Pelvic floor exercises for incontinence: what to do, how many, and for how long
Pelvic floor exercises are the first treatment guidelines recommend for women who leak urine, and the evidence for them is strong: in a 2018 Cochrane review, women with stress leaks who trained were about 8 times more likely to report being cured than women who didn't (56% versus 6%). The core is simple: slow and quick squeezes, about 30 a day, for at least 3 months, then using the squeeze at the moments you leak.
What most exercise lists miss is that the right plan depends on when you leak. This guide sorts the exercises by type of leak, gives sets and reps for each, lays out a 12-week programme, and says what to do if exercise alone isn't enough.
First: which kind of leak do you have?
| Type | When it happens | Exercises that help most |
|---|---|---|
| Stress incontinence | On a cough, sneeze, laugh, lift, jump or run; usually small amounts | Strength and quick squeezes, plus the squeeze before effort (the Knack) |
| Urge incontinence | A sudden strong need to go that you can't hold, often on the way to the toilet or at the key in the door | Quick squeezes to calm the urge, plus bladder training |
| Mixed incontinence | Both of the above | Both; start with whichever bothers you most |
| Something else | Constant dribbling, never feeling empty, leaks with no warning or trigger | See a doctor before exercising |
NICE, the UK's guidance body, recommends supervised pelvic floor training of at least 3 months as the first treatment for stress and mixed leaks, and bladder training of at least 6 weeks for urge or mixed leaks. Many women have some of both. Our free 1-minute check asks when your leaks happen and points you to the right start.
Before you start: finding the right muscles
The exercises only work if you squeeze the right muscles in the right direction. In one study, after a short spoken explanation, only about half of women did a correct pelvic floor squeeze, and about a quarter pushed down instead, which can make leaks worse.
- Lie on your back, knees bent. Imagine stopping wind and stopping the flow of urine at the same time.
- Squeeze and lift up and in. The feeling is a gentle draw upward inside, not a push down.
- Keep your bottom, thighs and belly soft. Keep breathing.
- Let go fully. You should feel the muscles drop back.
If you aren't sure, our guide on how to do Kegels correctly has five checks you can do at home.
The exercises, with sets and reps
1. Slow squeezes (for strength)
Lift and hold while breathing normally, then let go completely and rest as long as you held. 8 to 12 holds, 3 times a day. Start with whatever hold you can keep at full strength, often 3 to 5 seconds, and build to 10 seconds over the weeks. This is the backbone of every trial programme for stress leaks.
2. Quick squeezes (for speed)
A strong lift for 1 second, then a full let-go. 5 to 10 after each set of slow squeezes. These train the fast reflex that closes the urethra when a cough or sneeze hits.
3. The Knack: a squeeze before the pressure
Squeeze just before and during a cough, sneeze, laugh, lift or stand-up. In a 1998 study, selected older women with mild to moderate stress leaks learned this in a week, and leakage on a medium cough fell by 98% on average. Their strength had not changed; the timing had. Practise it on purpose: 5 deliberate coughs with a squeeze first, once a day, until it becomes automatic. Our guide to leaking urine when you sneeze or cough walks through it.
4. Squeeze and stand (sit to stand)
Many women leak as they get up from a chair. Sit near the edge of a firm chair, feet flat. Breathe in. As you breathe out, lift the pelvic floor, then stand up, keeping the squeeze. Sit back down slowly and let go. 8 to 10 times, once a day. This teaches the floor to work during a real movement.
5. Bridge with a lift
Lie on your back, knees bent. Breathe out, lift the pelvic floor, then lift your hips off the floor. Hold for 3 breaths, lower, let go. 8 to 10 times. The bridge works the buttocks and back with the floor, which helps it hold during lifting and walking. If your back or hips complain, lift less high.
6. Belly breathing (for letting go)
Lie or sit, a hand on your belly. Breathe in slowly through your nose and let the belly rise; feel the pelvic floor gently drop. Breathe out and let it return. 2 to 3 minutes a day. A floor that can't let go doesn't work well either, and for women with urge leaks or pain, letting go may matter more than squeezing.
7. Urge calming (for urge leaks)
When a sudden urge hits, stop and stand still or sit down. Do 5 quick, strong squeezes, breathe slowly, and wait for the wave to pass. Then walk calmly to the toilet. Rushing makes the bladder squeeze harder. Practising this is part of the stop-squeeze-breathe steps in our guide to sudden urges you can't hold.
A 12-week programme for incontinence
| Weeks | Daily sets | Holds | Add |
|---|---|---|---|
| 1–2 | 3 sets lying down: 6–8 slow + 5 quick | 3 seconds | Belly breathing 2 minutes; the Knack on 5 practice coughs |
| 3–4 | 3 sets lying or sitting: 8–10 slow + 5–8 quick | 5 seconds | Sit to stand × 8; urge calming whenever an urge hits |
| 5–8 | 3 sets sitting or standing: 10 slow + 8–10 quick | 6–8 seconds | Bridge × 8; the squeeze before every lift |
| 9–12 | 3 sets standing: 10–12 slow + 10 quick | 8–10 seconds | Squeeze during your own triggers: stairs, carrying, a brisk walk |
| After 12 | 1 set a day, or 3–4 a week | 10 seconds | Keep the Knack for life |
The whole day is about 10 to 15 minutes. For one session laid out minute by minute, see our pelvic floor exercise routine; for how many squeezes at each stage, see how many Kegels a day for women.
How long until the exercises help?
Cleveland Clinic puts first changes at about 6 to 8 weeks of daily training. NICE asks for at least 3 months before judging. The Knack can help within days, because it's a skill, not strength. Most women who stop do so because they forget or see no change in the first weeks, so measure: for three days, tally each leak and what set it off, and repeat the tally every two weeks. Our guide on how long Kegels take to work explains what changes each week.
Exercises for running, jumping and laughing leaks
Impact and laughter put fast, repeated pressure on the floor. They need the quick squeezes and the Knack more than long holds. For runners, our guide to leaking urine when running has a run-day routine and impact tests. For laughter, which you can't easily time, see leaking urine when laughing.
Habits that work alongside the exercises
- Drink normally. Cutting fluids makes urine stronger and can irritate the bladder. NICE suggests reviewing fluid intake if it's very high or very low.
- Cut back on caffeine. NICE recommends trying less caffeine for women with an overactive bladder. Fizzy drinks and alcohol bother some women too.
- Treat constipation. Straining stretches the floor; a full bowel presses on the bladder.
- Weight. For women with a BMI over 30, NICE advises that losing weight can help.
- Stop smoking. A smoker's cough loads the floor many times a day.
- Go when you need to, not "just in case". Frequent just-in-case trips train the bladder to hold less.
What to do if exercises aren't enough
If you've trained well for 3 months and leaks still bother you, there are other options. Talk to your doctor about:
- A pelvic floor physical therapist. They can check your squeeze with an exam and tailor your programme. NICE recommends supervised training rather than a leaflet alone.
- Biofeedback or electrical stimulation. Not routine, but sometimes used for women who can't contract the muscles at all.
- Vaginal estrogen after menopause, for urge symptoms with vaginal dryness. See bladder leakage and menopause.
- Medicines for an overactive bladder.
- A pessary or vaginal device that supports the urethra during exercise.
- Surgery for stress leaks that don't respond to other treatment.
When to see a doctor first
See a doctor before starting, or soon, if you have blood in your urine, pain or burning when you pass urine, fever, recurrent urine infections, trouble passing urine or a feeling you never empty, a bulge or heaviness in the vagina, constant dribbling, or leaks that started suddenly with numbness or leg weakness (the last one urgently).
Common mistakes
- Holding your breath. It pushes pressure down on the floor. Breathe out as you lift.
- Squeezing your bottom or thighs. They feel like effort but don't close the urethra.
- Never letting go. A full rest between squeezes is half the exercise.
- Never getting harder. Add a second or a squeeze every week or two.
- Only doing them lying down. Leaks happen standing and moving; train there too.
- Stopping at 4 weeks. Strength shows from about 6 to 8 weeks.
- Practising by stopping your stream. Fine once to find the muscles; not as training.
Frequently asked questions
What is the best exercise for incontinence?
Slow and quick pelvic floor squeezes (Kegels) done correctly, with the squeeze timed before a cough or lift. That combination has the most evidence for stress leaks.
Can incontinence be cured with exercise?
For many women with stress leaks, yes: over half of women in the trials reported a cure. Not everyone; results depend on the type of leak, the squeeze, and how long you train.
Do pelvic floor exercises help urge incontinence?
They help, especially quick squeezes to calm an urge. Bladder training is the main treatment for urge leaks, and the two together work well.
Are squats or Pilates good for incontinence?
They can help when combined with a pelvic floor lift, as in the sit-to-stand and bridge above. On their own, without targeted pelvic floor training, they have less evidence.
Can I do these exercises after menopause?
Yes. The trials include women of all ages. See pelvic floor exercises for women over 50 for positions that suit knees and backs.
How often should I do pelvic floor exercises for incontinence?
Every day, about three sets, for at least 3 months; then a set a day or a few times a week to keep the gains.
Where to start today
Today, start a three-day leak tally: each leak, what set it off, and how much. It tells you which type you have and gives you a number to beat. If you'd like a one-minute look at why Kegels often fail and what a daily plan that builds week by week looks like, take the free 1-minute check. For more on leaks, urges and the pelvic floor after 40, see all our pelvic floor guides.
Sources: Dumoulin C., Cacciari L., Hay-Smith J., Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women, Cochrane, 2018. NICE NG123, Urinary incontinence and pelvic organ prolapse in women: management, 2019. Miller J., Ashton-Miller J., DeLancey J., A pelvic muscle precontraction can reduce cough-related urine loss in selected women with mild SUI, J Am Geriatr Soc, 1998. Bump R. et al., Assessment of Kegel pelvic muscle exercise performance after brief verbal instruction, Am J Obstet Gynecol, 1991. Cleveland Clinic, Kegel exercises (my.clevelandclinic.org). Hinge Health, 6 exercises for incontinence (hingehealth.com). Training and education, not medical advice.