Kegel Exercises and the Underactive Pelvic Floor
Presented by Heather Rader
This course addresses the clinical challenges of identifying and treating pelvic floor muscle underactivity, a condition frequently linked to urinary and bowel dysfunction. While many healthcare providers recognize the term “Kegel,” there remains a significant gap in the ability to properly instruct patients on correct contraction techniques and functional exercise progressions. To bridge this gap, the curriculum focuses on the historical use of pelvic floor exercises from antiquity to modern-day rehabilitation science, the primary functions of the pelvic floor muscles, and the specific clinical indications for strengthening interventions. Participants will learn to guide patients through various levels of pelvic floor muscle training, from isolated power and endurance contractions to integrated lumbopelvic–hip movements. This training is specifically designed for a multidisciplinary audience—including physical therapists, occupational therapists, and nurses—practicing in settings such as outpatient clinics, hospitals, and home health.
Learning Outcomes
- Recall the history of Kegel exercises and their evolution into present-day rehabilitation standards
- Identify proprioceptive and kinesthetic visual, verbal, and tactile cues to assist pelvic floor muscle awareness instruction
- Differentiate exercise approaches for an underactive pelvic floor, including facilitation, isolation, and functional integration, to improve muscle activation during toileting
Meet your instructor
Heather Rader
Dr. Heather Rader is the owner of Rader Pelvic Physical Therapy, a practice devoted to the treatment of pregnancy-related pain and dysfunction, incontinence, pelvic organ prolapse, and complex pelvic pain in all genders. A physical therapist since 1994, she graduated from the University of Miami with a master’s degree in…
Chapters & learning objectives
1. The History of Kegel Exercises
Pelvic floor muscle exercises have roots in early medical practices for continence and have become a central component of modern rehabilitation. This progression was formalized by the mid-20th-century work of Dr. Arnold Kegel, whose research established pelvic floor muscle training as an effective nonsurgical treatment for incontinence and clarified key functional roles of the pelvic floor. Today, his contributions underpin evidence-based pelvic health rehabilitation across bladder, bowel, and pelvic dysfunctions. Understanding these foundational roles is essential for clinicians to recognize how muscle underactivity contributes to common clinical symptoms.
2. Finding the Pelvic Floor: Anatomy and Awareness Cues
Learners will examine the basic anatomy of the pelvic floor muscles to establish a foundation for teaching proprioceptive (location-sense) cues used in neuromuscular reeducation interventions. Kinesthetic cues to enhance movement awareness will also be introduced. Appropriate training and precise verbal cues to elicit an effective “lift and squeeze” contraction are essential for identifying signs of muscle underactivity and ensuring proper technique. These elements represent critical first steps toward developing an effective rehabilitation plan.
3. Exercise Approaches for the Underactive Pelvic Floor
This chapter outlines the implementation of three progressive exercise strategies to address underactive pelvic floor muscles, emphasizing both power and endurance training to improve muscle performance. These strategies progress from facilitation-assisted activation to isolated strengthening and finally to functional integration, ensuring that pelvic floor contractions are effectively incorporated into lumbopelvic–hip movements used in daily activities through overflow principles, progressive resistance, cocontractions, core stabilization, and functional precontractions (the Knack).
More courses in this series
Bladder and Bowel Function: What’s Normal?
Heather Rader
Overactive Bladder and Incontinence: Patient Education Strategies
Heather Rader
Constipation and Fecal Incontinence: Patient Education Strategies
Heather Rader
Kegel Exercises and the Underactive Pelvic Floor
Heather Rader
Pelvic Pain and the Overactive Pelvic Floor
Heather Rader
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