Should I Be Doing Kegels? Not Necessarily.

I thought everyone was supposed to be doing Kegels ... is that still true?

Have you heard that doing Kegels will solve your pelvic floor symptoms?

What if we told you that Kegels could actually be making your symptoms worse?

Pelvic floor dysfunction isn’t always caused by weakness. In many cases, symptoms are the result of increased pelvic floor muscle tension. When the pelvic floor muscles are already tight, performing Kegels can worsen that tension—and ultimately intensify symptoms.

Tight Does Not Mean Strong

Your pelvic floor muscles are like any other muscles in your body. When a muscle is tight, it is shortened and unable to function at its optimal capacity. For proper function, the pelvic floor must be able to both contract and fully relax.

Pelvic floor tightness can develop for many reasons, including but not limited to:

• Chronic stress or high anxiety

• Postpartum changes

• High-intensity training without adequate rest

• Congenital or structural factors

• Chronic pain conditions

  
  

Tightness may affect one specific pelvic floor muscle, multiple muscles, or present as trigger points—small, painful “knots” within the pelvic floor musculature.

Symptoms of Pelvic Floor Tension

Pelvic floor tension can contribute to a wide range of symptoms, including:

• Incomplete bladder emptying

• Frequent urination

• Recurrent UTIs or UTI-like symptoms with negative testing

• Constipation

• Difficulty fully emptying the bowels

• Pelvic, low back, or hip pain

• Painful intercourse

• Pain during gynecological exams

• Pain with tampon insertion

Relaxed Does Not Mean Weak

Effective pelvic floor training involves more than strengthening alone. True pelvic floor health requires balance—the ability to lengthen, relax, and then contract effectively.

Before strengthening exercises like Kegels are introduced, it’s often necessary to first address muscle tension. A muscle must be able to reach its fully lengthened position before it can truly become stronger.

Additionally, the pelvic floor does not work in isolation. It functions in coordination with the diaphragm, core muscles, glutes, and other stabilizing muscles. For this reason, comprehensive treatment focuses on coordination and movement patterns, not just isolated contractions. Training the pelvic floor as part of the whole system leads to better, longer-lasting symptom relief.

How We Treat Pelvic Floor Tightness

Your pelvic floor therapy plan may include:

• Diaphragmatic breathing techniques

• Pelvic floor lengthening stretches and relaxation strategies

• Bladder retraining or bladder scheduling

• External manual therapy to the pelvic floor and surrounding muscles

• A personalized maintenance program to support long-term success

  
  

Internal pelvic floor treatment may be recommended in some cases, but it is never required to participate in pelvic floor therapy.

Ready to Take the Next Step?

If you think pelvic floor tightness may be contributing to your symptoms, we’re here to help. Reach out today to schedule an appointment with our pelvic floor therapist and start your path toward relief and improved function.