Kegels are exercises that strengthen the muscles lining the floor of your pelvis. These muscles act like a hammock, supporting your bladder, uterus or prostate, and rectum. By repeatedly squeezing and relaxing them, you build strength that helps with bladder control, bowel function, and sexual health. First described by Dr. Arnold Kegel in 1948, the exercises remain one of the most effective non-surgical treatments for urinary leakage.
The Muscles You’re Actually Working
Your pelvic floor is made up of two main muscle groups: the levator ani and the coccygeus. Together, they stretch across the bottom of your pelvis like a sling. The levator ani does most of the heavy lifting. It holds your internal organs in place, helps maintain pressure inside your abdomen, and plays a role in breathing, urination, and bowel movements.
Within the levator ani, different sections handle different jobs. One part controls urine flow. Another forms a loop around the lower rectum, working with your sphincter muscles during bowel movements. In women, a section called the pubovaginalis supports the vagina. In men, the equivalent muscle supports the prostate. When you do a Kegel correctly, you’re engaging all of these fibers at once.
How Kegels Help Women
The most common reason women start Kegels is urinary leakage, especially stress incontinence, where urine escapes during a cough, sneeze, laugh, or jump. Pregnancy, childbirth, aging, and hormonal changes can all weaken the pelvic floor enough to cause this. A systematic review found that 58.8% of women with stress incontinence achieved significant improvement after 12 months of supervised pelvic floor training. For mixed incontinence (a combination of stress and urgency types), about 28% saw improved symptoms and quality of life after six months.
Beyond bladder control, stronger pelvic floor muscles help prevent or slow pelvic organ prolapse, a condition where the bladder, uterus, or rectum drops lower in the pelvis due to weakened support. Dr. Kegel’s original 1948 research showed the exercises could help prevent both bladder and rectal prolapse. Women with severe incontinence or advanced prolapse tend to see less benefit from Kegels alone, but for mild to moderate cases, they can be genuinely effective.
How Kegels Help Men
Men benefit from Kegels too, particularly after prostate surgery. Removing the prostate can lead to urinary leakage and erectile dysfunction. Roughly 6% to 8% of men experience ongoing stress incontinence after a prostatectomy, leaking urine when they cough, stand up, sit down, or lift something heavy. Strengthening the pelvic floor muscles around the bladder can reduce or completely stop this leakage in mild to moderate cases.
For erections, recovery after prostate surgery can take six months to two years even when nerves are fully preserved. Kegel exercises help by increasing blood flow and muscle strength in the area. Starting the exercises before surgery and continuing afterward leads to faster recovery and reduces the severity of side effects.
How to Find and Squeeze the Right Muscles
The trickiest part of Kegels is targeting the correct muscles. Here are the most reliable ways to identify them:
- For women: Imagine you’re trying to stop the flow of urine midstream, or preventing the passing of gas. You should feel your vagina and rectum pull upward and inward.
- For men: Imagine lifting the penis up and down without moving any other part of your body, or tightening the ring of muscles around the anus as if holding in gas.
In both cases, the sensation should be a closing and lifting feeling deep inside the pelvis. Your thighs, buttocks, and abdomen should stay relaxed. If you notice your glutes tightening or your stomach tensing, you’re recruiting the wrong muscles and won’t get the training benefit for your pelvic floor.
A Simple Routine to Follow
The National Institute of Diabetes and Digestive and Kidney Diseases recommends this approach: squeeze your pelvic floor muscles and try to hold for 3 seconds, then fully relax. Work up to 10 to 15 repetitions per session, and aim for at least three sessions per day. Try doing the exercises in different positions: lying down, sitting, and standing. Each position changes the load on your pelvic floor slightly, which builds more functional strength.
Consistency matters more than volume. Don’t increase the number of repetitions beyond this range, as overdoing it can lead to straining during urination or bowel movements. Most people notice results within a few weeks to a few months of daily practice.
Common Mistakes That Reduce Results
Many people perform Kegels incorrectly, especially when learning from written instructions alone. The most frequent errors:
- Squeezing the buttocks or thighs: If your pelvic floor is weak, your body naturally compensates by recruiting larger surrounding muscles. This feels like effort but does nothing for the muscles you’re trying to train.
- Bearing down instead of lifting up: A correct Kegel involves an upward squeeze. Pushing downward (a straining action) actually increases pressure on the pelvic floor and can progressively weaken it over time.
- Holding your breath: The pelvic floor works in coordination with your diaphragm. Breath-holding disrupts this relationship and pushes downward pressure onto the very muscles you’re trying to strengthen. Breathe normally throughout each repetition.
- Skipping the relaxation phase: Fully relaxing between contractions is just as important as the squeeze itself. Without adequate rest, you risk developing increased tension or spasm in the pelvic floor.
- Poor posture: Slouching increases the load on your pelvic floor, making the exercises harder and less effective.
It’s also worth knowing that exercises like bridges, Pilates, or yoga are sometimes promoted as pelvic floor training, but there’s currently no strong evidence that they effectively strengthen these specific muscles. They may be great for other purposes, but they aren’t a substitute for targeted Kegels.
When Kegels Can Make Things Worse
Kegels are not appropriate for everyone. Some people have a hypertonic pelvic floor, a condition where the muscles are already too tight and can’t fully relax. Symptoms include pelvic pain, difficulty urinating, pain during sex, or a feeling of constant tension in the lower pelvis. For these individuals, doing Kegels adds even more tension to muscles that are already in spasm, worsening pain and symptoms. Kegels should never cause pain. If they do, that’s a signal to stop and get an evaluation from a pelvic floor physical therapist who can assess whether your muscles need relaxation training rather than strengthening.