TThe Diary of a CEO
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Peak Performance

Progressive Pelvic Floor Practice

Learn a full squeeze-relax cycle before progressing from lying to standing

Difficulty
Moderate
Time to result
~weeks to results
Steps
6
Confidence
93%

Malik describes a Kegel as one strengthening exercise within broader pelvic-floor training. The basic rep is a deliberate contraction followed by an equally deliberate relaxation. For men, she offers three cues for locating the muscles: the sensation used to stop urine flow, lifting the penis without touching it, or holding in gas. The training progression starts lying down so other muscles contribute less, advances to sitting once control is reliable, and then to standing or daily activities. Her strongest warning is that repeated squeezing without relaxation can cause pain or dysfunction when the pelvic floor is already tense. Anyone with pain, urgency, emptying difficulty, or uncertainty about technique should seek assessment from a pelvic-floor physical therapist or clinician.

Origin

Extracted from The Diary of a CEO

Core principles

  • 01A Kegel is one pelvic-floor exercise, not the whole field
  • 02Relaxation is as important as contraction
  • 03The easiest position should be mastered before adding load
  • 04Too much strengthening can worsen an already tense pelvic floor
  • 05Symptoms should be assessed before assuming weakness

How to run it

  1. 1

    Screen for tension symptoms

    Before strengthening, notice pain with sex, erections, or ejaculation, urinary urgency, difficult emptying, or persistent pelvic discomfort.

    Pro tip These symptoms can have multiple causes, so use them as reasons for assessment rather than self-diagnosis.

    Watch out Strengthening an already tense pelvic floor may worsen pain or dysfunction.

  2. 2

    Find the contraction

    Use the sensation of stopping urine, lifting the penis without touching it, or holding in gas to identify the muscles.

    Pro tip Use these as identification cues, not as instructions to interrupt urination repeatedly.

  3. 3

    Pair squeeze with full relaxation

    Contract for about five seconds, then relax for about five seconds before starting another repetition.

    Pro tip Think of each rep like gym training: the recovery phase is part of the repetition.

    Watch out Do not perform continuous contractions without a relaxation phase.

  4. 4

    Start lying down

    Practice in a lying position so attention can stay on the pelvic floor instead of postural muscles.

    Pro tip Prioritize clean coordination over a high repetition count.

  5. 5

    Progress the position

    Move to sitting after lying-down control improves, then progress to standing and ordinary activities.

    Pro tip Advance only when contraction and full relaxation remain distinct.

  6. 6

    Get technique assessed

    Consult a pelvic-floor physical therapist or appropriately qualified clinician when symptoms persist or you cannot tell whether you are contracting and relaxing correctly.

    Pro tip Malik compares pelvic-floor therapists to personal trainers for these muscles.

In the wild

From lying down to daily movement

Malik recommends learning the squeeze-relax cycle while lying down, progressing to sitting only after control improves, and eventually practicing while standing or doing ordinary tasks.

The exercise gains complexity only after the person can contract and relax the intended muscles reliably.

Common mistakes

Squeezing without relaxing

Malik identifies inadequate relaxation as the common error and warns that excessive tension can cause pain and dysfunction.

Starting in the hardest position

Standing adds muscular demands before the person has learned to isolate and coordinate the pelvic floor.

Assuming every symptom means weakness

Pelvic floors can be weak, discoordinated, or too tight, and those states call for different care.

Is it for you?

Best for

People advised to strengthen a weak pelvic floor who can practice without pain and want a cautious starting progression.

Not ideal for

People with pain, urinary urgency, difficult bladder emptying, or a suspected high-tone pelvic floor until they have been assessed.

From the transcript

You're squeezing, contracting and relaxing.

Dr. Rena Malik · (1:30:30)

squeeze for 5 seconds, relax for 5 seconds.

Dr. Rena Malik · (1:31:30)

start lying down

Dr. Rena Malik · (1:31:30)

From the episode

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