Many people have heard of Kegels—pelvic floor muscle contractions—but there’s a lot of confusion about what they actually do. Research shows that most people perform them incorrectly. The bigger issue, though, is this: most people don’t understand when they might need them… and just as importantly, when they might not.
Doing Kegels without understanding what your pelvic floor truly needs can actually make certain symptoms worse. When the underlying cause isn’t addressed, well‑intentioned exercises can unintentionally contribute to pelvic floor dysfunction.
Most of us are never really taught about the muscles at the base of the pelvis even though they play an important role in our daily function (e.g. moving, toileting, sexual function). For many, “Kegels” are the only pelvic floor concept they’ve ever heard of — so it’s understandable that people assume they’re the universal fix.
As a pelvic health therapist with extensive training and experience, I can say that while there are certainly moments when pelvic floor contractions are warranted and helpful, I’m more often working with clients to restore balance in the pelvis using other strategies. These may include improving flexibility and mobility of the joints and tissues, enhancing muscular coordination, and teaching lifestyle habits to support overall pelvic floor health.
Are you experiencing any of the following symptoms?
- Constipation?
- Jaw clenching?
- Pain with sex or pelvic exams?
- Painful periods?
- Hip or back tightness?
- Urinary leakage?
If you are, pelvic floor tension may be contributing — meaning Kegels may be more harmful than helpful:
Assess your breathing: Take a deep breath in through your nose and out through your mouth. Can you notice your pelvic floor muscles lengthening and expanding like a balloon as you inhale? Can you notice it rising back up as you exhale? The pelvic floor should move with your diaphragm as you breathe. It can be tricky to notice this subtle movement at first, but should be easier to feel with practice.
If you suspect that you might have a “tight” pelvic floor, Kegels can contribute to symptoms associated with pelvic floor tension rather than alleviate.
If you’re dealing with symptoms that may indicate pelvic floor tightness, it’s far better to get a formal evaluation than to guess. A trained pelvic health therapist can assess what your body truly needs and guide you toward exercises and strategies that are safe, appropriate, and effective.
Shana Hoke, PT, DPT, CLT
Board-Certified Specialist in Women’s Health Physical Therapy
Better With Physical Therapy, Madison, NJ
(973) 791-8337