge the results.
Cleveland Clinic suggests working up to 10 squeezes per set, holding and relaxing for 5 seconds each, three sets a day. It says to expect results after six to eight weeks.
More isn't better. MedlinePlus warns that over-exercising can tire the muscles and increase leakage.
Core and hip strength that supports bladder control
Your pelvic floor works as part of your core. Per NIDDK, your core includes your lower back, pelvic floor and abdomen, and it keeps your pelvis lined up with your spine. A physical therapist trained in pelvic floor therapy can help you get more from Kegels by improving core strength.
I recommend pairing pelvic floor work with bridges, squats, pelvic tilts and core exercises for the hips and glutes. Our rehab and therapy treatment adds strengthening between visits, and my guide to strength training for seniors covers more moves.
When muscles stay weak after an injury or long inactivity, our functional wellness care works on rebuilding core, glute and leg strength. It's rehab for strength, and it doesn't replace a pelvic floor evaluation.
Kegel mistakes that keep the pelvic floor weak
These common mistakes come from MedlinePlus and Cleveland Clinic guidance:
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Squeezing your buttocks, thighs or belly instead of the pelvic floor.
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Holding your breath while you squeeze.
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Pushing down instead of lifting up and in.
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Doing Kegels while you pee, which MedlinePlus advises against.
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Doing too many, which can tire the muscles and make leaks worse.
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Ignoring back or belly discomfort, a sign you're likely using the wrong muscles.
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Stopping after a week or two, before the muscles have time to change.
What a strength evaluation for bladder leaks includes at our clinic
Our first visit typically runs 1 to 1.5 hours, and most of that time is with me. Expect four parts.
- Your history and goals. When leaks happen, what you've tried, and what you want to get back to doing.
- A hands-on exam. I check core, hip and back strength, posture, and how you sit, stand and lift.
- Imaging when needed. Digital X-rays on site if your exam points to a back or hip problem.
- A clear plan. Home exercises, in-clinic strength work, and a recommendation to see your physician or a pelvic floor physical therapist when your symptoms call for it.
What patients say about exercise advice at our clinic
just moving to the area both my wife and I have visited Dr. Ivan and I've been thoroughly impressed with how thorough he is with the process of evaluating our needs. Being a chiropractic patient for the last 15 years, he was the most extensive explanation of our situation and offered a series of remedies ranging from self-help to plans of improvement. All his staff genuinely care about their patients and we're very friendly. This was one of the most complete visits I've had in my history of chiropractic care. I would highly recommend using Dr. Ivan for your chiropractic needs.
Dan A., Lehigh Acres, Google review
Individual results vary.
When bladder leaks need a doctor or pelvic floor physical therapist
Most leaks aren't emergencies. Per Pelvic Floor First, leaks can have many causes and should be properly assessed. Get checked by your physician or a pelvic floor physical therapist if you notice any of these:
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Blood in your urine, or burning or pain when you pee.
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A bulge or heavy feeling in the vagina.
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Trouble emptying your bladder, or a weak or slow stream.
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Pain in your pelvis, bladder or back when you do the exercises.
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Leaks that haven't improved after 3 months of steady exercise.
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Sudden loss of bladder or bowel control with back pain or numbness, which needs emergency care right away.
Build pelvic floor and core strength with a plan in Fort Myers
If bladder leaks are holding you back, I'd like to examine you and build a plan around your core and hip strength. We see patients in Fort Myers and Lehigh Acres, in English and Spanish.
See functional wellness and core strength rehab
The questions I hear most about pelvic floor exercises, answered plainly.
Dr. Ivan Bracic, DC, is the founder and clinical director of Novaré Injury Care and Rehab in Fort Myers and Lehigh Acres, Florida. He has cared for more than 30,000 patients across Illinois and Florida since 1994 and is Trauma Team certified.
- Simple moves to build and keep muscle: strength training for seniors.
- Moves that build steadier legs and core: balance exercises for seniors.
- What a chiropractor actually does, and when to see one: what a chiropractor does.
Frequently Asked Questions
Will my bladder leaks get any better if I've had them for years?
Often, yes. NIDDK reports that women who did pelvic floor muscle training had fewer leaks per day than women who didn't. Start the routine now, and get checked if nothing changes after about 3 months.
Is it worth seeing a chiropractor for core strength if I'm nervous about going?
For most people, yes, when care starts with a proper exam. In one Fort Myers review, a patient says they were nervous about going to a chiropractor at first. Read what happens at <a href="/novare-first-chiropractic-appointment/">your first chiropractic appointment</a>, and ask every question before treatment starts.
What is the best exercise to strengthen the pelvic floor?
There isn't one best exercise. Cleveland Clinic says all Kegels help when done correctly, in any comfortable position. Combine slow holds, quick squeezes and bridges, then add squats as you get stronger.
Does squeezing your buttocks help the pelvic floor?
No. MedlinePlus says to keep your buttock, thigh and belly muscles relaxed during pelvic floor exercises. Rest a hand on your buttocks as you squeeze, and if they tighten, ease off.
What if I've tried many times to keep up with the exercises?
That's common, so build them into things you already do. MSKCC suggests doing a Kegel before you stand up, cough, sneeze or laugh. Tie a short set to meals or brushing your teeth so it becomes routine.
Are pelvic floor exercises safe after having a baby?
For most women, yes, once your own provider says you can start. Tommy's, a UK pregnancy charity, says these exercises can help with bladder control and healing after birth. Start gently, and get checked if you feel heaviness or pain.
This article is educational and is not medical advice. Bladder leaks have many causes, and some need prompt medical attention. If you leak urine, feel pelvic pressure or pain, or notice a change in bladder control, get evaluated by a qualified provider, such as your physician or a pelvic floor physical therapist, to find the right care for your situation.