The Truth About Kegels: Are They Really the Answer?

Katie Bayer
Jun 2
3 min read

If you've ever experienced leaking urine, pelvic pressure, or postpartum weakness, chances are someone has told you to "just do Kegels."

For years, Kegels have been presented as the go-to solution for nearly every pelvic floor issue. While pelvic floor muscle exercises can be incredibly helpful for some people, they're not the universal answer many believe them to be.

In fact, doing Kegels without understanding what's actually happening with your pelvic floor can sometimes make symptoms worse.

Let's talk about why.

First, What Exactly Is a Kegel?

A Kegel is an exercise that involves contracting and relaxing the pelvic floor muscles. These muscles form a supportive "hammock" at the base of your pelvis and help with bladder and bowel control, support your pelvic organs, contribute to core stability, and play a role in sexual function.

When performed correctly, a Kegel feels like gently lifting and closing the muscles around the vagina, urethra, and anus.

The goal is to improve the strength, endurance, and coordination of these muscles.

The Problem: Not Every Pelvic Floor Is Weak

One of the biggest misconceptions about pelvic floor health is that all pelvic floor problems are caused by weakness.

The reality is much more complex.

Some people have pelvic floor muscles that are weak and underactive. Others have muscles that are tight, overactive, or unable to relax properly. Many people have a combination of weakness, tension, poor coordination, and altered breathing patterns.

Imagine having a shoulder muscle that's already tense and painful. Constantly strengthening it without addressing the tension first probably wouldn't help—and could make it feel worse.

The same concept applies to the pelvic floor.

When Kegels Can Help

Kegels may be beneficial for individuals who have:

Stress urinary incontinence (leaking with coughing, sneezing, laughing, or exercise)
Reduced pelvic floor strength after pregnancy or childbirth
Difficulty generating enough support during physical activity
Certain types of mild pelvic organ prolapse
Poor pelvic floor awareness and control

However, even in these situations, proper technique matters.

Research has shown that many people perform Kegels incorrectly when instructed to do them on their own. Some bear down instead of lifting, hold their breath, tighten surrounding muscles, or engage the pelvic floor at the wrong time.

A pelvic floor physical therapist can help determine whether you're activating the correct muscles and whether strengthening is truly what your body needs.

When Kegels May Not Be the Right Answer

Kegels are often not the first line of treatment for individuals experiencing:

Pelvic pain
Painful intercourse
Tailbone pain
Constipation
Difficulty emptying the bladder
Urinary urgency or frequency
A feeling of pelvic tension or tightness

In these cases, the pelvic floor muscles may already be working too hard.

Many patients are surprised to learn that their symptoms improve when they focus on relaxation, breathing, mobility, and coordination rather than strengthening.

Sometimes the pelvic floor needs to learn how to let go before it can learn how to get stronger.

Your Pelvic Floor Is Part of a Bigger System

The pelvic floor does not work in isolation.

It works together with your diaphragm, abdominal muscles, hips, low back, and nervous system. Factors such as posture, breathing mechanics, stress levels, exercise habits, and previous injuries can all influence pelvic floor function.

That's why successful treatment often involves much more than a set of pelvic floor contractions.

At Transition Physical Therapy, we evaluate the whole person—not just the pelvic floor muscles. By understanding how your body moves, breathes, and functions as a system, we can create a treatment plan that addresses the root cause of your symptoms.

So, Should You Do Kegels?

Maybe.

The better question is whether Kegels are appropriate for your specific symptoms and goals.

For some people, they are an important part of recovery. For others, they may not be needed at all. And for many, they are just one piece of a much larger treatment plan.

If you're experiencing leaking, pelvic pain, prolapse symptoms, constipation, pregnancy-related discomfort, or postpartum concerns, a pelvic floor evaluation can help determine what your body truly needs.

Because when it comes to pelvic floor health, there is no one-size-fits-all exercise.

Ready to Learn What Your Pelvic Floor Needs?

If you've been told to "just do Kegels" but aren't seeing results, you're not alone.

At Transition Physical Therapy, we provide individualized, one-on-one care to help you understand your body and address the underlying causes of your symptoms. Whether you're pregnant, postpartum, navigating menopause, or dealing with pelvic floor dysfunction at any stage of life, we're here to help.