How do I do Kegel exercises for urinary incontinence?

Dr. Evelyn Minaya, MD
OBGYN (Obstetrician & Gynecologist)

Watch as obstetrician and gynecologist Dr. Evelyn Minaya explains how Kegel exercises can help with urinary incontinence issues.

Kegel exercises for urinary incontinence are easy to do and can be done anywhere without anyone knowing. Keep in mind the following tips:

  • Kegels work best when done on a regular schedule.
  • Your doctor may want you to try doing Kegels with biofeedback. It lets you to see, feel or hear when an exercise is being done correctly.
  • It may take three to four months to notice improvement.
Dr. Marc B. Garnick, MD
Hematologist & Oncologist

The strength and proper action of your pelvic floor muscles are important in maintaining urinary continence. Here's how to do basic pelvic muscle exercises, named for Arnold Kegel, the physician who first developed them:

  • Pretend you are trying to avoid passing gas. You will feel a contraction more in the back than in the front, as if you are pulling the anal area in.
  • Practice both short contractions and releases and longer ones, gradually increasing the strength of the contraction and holding it for up to 10 seconds.
  • Repeat multiple times, several times a day.

Kegel exercises help strengthen pelvic floor and sphincter muscles. And by improving the strength of these muscles, you may be able to reduce or stop leaking if you have urinary incontinence.

Kegels are easy to do and don't take much time, but it's important to do them correctly. They can be done while lying down, standing or sitting. You can do these exercises anywhere, but studies show that when people do Kegels at home, they're more likely to do them correctly.

To do Kegel exercises:

  1. Figure out which muscles you should be exercising. Do this by imagining you're trying to stop the flow of urine or trying to stop yourself from passing gas. The muscles you tighten are your pelvic floor muscles.
  2. Slowly tighten your pelvic floor muscles, and maintain the contraction while you count to four. Then, let the muscles relax for a count of four. Repeat 10 times.
  3. Make sure you're not tightening the muscles in your legs, buttocks or abdomen. You want to focus on your pelvic floor muscles only. And remember to breathe.
  4. Aim to do 10 sets of 10 every day to start. Your doctor may suggest you increase this number, but you may need to work up to it gradually.

It may help to set aside a specific time each day to do your pelvic exercise, such as before you get out of bed or before you go to sleep at night. You may not notice improvements in pelvic function for 3 to 6 months, but keep doing the exercises to keep your muscles strong.

Kegel exercises are internal exercises for the pelvis. By strengthening the pelvic floor muscles, you strengthen the muscles that control the flow of urine. These are particularly helpful to treat stress incontinence, but they can also sometimes work for urge incontinence. To do Kegels, squeeze your muscles as if you're stopping the flow of urine, and hold for ten counts then relax. Do ten repetitions, two to three times a day. You may need to begin slowly by starting with holding for three counts then work your way up to ten counts. If you feel like you're "pulling up" with your muscles, you are likely doing it right. You can confirm this by checking a mirror to see if any of your external muscles are tightening. If you see your butt, leg, or stomach muscles contracting, you're not using the right muscles. If you have questions, your doctor can help.

Follow these steps to do Kegel exercises (exercises for the pelvic floor muscles) for urinary incontinence:

  • Locate your pelvic muscles. Pretend you are trying to avoid passing gas; in addition, if you are a woman, you can pretend to tighten your vagina around a tampon. Both actions involve the pelvic muscles. You will feel a correct contraction more in the back than the front, like you are pulling the anal area in or stopping gas from escaping.
  • Choose your position. You can start by lying on your back until you get the feel of contracting the pelvic floor muscles. Later, you can practice while sitting and standing as well.
  • Practice contractions. Practice both short contractions and releases (sometimes called "quick flicks") and longer ones (gradually increasing the strength of the contraction and holding it at your maximum for up to 10 seconds). Consciously relax the muscles between each repetition, and hold the relaxation phase for the same amount of time as the contraction.
  • Keep other muscles relaxed. When doing pelvic floor exercises, don't contract your abdominal, leg or buttock muscles or lift your pelvis. Place a hand gently on your belly to detect unwanted abdominal action.
  • Repetitions. Your health professional may advise you how many Kegel exercises to do. It is more effective to spread the exercises throughout the day than to do them all at once. One simple starting regimen is to do 10 before getting out of bed, 10 standing after lunch, 10 in the evening while sitting watching TV, and another 10 before going to sleep. You can do them at other times as well: in the car sitting at a stoplight, waiting for an elevator or waiting in a grocery line.
  • Determine your strategy. You can practice using these exercises to control your symptoms. If you have stress incontinence, tighten your pelvic floor muscles just before lifting, coughing, laughing or whatever usually causes urine leakage. Do the same several times when you have the urge to urinate and doubt you are going to make it to the toilet. This should relax your bladder muscle so you can walk to the toilet under control.
  • Be consistent. Practice consistently, using whatever schedule works for you. It may take a few months for you to notice an improvement in your symptoms.

To do Kegel exercises, also called pelvic exercises, for urinary incontinence, follow these steps:

  • Zero in on the correct muscles to exercise by stopping the flow of urine when you are on the toilet.
  • Find a quiet spot and lie on your back. Pull in the pelvic muscles and count to three.
  • Relax the muscles for a count of three and then repeat.
  • Work up to 10 to 15 repetitions three times a day.
  • With practice, you will be able to do the exercises sitting up or standing.
Dr. Mehmet Oz, MD
Cardiologist (Heart Specialist)

Kegel exercises are easy to do, but it's important to practice a bit first to make sure you are working the pelvic floor muscles. To get a sense for how that should feel, the next time you're urinating try to stop the stream for a moment. Feel those muscles at work? Those are the pelvic floor muscles.

To do Kegel exercises, begin by tightening the pelvic floor muscles. After a count of 10, relax for 10 seconds. Repeat this process 10 times to complete one session. Do a session in the morning, afternoon and evening. Be sure to empty your bladder before each session.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.