Short answer
Begin a Kegel by gently closing around the passages for gas and urine, then let that closing action draw a small distance inward or upward. Think “close, then lift away from the toilet,” not “push harder.” Keep breathing, let the buttocks and thighs stay relatively quiet, and finish by releasing the effort rather than bearing down.
The movement is internal and subtle. You do not need to feel a large rise, and a strong pressure sensation is not proof of success. If every attempt creates bulging, downward pressure, pain, or pelvic heaviness, stop practising and seek qualified feedback.
Why direction matters
The familiar word “squeeze” can be misunderstood. It may prompt someone to clamp the buttocks, brace the abdomen, or push as though emptying the bowel. In pelvic-floor exercise, the intended squeeze is local: a closing around the pelvic openings paired with an inward lift.
Bø and colleagues describe those two components as central to a correct voluntary contraction. The distinction matters because some people bear down when first asked to contract an internal muscle. More force does not correct the direction; it can make the wrong pattern more obvious.
This guide teaches a movement cue. It cannot confirm muscle force, diagnose pelvic-floor dysfunction, or establish that strengthening is appropriate for you.
Understand the two parts of the action
Part 1: close around the openings
Imagine gently preventing gas from passing. Add the sense of closing the urinary opening without actually urinating or interrupting the urine stream. Depending on anatomy, you may also notice a slight narrowing around the vagina, a drawing-in near the anus, or a subtle change at the base of the penis.
This is not a hard buttock clench. The focus is around the passages themselves. If the only clear movement is the gluteal muscles pressing together, reset and use less effort.
Part 2: continue inward
Let the closing action continue slightly into the pelvis. Words such as “lift” or “draw inward” describe direction, not distance. Pelvic-floor movement may be small, and not everyone has a clear upward sensation.
An inward intention is more useful than chasing a dramatic movement. If you try to pull so hard that you hold your breath, tuck the pelvis, or lift your body from the chair, the larger action can obscure what the pelvic floor is doing.
A step-by-step learning attempt
1. Settle into a supported position
Lie with your knees comfortably supported or sit with your feet resting and legs slightly apart. Let the surface carry your weight. Soften your jaw, shoulders, abdomen, buttocks, and inner thighs. Take two or three ordinary breaths.
Do not begin during urination. Although urine-flow interruption is sometimes presented as a recognition method, NIDDK advises against regularly exercising while urinating because it can interfere with complete bladder emptying.
2. Start with a light closing cue
Think of quietly preventing gas from escaping while closing the urinary passage. Use a light effort, as if you were practising accuracy rather than testing maximum strength. Avoid squeezing the legs together.
If that cue creates a downward push, stop immediately. Return to normal breathing and let the abdomen settle before another attempt.
3. Add the inward-lift intention
Once the closing sensation is present, imagine it moving away from the surface beneath you. In sitting, you might think of the pelvic openings becoming slightly narrower and lighter on the seat. The body should not rise from the chair.
Do not force a visible lift. A correct movement can be subtle, and scars, childbirth, surgery, pain, reduced sensation, or unfamiliarity may change what you perceive.
4. Keep the pressure direction quiet
Let an ordinary breath continue. Notice whether the abdomen is pushing outward forcefully, the ribs are locked, or the pelvis is pressing down. Reduce the contraction if you need a breath-hold or a large brace to maintain it.
Some natural coordination between the pelvic floor and nearby muscles can occur. The goal is not laboratory isolation; it is to stop a downward pressure strategy from replacing the intended local action.
5. End and release
Stop adding tension. Allow the closing and inward sensation to fade while you keep breathing. Do not push downward to “undo” the lift. Wait until you feel comfortable and can distinguish rest from the active phase before considering another attempt.
How bearing down may feel
Bearing down is an active increase in pressure toward the pelvic openings. People may describe:
- a bulge or widening at the anus or vaginal opening;
- pressure toward the toilet or seat;
- a bowel-emptying or pushing sensation;
- the abdomen bracing while the pelvic area moves downward;
- increased heaviness or the feeling that something is descending.
These sensations are not a home diagnosis. They are directional warning signs. A person may also have pressure or heaviness for reasons unrelated to one exercise attempt, so persistent symptoms deserve assessment rather than repeated self-testing.
What to do if you keep pushing down
Reduce the effort
Try to make the action smaller. A gentle, well-directed attempt is more useful for learning than a maximal strain. If less effort removes the downward pressure but leaves the movement uncertain, stop after a few tries and seek feedback rather than escalating again.
Change the setup
Use a position with more support. Let the legs remain comfortably apart and avoid pressing through the feet. Some people can notice direction more easily lying down; others prefer supported sitting. A position is useful only if it improves control and comfort.
Separate the cue from bowel emptying
“Hold in gas” is a location cue, not an instruction to imitate straining. Focus on closing first. If the word “lift” makes you inhale sharply or arch the back, return to the simpler closing cue and keep breathing.
Ask for external feedback
Pelvic-health clinicians may use observation, palpation, ultrasound, pressure measurement, or biofeedback when appropriate. The ICS assessment terminology distinguishes voluntary contraction, relaxation, coordination, and other qualities because one sensation cannot verify them all.
Common misconceptions
- “A Kegel should push upward with the abdomen.” A large abdominal effort does not prove an inward pelvic-floor lift.
- “If I feel pressure, the muscles must be strong.” Pressure can come from breath-holding or bearing down as well as muscle activity.
- “Lift means I should pull as high as possible.” It is a directional cue, not a required distance or maximum-effort target.
- “Relaxing afterward means pushing back down.” Release is the end of voluntary tension; bearing down is a different action.
- “If I cannot feel a lift, I should do more repetitions.” Repetition does not resolve uncertain direction. Feedback is more useful than volume.
What unaided observation cannot confirm
You may be able to notice whether an attempt feels inward or downward, but you cannot reliably grade strength, endurance, resting activity, or coordination from that sensation alone. Even visible inward movement does not show how much force is produced or whether the exercise matches your symptoms.
The standardized IUGA/ICS terminology report provides a common language for pelvic-floor exercise and training, while clinical assessment adds methods that a screen cannot reproduce. Treat the cue as a learning tool, not a pass certificate.
When to stop and seek help
Stop self-guided contractions if they cause pain, increasing pressure or heaviness, worsening urinary urgency, a lasting clenched feeling, or new difficulty passing urine or stool. Seek a pelvic-health physiotherapist or another qualified clinician if you repeatedly bear down, cannot tell which direction the movement takes, or have been given surgery- or treatment-specific restrictions.
Seek urgent medical care for sudden inability to urinate. New genital or saddle-area numbness with sudden bladder or bowel change, leg weakness, or severe worsening back and leg symptoms also needs urgent assessment.
What to do next
When the close-and-lift direction feels reasonably clear and comfortable, add the other quality checks in how to know whether you are doing Kegels correctly. If breathing is the part that changes first, work through how to breathe normally during Kegel exercises before adding repetitions.
Sources
- Bø K, Berghmans B, Mørkved S, Van Kampen M, editors. Evidence-Based Physical Therapy for the Pelvic Floor. 3rd edition. Elsevier; 2023. Chapters 5 and 6. Official publisher record.
- Bø K, Frawley HC, Haylen BT, et al. IUGA/ICS joint report on terminology for conservative and nonpharmacological management of female pelvic-floor dysfunction. International Urogynecology Journal. 2017;28(2):191–213. PubMed record.
- Frawley H, Shelly B, Morin M, et al. International Continence Society report on terminology for pelvic-floor muscle assessment. Neurourology and Urodynamics. 2021;40(5):1217–1260. Official ICS report.
- National Institute of Diabetes and Digestive and Kidney Diseases. “Kegel Exercises.” National Institutes of Health. Last reviewed November 2021. NIDDK guidance.