Reverse kegels: how to do them

At a glance

Reverse kegels are a pelvic floor relaxation technique — the opposite of the squeezing and lifting that standard kegels involve. They are designed to help people who have a hypertonic (overly tight) pelvic floor learn to consciously relax those muscles.

For people with conditions like levator ani syndrome, chronic rectal pain, or difficulty relaxing the sphincter during bowel movements, reverse kegels can be an important part of management. This guide covers the technique, common mistakes, and how to build the practice.

Why relaxation, not strengthening

Most people have heard of kegels — the pelvic floor strengthening exercises commonly recommended for incontinence or after childbirth. These work by tightening and lifting the pelvic floor muscles.

But for some people, the pelvic floor is already too tight. The muscles are in a state of chronic tension, and this tension causes:

• Rectal pain — a dull ache or pressure that can be constant or episodic
• Painful bowel movements — the muscles do not relax properly to allow stool to pass
• Sphincter spasm — the internal sphincter clenches rather than opening
• Referred pain — to the tailbone, lower back, hips, or thighs

For these people, standard kegels can make things worse by further tightening already tight muscles. Reverse kegels — learning to release and lengthen — are what is needed.

How to do a reverse kegel

Finding the right muscles

Before you can relax the pelvic floor, you need to identify it. Try this:

1. Identify the muscles — imagine you are beginning to pass gas, or beginning to urinate. The sensation of gently opening and releasing in the pelvic area — that is the pelvic floor relaxing.
2. Alternatively — do a standard kegel (squeeze and lift), then consciously let go. The letting-go part is the beginning of a reverse kegel. A reverse kegel takes this further — actively encouraging the release rather than just stopping the squeeze.

The technique

1. Find a comfortable position — lying on your back with knees bent is often easiest to start. Side-lying or sitting can also work.
2. Breathe in deeply — let your belly expand fully. Diaphragmatic (belly) breathing naturally encourages the pelvic floor to descend and relax.
3. As you breathe out, gently release the pelvic floor — imagine the muscles lengthening, softening, opening. Not pushing — releasing.
4. Hold the relaxed state for a few seconds while continuing to breathe normally.
5. Release and return to neutral — do not squeeze back up. Just let the muscles return to their resting state.

Key points

• Gentle — this is a subtle movement, not a forceful push
• Breathing is essential — the diaphragm and pelvic floor move together; deep belly breathing facilitates relaxation
• No straining — if you feel like you are bearing down on the toilet, you are pushing too hard
• Patience — the sensation is much subtler than a standard kegel, and it takes practice to feel confident you are doing it correctly

Common mistakes

• Pushing down too hard — the most common error. A reverse kegel is a release, not a push. Think “letting go” rather than “forcing open.”
• Holding the breath — breath-holding creates tension. The exercise works with the breath, not against it.
• Doing standard kegels instead — some people accidentally squeeze when they mean to release. It takes practice to isolate the release.
• Expecting immediate results — pelvic floor retraining takes weeks. The muscles are learning a new pattern.
• Only practising during pain — the best results come from regular daily practice, not just using the technique when symptoms flare.

Building a practice

Starting out

• Two to three times daily for five minutes each session
• Start lying down — gravity is neutral in this position, making it easier to feel the release
• Pair with breathing exercises — diaphragmatic breathing and reverse kegels complement each other naturally
• Set a cue — practise at the same time each day (morning, lunchtime, evening) to build the habit

Progressing

As you become more confident:

• Practise in different positions — sitting, standing, walking
• Use the technique before bowel movements — a few minutes of reverse kegels and deep breathing before sitting on the toilet can help the sphincter relax
• Apply during pain episodes — when levator ani spasm or rectal tension occurs, consciously reverse kegel and breathe through it
• Combine with other relaxation — warm baths, gentle stretching, progressive muscle relaxation

Long term

Reverse kegels often become a maintenance practice rather than something you stop. People with chronic pelvic floor tension describe:

• Checking in with pelvic floor tension throughout the day
• Using reverse kegels proactively when they notice tension building
• Integrating the technique into their response to stress (stress often increases pelvic floor tension)

Working with a physiotherapist

While this guide covers the basics, working with a pelvic floor physiotherapist — at least for a few sessions — is strongly recommended. A physiotherapist can:

• Confirm your technique — ensuring you are relaxing rather than pushing or squeezing
• Assess your pelvic floor — determining whether tension, weakness, or a combination is present
• Provide biofeedback — using sensors to show you in real time whether you are relaxing the muscles
• Tailor the programme — based on your specific condition and symptoms
• Monitor progress — adjusting the approach as your muscles respond

Many people describe the first physiotherapy session as the moment the technique finally clicked.