Am I Doing Kegels Wrong?

If you've dealt with any pelvic floor symptom, you've probably been told the same thing: do some Kegels. If you leak when you sneeze, feel pressure after having a baby, deal with urgency or pain, it doesn't matter, the answer is always more Kegels.

Yes, pelvic floor strengthening absolutely helps in some situations and we need our pelvic floors to be strong, but kegels are not automatically the right answer for every pelvic floor issue. For a lot of women, doing more of them without understanding what their body actually needs can increase tension, worsen symptoms, or leave them more frustrated when nothing changes.

The Pelvic Floor Is About Coordination, Not Just Strength

The pelvic floor works together with your core, diaphragm, abs, hips, posture, and breathing to help manage pressure throughout your body. Like any muscle group, it needs strength and flexibility, the ability to contract when you need support, and just as importantly, the ability to fully relax and lengthen.

This is where the Kegels conversation gets oversimplified. A lot of women assume pelvic floor dysfunction always means weakness. However, I see plenty of women dealing with urgency, leaking, constipation, pelvic pain, or pain with intimacy whose pelvic floor is already overworking and struggling to relax. A muscle that stays clenched all day isn't functioning well just because it's strong. Also, pelvic floor dysfunction is often not simply a muscular issue, but can be contributed to by multiple other factors like lifestyle contributors and nervous system regulation.

Why Kegels Sometimes Make Things Worse

When the pelvic floor is already tense, adding more contraction on top of that, without addressing relaxation and coordination first, can make things worse. I've seen it show up as more tension, more urgency or frequency, discomfort during intimacy, pelvic pain, trouble fully emptying the bladder, or more pressure and heaviness, not less.

Kegels aren't the villain here. Sometimes a woman needs more strength and support. Other times her body needs better breathing mechanics, pressure management, nervous system regulation, mobility, or just the ability to fully relax the pelvic floor again first.

Many Women Aren't Sure If They're Even Doing Kegels Right

Pelvic floor muscles are hard to self-assess. Women end up holding their breath, squeezing everything around the pelvic floor instead of the pelvic floor itself, gripping without ever fully relaxing, over-bracing through the abdominal wall, or compensating with posture or glutes. Weakness and tension can also look pretty similar from the outside, so it's often hard to know what your body actually needs without a more comprehensive assessment.

That can be why women feel discouraged after trying pelvic floor exercises they found online and not seeing any real change or doing kegels at every red light because the doctor told them too. The reality is most women I assess are not aware of how to coordinate their pelvic floors to contract or lengthen and need some training on how to do these movements correctly.

Pelvic Floor Therapy Looks at the Whole System

At Fortis, we look at how your whole system is functioning together: your breathing, posture, pressure management, movement coordination, pelvic floor muscle function, nervous system tension, mobility, exercise habits, and symptom triggers.

Treatment can include a combination of different approaches in order to address the root issue. This can be real strengthening work with movements that translate to each person’s functional needs or it can be focused on relaxation, coordination, posture, breathing mechanics, lifestyle modification, or breaking chronic gripping patterns that are keeping symptoms around. The goal is a pelvic floor that responds well to whatever your day actually asks of it, whether that's a workout, chasing a toddler, or just getting through the day without bracing.

Pelvic Floor Dysfunction Is More Nuanced Than Social Media Makes It Seem

One of the most frustrating things about pelvic floor symptoms is how much conflicting advice is out there. Do more Kegels. Stop doing Kegels. Strengthen your core. Relax more. Especially since a lot of folks on social media have very loud mouths but very limited education or training.

But pelvic floor dysfunction is rarely one size fits all. Our bodies adapt around pregnancy, stress, posture, exercise habits, injury, breath holding, and movement compensations in ways that look different for every woman.

Healing might start with strengthening, or with learning to stop gripping, or with realizing your symptoms have more to do with coordination and pressure management than strength alone. It depends on you, which is exactly why a generic answer online was never going to be the whole picture.

If you're not sure whether your body needs more strength, more relaxation, or both, that's exactly what a pelvic floor evaluation is for. Come see us and we'll figure it out together.

Frequently Asked Questions

Can Kegels make pelvic floor symptoms worse?

Yes. If the pelvic floor is already overactive or tense, repeatedly contracting the muscles without improving relaxation and coordination can worsen symptoms.

How do I know if I should be doing Kegels?

A pelvic floor evaluation can help determine whether your symptoms are more related to weakness, tension, coordination, pressure management, or some combination of all of it.

Are Kegels enough to fix leaking?

Not always. Leaking can also be influenced by breathing mechanics, pressure management, posture, movement coordination, and pelvic floor tension. If a muscle can’t lengthen enough to generate adequate force, then it won’t be able to stop the flow of urine, especially when combined with pressure, stress, jumping, or urgency.

Can a tight pelvic floor cause urgency or pain?

Yes. Overactive pelvic floor muscles can contribute to urgency, pelvic pain, constipation, discomfort with intimacy, and feelings of pressure.

What does pelvic floor therapy involve besides exercises?

It can include breathing strategies, pressure management, mobility work, posture assessment, nervous system regulation, movement retraining, and coordination exercises.

Is pelvic floor dysfunction common postpartum?

Yes. Pregnancy, birth, hormonal changes, and postpartum recovery can all influence pelvic floor function and pressure management throughout the body. However, this can also be common in women who have never had kiddos, in men, in menopausal women, and really in anyone with a pelvis.