Patient information from BMJ

Stress incontinence: how to do pelvic floor exercises

Last published:Aug 30, 2022

If you are a woman with stress incontinence, regularly doing pelvic floor exercises is likely to improve your symptoms. Studies suggest that many women stay dry or leak less after doing these exercises for three months.

Here is an overview of how to do these exercises.

Find the right muscles

There are a few ways to identify your pelvic floor muscles.

• Try to stop the flow of urine when you're sitting on the toilet. If you can do this, you've found the right muscles to exercise.

• Imagine you're trying to stop passing wind, and squeeze these muscles. If you have a 'pulling' feeling, then you're squeezing the right muscles.

• Lie down and put your finger in your vagina and squeeze as if you're trying to stop urine from coming out. If you feel tightness on your finger, then you've found the right muscles.

If you're not sure, ask your doctor, nurse, or physiotherapist to help you find these muscles. Many women squeeze the wrong muscles at first. Some other tips:

• Be careful not to squeeze other muscles at the same time, such as muscles in your thighs, back, and stomach. Squeeze only the muscles of your pelvic floor, and don't hold your breath! Breathe slowly and deeply.

• Draw your muscles up and in. Try not to strain down. Rest a hand lightly on your stomach. If you feel your stomach pushing out against your hand, then you're straining down. If you find that you always push down, check with your doctor, nurse, or physiotherapist to learn how to do the exercises properly.

Get the most benefit from your exercises

• Pull in the muscles of your pelvic floor as much as possible to the count of five, and then relax to the count of five. Repeat this 10 times, three times a day.

• Pull in your pelvic floor muscles as much as possible and then quickly relax them. Repeat this 10 times, five times a day.

• You can do these exercises anywhere and any time, but they usually don't work as well if you do them when you’re focusing on something else (for example, when you’re watching television). You need to concentrate, especially at first.

• Get into a routine of doing the exercises. For example, you may like to do them before you get up in the morning and before you go to sleep.

Be patient

You may start to feel some benefit from these exercises after one week. You should do the exercises for at least three months, and continue them if they help.

If you do these exercises regularly, you should notice an improvement.