Pelvic floor exercises lying down: a 10-minute routine in bed
Yes, you can do pelvic floor exercises lying down, and it's the best place to start. Lying on your back with your knees bent takes the weight of your organs off the pelvic floor, so it's easier to feel the muscles lift and let go. NHS physiotherapy leaflets start women lying down, then move them to sitting and standing as the squeeze gets stronger.
Below: how to set up, the five exercises for a 10-minute session in bed, the four lying positions and who each suits, how many to do, a six-week plan from lying to standing, and when it makes sense to keep doing them lying down.
Why start lying down
- Less load. Standing, the pelvic floor holds up your bladder, womb and bowel against gravity. Lying, that weight shifts, so a weak floor can lift further and hold longer.
- Easier to feel. With your back, bottom and legs supported, the big muscles (buttocks, thighs, belly) can relax. That makes it easier to squeeze only the pelvic floor.
- Easier to breathe well. Belly breathing, which helps both the squeeze and the let-go, comes naturally on your back.
- Easy to fit in. In bed before you get up, or before sleep: no change of clothes, no space needed.
- Kinder with prolapse. If you have a heavy, dragging feeling in the vagina, lying down usually eases it. Patient leaflets for prolapse suggest doing exercises lying down when the heaviness is bad.
The catch: lying is the easy version. Leaks happen when you're up: sneezing standing, lifting, walking to the toilet. So lying down is where you start, and where you return on tired days, not where you stay for good.
How to set up
- Empty your bladder first.
- Lie on your back on the bed or a mat, with a pillow under your head.
- Bend your knees, feet flat, about hip-width apart. A pillow under your knees helps if your back aches.
- Let your knees and thighs relax. They can fall slightly apart; you don't need to hold them.
- Put one hand on your lower belly, below the belly button. It tells you if the belly is gripping.
- Breathe normally for a few breaths, belly rising on the in-breath.
How to find the muscles: squeeze as if stopping wind, and at the same time as if stopping the flow of pee. You should feel a lift and a tightening around the back passage and vagina, drawing up and in. Your buttocks, thighs and the hand on your belly should stay quiet, apart from a small, gentle tightening low in the belly. Our guide to how to do Kegels correctly has more ways to find them.
The 10-minute routine in bed
| Minutes | Exercise | How many |
|---|---|---|
| 0–2 | Belly breathing with a let-go | About 10 slow breaths |
| 2–6 | Slow holds | 8 to 10, hold 3 to 10 seconds, rest as long |
| 6–7 | Quick squeezes | 10 in a row |
| 7–9 | Cough with a squeeze (the Knack) | 3 to 5 |
| 9–10 | Bridge with a squeeze | 5 to 8 |
1. Belly breathing with a let-go (2 minutes)
Breathe in through your nose for about 4 seconds, belly rising under your hand, and let the pelvic floor soften. Breathe out for about 6 seconds. Repeat about 10 times. This starts every session with the floor relaxed, so the squeezes that follow have room to move.
2. Slow holds (4 minutes)
Breathe in. As you breathe out, squeeze and lift the pelvic floor. Hold, breathing normally. Let go fully, and rest for as long as you held. Start with what you can hold well, even 3 seconds, and build to 10. The NHS leaflet that teaches a lying-down evening routine starts at 5-second holds and builds to 10, ten times. NICE recommends at least 8 contractions, 3 times a day.
If the squeeze fades halfway through the hold, stop there; that's your hold time for now.
3. Quick squeezes (1 minute)
Squeeze and lift as strongly as you can, fast, then let go straight away. Do 10, about one a second, with a full let-go between each. These train the fast response that stops a leak when you sneeze, and the quick squeezes that calm a sudden urge.
4. Cough with a squeeze (2 minutes)
Squeeze and lift, then cough while you hold the squeeze. Let go. Rest. Do 3 to 5. This is the Knack: tightening just before pressure arrives. Lying down is the safest place to learn it before you try it standing. The NHS lying routine includes 3 coughs with the floor held closed.
5. Bridge with a squeeze (1 minute)
Breathe out, squeeze the pelvic floor, then lift your bottom off the bed a few inches. Hold for 3 breaths, keeping the squeeze. Lower slowly, then let the floor go. Do 5 to 8. This adds your bottom and back muscles, and starts linking the squeeze to movement. Skip it if it hurts your back or hips.
Finish with two slow belly breaths with the floor fully relaxed.
Four lying positions, and who each suits
| Position | How | Good for |
|---|---|---|
| On your back, knees bent | Feet flat, knees hip-width, pillow under head | Most women; the standard start |
| On your back, hips raised | A firm pillow or folded towel under your bottom | Prolapse heaviness; a very weak floor that tires fast |
| On your side | Knees bent, a pillow between them | Back pain, hip pain, later pregnancy, lying in bed at night |
| On your front | A pillow under your hips, forehead on hands | Some women feel the back passage squeeze better; skip if it strains your neck |
Pregnant women past about 16 weeks are usually advised not to lie flat on their back for long; side-lying or propped up on pillows is the alternative. Everyone else can pick whatever lets them feel the squeeze best, and change positions within a session.
How many, and how often
- Per session: 8 to 10 slow holds and 10 quick squeezes.
- Per day: 3 sessions while you're building strength, as NICE recommends; the NHS lying routine is part of a three-times-a-day plan (standing in the morning, sitting at lunch, lying in the evening).
- For how long: at least 3 months daily, then a few times a week, or twice a day, to keep the strength.
If three a day is too much at first, one good session lying down is better than three rushed ones. Our guide to how many Kegels a day has a 12-week build.
A six-week plan from lying to standing
| Week | Lying (in bed) | Sitting and standing |
|---|---|---|
| 1 | Every session: breathing, 5 holds of 3 to 5 seconds, 5 quick | None yet |
| 2 | 8 holds of 5 seconds, 10 quick, 3 coughs with a squeeze | One session a day sitting, if you can feel the squeeze |
| 3 | Holds of 6 to 8 seconds; add the bridge | Morning in bed, lunch sitting, evening in bed |
| 4 | 10 holds of 8 to 10 seconds | Add one standing session; squeeze before standing up from a chair |
| 5 | Evening session in bed | Morning standing, lunch sitting. Knack before every sneeze and lift |
| 6 | Keep one lying session a day, or on tired days | Squeeze while walking a few steps, on the stairs, lifting a bag |
When to move up: once you can do 10 slow holds of 10 seconds and 10 quick squeezes lying down, each one as strong as the first, try the same sitting. Aim for the same squeeze and lift you had lying down. If it's much weaker sitting, go back to lying for another week.
For the whole routine across the day, see our pelvic floor exercise routine for women. To see in one minute why so many women find Kegels alone don't help with leaks, and what a 10-minute daily plan looks like, take the free 1-minute check.
When to keep doing them lying down
- Prolapse: lying, with your hips raised on a pillow, often feels best at the end of a day. Keep doing that alongside standing work.
- After pelvic surgery or birth: lying down is usually where you restart, once your doctor or midwife says it's fine. Patient leaflets after hysterectomy and repair surgery start women gently, lying.
- Bad knees, hips or back: lying or side-lying avoids the strain. See pelvic floor exercises for women over 50 for more positions.
- Tired days: a short session in bed keeps the habit going.
- A tight floor: relaxation work is easiest lying down. If your floor is tight, the let-go matters more than the squeeze; see how to relax your pelvic floor.
Can you do Kegels lying in bed at night?
Yes. Many women find it the easiest time to remember. Do the session before you settle to sleep. A few things help:
- Do it before you get too sleepy, or the squeezes get sloppy.
- If you wake at night needing to pee, a few quick squeezes and slow breaths before you get up can help you get to the toilet calmly. See our guide to a sudden urge to pee.
- In the morning, a short session before you get up, then squeeze as you sit up and stand. That first stand is a common moment for leaks.
Common mistakes lying down
- Pushing your bottom into the bed. That's your buttocks working. Keep them soft.
- Lifting your bottom off the bed during a hold. That's the bridge, not a Kegel. Save it for exercise 5.
- Holding your breath. Count out loud during long holds to keep breathing.
- Squeezing your thighs together. Let the knees fall apart a little.
- Not letting go between squeezes. Each squeeze ends with a full release.
- Only ever lying down. Move up to sitting and standing over the weeks.
- Practising while you pee. Stopping your stream is a test you can try once to find the muscles, not an exercise; the NIDDK advises against it as a habit.
To check your technique more closely, see how to know if you're doing Kegels correctly.
When to see a doctor or pelvic floor physical therapist
- You can't feel any squeeze after 2 to 3 weeks of trying.
- The exercises cause pain, or make symptoms worse.
- A bulge or heaviness in the vagina.
- Blood in your urine, burning, or trouble emptying your bladder.
- No change after 3 months of daily exercises.
NICE recommends supervised pelvic floor training: a physiotherapist or continence nurse can check your squeeze by internal exam and set the right holds for you.
Frequently asked questions
Are pelvic floor exercises better lying down or standing?
Lying is easier and better for learning. Standing is harder and closer to when leaks happen. Start lying and build towards standing over weeks.
Can I do Kegels lying flat with straight legs?
Yes, but most women find it easier with knees bent, because the back and hips relax more. Try both.
How long should a session lying down take?
About 5 to 10 minutes. The routine above fits in 10.
Is it OK to do pelvic floor exercises in bed every day?
Yes. Daily is the goal while you build strength. Just add sitting and standing sessions over time.
Can I do them lying down after a hysterectomy?
Usually yes, once your surgeon says it's fine; gentle lying-down squeezes are often where recovery starts. Follow the advice you were given after surgery.
Why can I feel the squeeze lying down but not standing?
Because standing adds gravity and the weight of your organs. That's normal early on. Keep building lying down, then try sitting before standing.
Your first session tonight
Tonight in bed: knees bent, hand on belly, 10 slow breaths, then 5 slow holds and 5 quick squeezes. That's the start. For a free one-minute look at why Kegels alone often don't stop leaks, take the 1-minute check. For more on routines, leaks and urges after 40, see all our pelvic floor guides.
Sources: United Lincolnshire Hospitals NHS Trust, A guide to pelvic floor exercises (patient leaflet). NICE guideline NG123, Urinary incontinence and pelvic organ prolapse in women: management, 2019. NHS, Pelvic floor exercises. NIDDK, Kegel exercises. Pelvic, Obstetric and Gynaecological Physiotherapy (POGP), Pelvic organ prolapse: guidance for women (leaflet). Mayo Clinic, Kegel exercises: a how-to guide for women. This guide is education, not medical advice.