Doing Kegel exercises? Here’s how to tell if you’re doing them correctly
Kegels can strengthen your pelvic floor and prevent urine leaks, but they’re not for every woman. Here’s how to do them safely – and when to avoid them.
Kegel exercises can help strengthen the pelvic floor muscles but must be done correctly. (Photo: iStock/nirat)
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Ever sneezed or coughed and found yourself “leaking” urine? If you’ve mentioned this to your friends, they might have suggested you do Kegel exercises to strengthen your pelvic floor muscles.
According to SingHealth, about 15 per cent of women in Singapore have stress urinary incontinence, which can be caused by weakened pelvic floor support.
“Kegel exercises are simple muscle-tightening movements,” said Dr Harvard Lin, obstetrician and gynaecologist at Gleneagles Hospital.
They are done to strengthen the pelvic floor muscles, added Dr Aswini Balachandran, obstetrician and gynaecologist at Raffles Women’s Centre. These muscles should be firm and supportive, but not tight or overactive. Overactive pelvic floor muscles remain tense and contracted even when at rest.
Dr Aswini explained that the pelvic floor is composed of a thin sheet of muscle and connective tissue, which spans the area underneath the pelvis like a hammock.
It holds the womb, bladder and rectum in the correct position, especially when standing. It also helps control urination, passing wind and bowel movements, and prevents involuntary leakage of urine and faeces, she added. The pelvic floor also plays an important role in sexual function.
Dr Lin told CNA Women that the weakening of the pelvic floor muscles can happen to any woman, even if they have never given birth or had sexual intercourse.
“The pelvic floor is a set of muscles subject to the same wear, tear, strain and hormonal shift as any other part of the body,” he said. “Sexual activity itself has no impact on muscle strength, so virgins and sexually active women share the exact baseline risks.”
CAUSES OF WEAK PELVIC FLOOR MUSCLES
Besides pregnancy and childbirth, a weak pelvic floor can be caused by a combination of factors, said Dr Aswini Balachandran, obstetrician and gynaecologist at Raffles Women’s Centre.
BMI above 25: Carrying excess body weight exerts constant pressure on the bladder and the surrounding muscle structures, said Dr Aswini. In a 2026 study published in the Medical Science Monitor journal, researchers found that excess weight can result in a strain that can stretch the muscle fibres and weaken connective tissues.
Sports and activities: Dr Harvard Lin, obstetrician and gynaecologist at Gleneagles Hospital, said elite gymnasts, weightlifters and runners may experience leaks due to high, repetitive pressure these activities place on the pelvic floor. According to a 2018 article in An International Journal of Obstetrics & Gynaecology, repeated impact over time can fatigue the pelvic floor muscles and supporting structures.
Chronic straining through coughing and constipation: Long-term increased pressure on the pelvic area repeatedly pushes down on the pelvic floor, weakening it over time, said Dr Aswini.
Dr Lin added: “Constantly straining to pass bowel movements overstretches and severely weakens the pelvic hammock over time while long-term conditions like asthma or a persistent smoker’s cough place continuous downward pressure on the pelvic organs.”
Genetics: Collagen disorders such as Ehlers-Danlos syndrome are associated with increased tissue laxity (stretchability), which reduces the tone of the pelvic floor muscles, said Dr Aswini. This can affect pelvic floor support.
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HOW TO DO KEGEL EXERCISES PROPERLY
Kegel exercises might sound simple enough to do – contracting and lifting your pelvic floor muscles. But to be truly effective, identifying the right muscles is crucial. Improper technique can strain or worsen already weakened pelvic floor muscles.
You may have heard that stopping your pee mid-stream is the easiest way to locate the right muscles, but Dr Lin and Dr Aswini advise against this. Doing so forces urine back into the bladder, which can introduce bacteria into the bladder and increase the risk of urinary infections, said Dr Lin.
Follow these steps to do Kegel exercises correctly and safely:
Step 1: Sit upright or lie down with your legs slightly apart, keeping your stomach, legs and buttocks relaxed.
Step 2: Tighten your pelvic floor muscles, holding the contraction for a few seconds. Continue breathing normally as you do so.
To contract your pelvic floor muscles, imagine that you are trying to stop yourself from passing wind. When done correctly, you should feel a distinct pulling or lifting sensation around your rectum.
Alternatively, imagine yourself sitting on a small marble. Then visualise your pelvic muscles gripping the marble and slowly lifting it upwards and towards your belly button.
Step 3: Fully relax the muscles for the same amount of time as the contraction. Do eight to 12 contractions, three times a day.
“The goal is to focus on quality, ensuring proper contraction and relaxation, rather than high volume,” advised Dr Lin.
But if you still find it difficult to contract your pelvic floor, a pelvic floor physiotherapist at a specialised physiotherapy clinic can help improve your technique, said Dr Aswini.
BODY CUES THAT YOU’RE DOING KEGELS CORRECTLY
Still unsure? Follow Dr Lin’s advice:
The belly check: Place a hand on your stomach while you squeeze. Your lower abdomen should remain soft, relaxed and completely still. If your stomach muscles tense up, harden or suck inward heavily, you are using your abdominal muscles instead of your pelvic floor muscles.
The talking test: You must be able to breathe freely, speak or count out loud during each contraction. If you find yourself holding your breath or tightening your chest, you are creating excess downward pressure in your abdomen that strains the pelvic floor.
The butt check: Sit on a firm chair or lie down. Your buttocks, inner thighs and hip muscles should stay entirely relaxed. If your body lifts off the chair or your thighs squeeze together, you are using the wrong muscle groups.
In versus out: Pay attention to the direction of the internal movement. The sensation must be an upward lift toward your belly button. If you feel a sensation of pushing downward, straining or bulging outward, stop immediately, as this can worsen pelvic issues.
The let-down: Kegels require a deliberate, conscious release after the squeeze. Check whether you can feel the muscles fully drop and relax back to their starting position. If you cannot feel the release, you may be keeping the muscles chronically over-tightened.
NOT FOR EVERY WOMAN
Dr Lin said many women unknowingly hold intense, chronic tension in their pelvic muscles. When the pelvic floor muscles are too tight, doing daily Kegel exercises is akin to lifting weights with a muscle that is already cramping, which can worsen pelvic pain and even cause constipation or increase urinary urgency.
Dr Aswini added that having a tight pelvic floor (medically known as a hypertonic pelvic floor) means the pelvic floor muscles stay constantly contracted, and this can result in pain in the lower back, hips, tailbone or deep inside the pelvis.
Other symptoms associated with tight pelvic floor muscles include difficulty starting to urinate, slow urinary flow, the inability to completely empty your bladder, and pain during sexual intercourse, said Dr Aswini.
“The primary purpose of Kegel exercises is to strengthen the pelvic floor muscles. Performing them when your pelvic floor is too tight may exacerbate these symptoms,” said Dr Aswini.
Women who have conditions such as vaginismus (a condition where the muscles around the vagina tighten or spasm involuntarily) or experience pain during sexual intercourse should also avoid Kegel exercises.
Squeezing an overactive, spasming muscle group can make these conditions significantly worse. Instead, they should be addressed through lengthening and relaxation therapy, said Dr Lin.
KEGELS AT EVERY STAGE OF LIFE
Dr Lin said pelvic floor awareness can begin in adolescence.
Guidelines from the National Institute for Health and Care Excellence in the United Kingdom recommend educating girls aged 12 to 17 about pelvic floor anatomy and how to prevent pelvic floor dysfunction.
It is also never too late to start, as women can benefit from pelvic floor muscle training as they age.
In fact, both doctors advised that women maintain pelvic floor care for life, especially during and after menopause. As women age, oestrogen levels drop significantly. This hormonal shift causes the pelvic floor tissues to become thinner, less elastic and naturally weaker.
Caring for these muscles through your 50s and beyond is one of the most effective ways to maintain independence and prevent common senior health issues, said Dr Lin.
These issues include urinary and faecal incontinence, and vaginal wall prolapse, which can affect one’s quality of life, said Dr Aswini.
Leaking urine and faeces can be embarrassing, while vaginal wall prolapse – where the muscles and tissues supporting the vagina weaken, allowing the bladder, bowel or uterus to bulge into or drop through the vaginal canal – can cause persistent discomfort when moving and sitting, she added.
CNA Women is a section on CNA Lifestyle that seeks to inform, empower and inspire the modern woman. If you have women-related news, issues and ideas to share with us, email CNAWomen [at] mediacorp.com.sg.
Source: CNA/pc
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