Kegel exercises lying down, sitting or standing: which position?

Is there one best position?

There is no single position everyone needs to master first. Royal Devon's exercise leaflet describes lying, sitting and standing options, noting that some people find lying down easier initially. Use that as a choice, not a compulsory ladder.

Think about the obstacle you are trying to solve. Is the movement hard to feel, is sitting uncomfortable, or is getting onto the floor impractical? Tell your physiotherapist which one applies. The most useful starting position is one you can access comfortably and describe clearly at your next review.

Lying down: reduce distractions

Gloucestershire Hospitals includes side-lying and lying on the back with bent knees among its options. Side-lying may make the sense of lift easier to notice. Choose support that lets you settle rather than balancing or gripping.

Set your timer or written instructions where you can see them before you begin. There is no need to crane your neck toward a phone throughout the session. Note which side or arrangement felt comfortable so you can reproduce it without experimenting each time.

If you are pregnant, avoid exercise lying flat on your back for prolonged periods after 16 weeks, and follow your maternity team's advice. The NHS Healthier Together pregnancy exercise guide explains this precaution. Sitting or side-lying may be more suitable choices.

Sitting: make the setup repeatable

The Gloucestershire guidance also describes sitting with the knees apart. Pick a stable chair and a position where you do not need to clamp your legs together. Keep the exercise separate from passing urine; a desk or comfortable chair is a simpler practice setting.

For a useful note, write “supported dining chair, feet on floor” instead of just “sitting.” If you compare practice on a soft sofa with practice on a firm chair, record that difference. This is not about finding a perfect furniture specification. It is about giving yourself and your clinician a clear description of what you tried.

Standing: a change to discuss, not a test to pass

Standing with the feet apart is another position in the Gloucestershire leaflet. The Royal National Orthopaedic Hospital also includes several positions because the pelvic floor works during everyday activities.

If your clinician recommends standing practice, ask whether the hold time and repetitions should stay the same. Do not automatically combine a new position with longer holds and extra sets. Keep a chair or support nearby if balance is an issue, and avoid practicing while driving or doing a task that needs your full attention.

A simple way to compare positions

Use these questions after the practice already included in your plan; they are not a reason to add three extra sessions:

• Which position did I use?
• Could I identify the beginning and end of the contraction?
• Did I keep breathing without concentrating on it constantly?
• Was anything uncomfortable or unclear?

For example: “The lift was clearer on my side; in standing I squeezed my thighs.” That is more useful at a review than “standing did not work.” It gives your clinician something specific to check.

Pain, a bulging sensation or being unable to feel the muscles are reasons to seek assessment, as the RNOH leaflet advises. Read what happens at pelvic floor physiotherapy if you are unsure what booking an appointment involves.

Common questions

Sources & further reading

The guidance above draws on these public health and clinical resources, consulted October 24, 2026. Sources support general education; they have not reviewed or endorsed Pelvic Gym.

1. Royal Devon: Pelvic floor muscle exercises for women
2. Gloucestershire Hospitals: Pelvic floor exercises for women
3. Royal National Orthopaedic Hospital: Pelvic floor exercise leaflet
4. NHS Healthier Together: Exercise in pregnancy