Digestive Health Tightening Your Anal Sphincter Muscle Learning to strengthen your pelvic floor muscles can help incontinence By Julie Wilkinson, BSN, RN Updated on June 15, 2023 Medically reviewed by Jenny Sweigard, MD Print Table of Contents View All Table of Contents Anatomy Causes of Incontinence Before Exercising How to Exercise Results When It's Not Enough Exercises to strengthen and tighten your anal sphincter may help treat bowel incontinence (fecal incontinence) or reduce your chance of leaking stool or gas in the future. Your anal sphincter is made up of thick bands of muscle. They surround the entrance of your anus and can open and close. The anal sphincter keeps stool inside your body until you are ready to have a bowel movement. These muscles can be strengthened through exercise. Kelvin Murray / Getty Images Bowel control problems are surprisingly common. They affect 36% of adults in the United States (and it's thought that this number may be even higher). Unfortunately, many people don't realize that simple exercises may improve bowel control and quality of life in general. This article discusses the anal sphincter, the causes of fecal incontinence, and what you can do to strengthen the anal sphincter. It will also talk about how a healthcare provider might help you. Fecal Incontinence Anal Sphincter Anatomy Knowing the muscles that control your anal sphincter and how they work makes it easier to understand the strengthening exercises you can use to tighten the anus muscles. The anus has two rings of muscles—the internal anal sphincter and the external anal sphincter. Female Anal Sphincter Internal Anal Sphincter The internal anal sphincter is an inner ring of muscle and is an involuntary muscle, which means you cannot consciously control it. Similar to your beating heart and your diaphragm, this muscle does its job every second of the day without you having to think about its function. The internal sphincter is programmed to stay shut. This is why most adults do not leak stool while they sleep. External Anal Sphincter The outer ring of muscle around the anus is the external sphincter—a voluntary muscle you can control and close more firmly. This muscle can be exercised and strengthened to help you keep control of bowel movements. Pelvic Floor Muscles The organs in your lower pelvis, such as your bladder and colon, are supported by a large group of muscles called the pelvic floor muscles. Working with your anal sphincter, the pelvic floor muscles help you stop gas and stool leaks. These are the muscles that you squeeze tightly when you feel diarrhea coming on and there's no nearby restroom. Likewise, these muscles also help you control urine flow and flatulence (gas). A Word From Verywell Pelvic floor dysfunction can also occur with sexual trauma or PTSD from trauma. You may tighten or tense up these muscles as a result of memory of the trauma. Excessive tensing of these muscles can cause hypertrophy, constipation, and worsen pelvic floor dysfunction. — KUMKUM PATEL, MD, MEDICAL EXPERT BOARD Causes of Incontinence As we age, bladder incontinence and fecal incontinence can occur due to loss of muscle tone in the pelvic floor. Weakness may occur in younger people as well. It might begin as having less control than usual over passing gas. Or maybe you leak a little urine or stool when you sneeze or quickly stand up. But it can progress to the inability to control your bladder or bowels completely. Factors leading to fecal incontinence include: Vaginal childbirth Chronic constipation and straining to have bowel movements Chronic urinary tract infections Inflammatory bowel diseases such as Crohn's disease or ulcerative colitis Neurological issues (such as a spinal cord injury) Nerve damage Rectocele (a weakening of the wall between the vagina and rectum) Physical inactivity Before Doing Anal Sphincter Exercises If you are struggling with leakage of gas or stool, it's important to first talk to your healthcare provider. A new health issue like this should always be evaluated. Along with a physical exam and asking about symptoms, your healthcare provider may order tests such as an electromyography (EMG) or an ultrasound. See Your Healthcare Provider First There are many treatable conditions that can lead to fecal incontinence. In those instances, simply tightening the pelvic floor muscles with exercise would not be effective. It could even interfere with you getting the right treatment for an underlying medical condition. How to Exercise Your Anus Muscle If you do not have a disease or functional problem that is causing your fecal incontinence, you can work to tighten the anal sphincter and pelvic floor muscles in the privacy of your own home. It will take just a few minutes of exercise each day. The Kegel exercises—consciously tightening your pelvic floor muscles—has been around for decades and is very simple to do. If you've ever stopped your urine flow midstream or consciously held in gas, then you have already done a Kegel. Women may have had Kegel exercises recommended after childbirth. The key to Kegel exercises is knowing which muscles to contract—it's the same muscle group you use to stop your urine flow. One way to know which muscles are involved is to start and stop your urine stream to feel which muscles contract. Men might feel the muscles differently than women—most men report feeling tightness around the anus whereas many women feel the pull closer to the vagina. How to Do Kegel Exercises You can practice your Kegels standing or lying down. But if you're a beginner, it may be helpful to try the exercise while seated in a firm chair: Relax your abdomen and buttocks since you don't want to exercise those muscle groups.Spread your legs slightly apart.Consciously squeeze your anus and pelvic floor muscles—as if you were trying to stop urinating midstream.Hold for three seconds.Release gently.Repeat as many times as you are able, up to 10-15 times. It might help to think of these muscles as an elevator. As you contract (squeeze) them, the elevator slowly rises to the top. As you gently release the tension on your muscles, imagine the elevator returning to ground level. Gradually work up to doing these exercises three times per day. No one has to know that you're exercising your pelvic floor. You can do Kegels sitting at your desk or waiting in your car at a stoplight. Muscle Strengthening Takes Time If you're doing the exercise correctly, you should actually feel the pelvic floor muscles lifting. It may be difficult to contract these muscles for 10-15 repetitions, but as your muscle tone improves, it will become easier. If you repeat the exercise a few times daily, you should see an improvement in just a few months. When you're trying to strengthen any muscles, it's important to be patient. If you've ever tried to get in shape more quickly by lifting too much weight or running too many miles, you know that trying to hurry the process can backfire. Don't overdo it. In this case, more is not better. You can actually fatigue these muscles and cause a little bit of temporary incontinence. When Strengthening Isn't Enough When the weakness of the pelvic floor muscles isn't due to an irreversible injury (such as complete spinal cord injuries), many people improve with these exercises and for some, the problem goes away completely. Other people may find that their symptoms don't go away. When this is the case, there are other options to treat fecal incontinence. Physical Therapy If you aren't noticing improvement in anal sphincter strength, it's important to make sure you are doing the exercises correctly. Your healthcare provider may refer you to a physical therapist to assist you. It's important to find a therapist who has experience working with people who have pelvic floor muscle dysfunction. A 2018 study found that people who received supervised pelvic floor muscle training (that is, they worked with a physical therapist) were five times more likely to report improvements in fecal incontinence than those who did the exercises on their own. Biofeedback or Electrical Stimulation Biofeedback is a technique that is used to help you learn to control body functions. During this treatment, you are connected to electrical sensors. The sensors give the healthcare provider information about your body so they can coach you during the exercises. A 2015 study found that using a combination of pelvic floor physical therapy and biofeedback worked better than pelvic floor muscle exercises alone. In addition, adding electrical stimulation (sacral nerve stimulation) to these two therapies improved results even more. Summary The anal sphincter is a band of muscles that surrounds the entrance of your anus. It's in charge of holding the stool inside your body until you are ready to have a bowel movement. Bowel incontinence, also known as fecal incontinence, is a common problem. It occurs when you leak stool or gas. Your healthcare provider can help identify what is causing the incontinence. They may suggest strengthening your anal sphincter by performing Kegel exercises or trying other therapies, such as biofeedback or electrical stimulation to treat fecal incontinence. 7 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. MedlinePlus. Pelvic floor muscle training exercises. Whitehead WE, Palsson OS, Simren M. Treating fecal incontinence: an unmet need in primary care medicine. N C Med J. 2016;77(3):211-5. doi:10.18043/ncm.77.3.211 Michigan Medicine. Accidental bowel leakage (fecal incontinence). National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms & causes of fecal incontinence. National Institute of Diabetes and Digestive and Kidney Diseases. Kegel exercises. Ussing A, Dahn I, Due U, et al. Efficacy of supervised pelvic floor muscle training and biofeedback vs attention-control treatment in adults with fecal incontinence. Clinical Gastroenterology and Hepatology. 2019;17(11):2253–2261. doi:10.1016/j.cgh.2018.12.015 Arnouk A, De E, Rehfuss A, Cappadocia C, Dickson S, Lian F. Physical, complementary, and alternative medicine in the treatment of pelvic floor disorders. Curr Urol Rep. 2017;18(6):47. doi:10.1007/s11934-017-0694-7 Additional Reading Cleveland Clinic. Pelvic floor dysfunction. National Institute of Diabetes and Digestive and Kidney Diseases. Kegel exercises. By Julie Wilkinson, BSN, RN Julie Wilkinson is a registered nurse and book author who has worked in both palliative care and critical care. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit