Bladder Control & Pelvic Floor Strength — A Quick Guide
What Are Pelvic Floor Muscles & Why They Matter
- The pelvic floor is a group of muscles and connective tissues that support the bladder, urethra, rectum, and, in women, the uterus.
- These muscles help maintain urinary control by contracting to prevent leakage and relaxing when you decide to urinate.
- When these muscles are weak or uncoordinated, you may experience incontinence, urgency, or leakage.
How Pelvic Floor Muscle Strength Affects Bladder Control
- Strong pelvic floor muscles act as a “brake” on leaking — they help manage sudden urges or pressure (e.g., when you cough, laugh, or lift)
- When you contract them, the urethra narrows slightly, helping prevent leaks
- When you relax them, urine can flow normally when you choose to empty the bladder
- Reliable control improves confidence, quality of life, and ability to delay urgency
Strengthening Your Pelvic Floor: Kegel Steps
Isolate the muscles
- Try tightening the muscles you’d use to stop gas or urine flow
- You should not feel your belly, legs, or buttocks tighten
Basic Exercise Pattern
- Squeeze for 1 second, then relax for 2 seconds → that’s one rep
- Do this 5 times (a set)
- Over time, increase to 10 sets per day
- Next stage: hold each squeeze for 3 seconds, then relax for 3 seconds
- Eventually aim for holds of ~10 seconds each
Practice Kegels in different positions
- Lying down
- Sitting
- Standing
Build a habit
- Do one set in the morning and one at night (or as fits your schedule)
Suggested routine:
- Do exercises in three positions: lying down, seated, and standing
- Start with 5 sets per position, each set being multiple squeezes
- When that becomes easy, increase frequency and duration (e.g., 10 sets daily)
- Always relax between squeezes so muscles recover
Note: It often takes ~6 weeks of consistent practice before noticeable improvement.
Tips for Proper Technique & Practice
- Begin on an empty bladder
- Sit, lie, or stand with good posture
- Relax your abdominal, buttock, and leg muscles — only the pelvic floor should contract
- You can rest one hand on your belly to check that it doesn’t move during contraction
- Practice mindfully: set cues (morning, after brushing teeth, bedtime) to remember
- Don’t overdo it — too many or forceful contractions can cause strain
- Let muscles fully rest and relax between contractions
- If you’re unsure you’re doing them correctly, working with a pelvic floor therapist or clinician may help
- If urinary urgency or leakage continues despite exercises, talk to your provider about other treatment options
When Pelvic Floor Training May Need Support
- If you have urgency or leakage that doesn’t improve
- If you experience pain, discomfort, or inability to locate the correct muscles
- If you have chronic urinary conditions, prior surgeries, or neurological disease
- Working with a pelvic floor physical therapist can ensure correct form and progression
Remember: Always ask your healthcare provider for specific advice on when to call to report symptoms, and when to seek urgent/emergency care.