Top 5 Exercises to Strengthen the Pelvic Floor

These exercises can be incorporated into your regular exercise routine, or you can repeat all of them as a stand-alone routine.

Exercise #1: Kegel Exercises:

Kegel exercises are the most commonly known type of pelvic floor strengthening exercise, and this is the only reason they are at the top of this list. Kegels are not recommended as a first exercise for people who have overactive pelvic floor muscles. If you frequently experience a sense of your pelvic floor being “too tight,” or if you’ve been diagnosed with a hypertonic pelvic floor, you may want to start with one of the other exercises listed here. As well, when you perform a kegel, you are training the pelvic floor in isolation, this doesn’t always translate to more dynamic whole-body movements. Kegels are appropriate at times, but they’re not the only exercise for pelvic floor strength and not the first that I recommend.

A Kegel, performed correctly, includes both a concentric contraction and a relaxation of that contraction. Here’s how to do it:

• Begin by sitting or lying down
• Imagine that you’re holding a blueberry or marble just at the entrance to your vagina, or imagine that you’re trying to draw your scrotum up into your pelvis, if you have a penis
• Gently lift the marble and hold it for a few seconds
• Slowly release it all the way down and allow yourself to relax
• Do not hold your breath, and try to focus only on the muscles toward the front of your pelvic floor, not the butt, anus, or abdominal muscles
• Repeat 10 times, or break up into smaller sets throughout your day

Exercise #2: Squats:

Squats are a functional movement pattern and can benefit your pelvic floor when performed correctly. I generally teach a squat that is more like a hip hinge (watch a video of this here). Use a mirror to check your form as you perform this exercise.

• Stand with feet parallel and a little wider than pelvis width apart
• Bend your knees and rest your hands on your thighs 
• Really stick your butt out behind you, and check to make sure you’re not tucking your pelvis under you
• Don’t let your ribs sink in and collapse, but don’t arch your back, either
• Lifting out of your butt is going to put your glutes on a big stretch as you strengthen them–and that’s exactly what your pelvic floor needs
• Inhale, and exhale as if blowing out candles, so that the abdominals corset in 
• Then take your hands off your thighs, one at a time
• Holding this position, check your form in the mirror 
• Then push down through your legs to come up to stand
• Repeat several times (8-10 times)

You can also use a chair to support:

• Sit on a chair with your feet parallel and slightly wider than pelvis width
• Make sure your knees are stacked over your ankles and weight on the sit bones (not a tucked pelvis)
• Lean forward slightly and try to stand up. If you find yourself holding your breath, using your hands, shifting your feet back, or otherwise struggling to get up, grab some folded up towels or a bolster and raise the height of your seat until you can push through your feet to stand without your knees coming forward of your ankles
• Repeat several times

Exercise #3: Bridge Pose:

Bridge pose is a great pelvic floor strengthening exercise because it targets the glutes, hamstrings, and inner thighs. Try these two options to increase the effectiveness of this exercise:

Option 1: bridge with a block (substitute with a pillow or squishy Pilates ball)

• Lie on your back with your feet pelvis width apart, flat on the floor
• Bring place the block between your thighs, squeezing with with just enough tension to keep the block in place
• Press down through your feet and squeeze the block more firmly as you lift your hips
• Only go as high as you can without straining or arching your back
• Slowly lower your hips and release the tension on the block
• Repeat 8-10 times. Bonus round: Come up into the bridge, hold that position and add 10 small pulses up and down, then release

Option 2: Crooked bridge

• Lie on your back with your feet pelvis width apart, flat on the floor
• Step one foot out to the side slightly (if you’re on a yoga mat, place it just off the mat)
• Press down through your feet to raise your hips, keeping your pelvis level
• Only go as high as you can without straining or arching your back
• Slowly lower your hips 
• Repeat 8-10 times each side

For a fun before and after experience: Try a regular bridge before you do the crooked bridge reps, then try again after you’ve worked each side. Notice what feels different from the first time you did the bridge

Exercise #4: Pelvic Tilts:

Pelvic tilts are a classic pelvic floor rehabilitation exercise. They help you mobilize the pelvis and isolate pelvic movement from the rest of the body. You can perform this exercise lying down, sitting in a chair, or standing with your back against a wall and knees bent, or even on all fours. The basic instructions remain the same: Begin from a neutral pelvic position

• Exhale as you tuck your pelvis so that your pubic bone moves toward your nose
• Inhale and untuck your pelvis as if sending your sit bones behind you
• Repeat until the movement becomes fluid and even

Exercise #5: Reverse Marching

Reverse marching is an exercise that engages the deep core muscles to stabilize spine and torso as you lift your leg. It’s a precursor to other exercises like single leg raises and dead bug. Reverse marching helps train your core to be responsive to loads like walking, so that your core and pelvic floor can be better coordinated. As part of practicing reverse marching, let’s also test your core engagement strategy:

• Lie on your back with your pelvis and spine neutral and feet flat on the floor; you may need to place a rolled-up towel under your head so your ribs are in line with your pelvis. If your ribs are thrust forward, it’s difficult to activate your deep core
• Place your hands on your belly below your bellybutton
• Inhale and allow your ribcage to expand
• Exhale slowly through your mouth as if you’re blowing out 100 candles on a birthday cake. This exhale is called “candles breath”
• As you exhale, allow your lower belly to sink down toward the floor–you will feel your belly move away from your hands
• If your belly moves up into your hands instead of down during the exhale this is what I call bulging. Experiment with the way that you engage your core muscles until you can find a sense of “corseting in” as if you’re zipping up a jacket. Do not bear down with your pelvic floor muscles as you do this
• Inhale and allow the breath to fill your lungs and your belly to gently relax, and repeat as many times as needed to get a sense of core engagement

Now, add some movement:

• On your next exhale, lift your right knee until your shin is parallel to the floor
• Slowly lower it down, then switch sides; repeat 8 times per side
• Do not push through the foot on the floor to get your leg up; imagine that the leg is floating up
• Notice whether your pelvis rocks to the side as you lift your leg; what do you need to do to keep the pelvis stable?