Why Kegels Aren’t Enough to Fix Your Pelvic Floor
Kegels can help some pelvic floor issues, but they are not a universal solution and can sometimes make symptoms worse.
Introduction
Have you ever been told to “just do kegels” when you started experiencing urinary leakage after giving birth? Or when you began having pain during intercourse? Some women are even told to do kegels simply to “tighten” their pelvic floor muscles. These are some of the most common things I hear from patients during their first pelvic floor physical therapy visit.
While kegels are one of the most commonly recommended exercises for pelvic floor issues, they are far from the only treatment. In fact, more than half of the patients I see in the clinic do not actually need to perform kegels to address their symptoms.
The reason is simple: pelvic floor problems are not always caused by weakness from an inability to contract.
What Kegels Actually Do
Kegels were originally recommended to help strengthen the pelvic floor muscles, particularly for stress incontinence - leaking that happens when you cough, sneeze, laugh, or exercise. A kegel is simply a contraction of the pelvic floor muscles. When you perform one, the muscles lift and tighten around the bladder, vagina, and rectum.
This contraction helps:
Close the openings that prevent urine and stool from leaking
Support the pelvic organs
Manage pressure when activities like coughing, lifting, or jumping increase abdominal pressure
Because of this, kegels became widely recommended for pelvic floor issues. However, the pelvic floor does not just need to tighten. It also needs to relax, lengthen, and coordinate with the rest of our deep core muscles.
When Kegels Help - And When They Don’t
Kegels can be helpful for some people, but they are not a one-size-fits-all solution. For individuals whose pelvic floor muscles are weak, strengthening exercises like kegels can improve support and help reduce symptoms such as leaking. However, weakness is not always the problem.
For many people, the pelvic floor is actually overactive, tight, or poorly coordinated. In these cases, the muscles struggle to fully relax when they need to.
When this happens, people may experience symptoms such as:
Difficulties emptying the bladder
Urinary urgency
Urinary frequency
Constipation
Pelvic pain
Pain with intercourse
Think of it this way: imagine trying to squeeze a muscle that is already tightly squeezed. There is not much left to contract.
In these cases, doing more kegels will not solve the problem. It will oftimes make symptoms worse.
The Bigger Picture of Pelvic Floor Health
The pelvic floor functions like any other muscle group in the body. It needs strength, but it also needs flexibility and coordination. Kegels train one piece of that puzzle but a healthy pelvic floor involves much more than simply tightening the muscles. It requires the pelvic floor to work together with our deep core system during breathing and movement in our daily activities.
Understanding this bigger picture is often the key to truly addressing pelvic floor symptoms - and helping people move, exercise, and live more comfortably.
DISCLAIMER
This article is intended for educational purposes only and should not be considered medical advice. Pelvic floor symptoms can have many different causes, and treatment recommendations vary from person to person. If you are experiencing pelvic pain, urinary or bowel symptoms, pain with intercourse, or other pelvic floor concerns, consult a qualified healthcare provider or pelvic floor physical therapist for an individualized evaluation and treatment plan.
