Kegel or Not to Kegel
Should You Be Doing Kegels or Pelvic Floor Relaxation? A Pelvic PT’s Guide:
One of the most common questions I get as a pelvic floor physical therapist is:
“Do I need to do Kegels… or should I actually be relaxing my pelvic floor?”
The answer isn’t the same for everyone — because pelvic floors aren’t one-size-fits-all.
What Kegels Are For
Kegels strengthen the pelvic floor by targeting the muscles that support the bladder, bowels, and reproductive organs.
They’re helpful if you have symptoms like:
Leakage with coughing, sneezing, running
Pelvic organ prolapse
Weakness after childbirth
Difficulty holding in gas or stool
If your pelvic floor is underactive, Kegels can improve strength, coordination, and support.
When NOT to Do Kegels
Many people are surprised to learn that Kegels can make symptoms worse if the pelvic floor is too tight or unable to relax.
You may need relaxation, not strengthening, if you experience:
Pelvic pain
Painful sex or tampon insertion
Constipation or difficulty emptying your bowels
Urinary urgency/frequency
Low back or hip pain tied to muscle tension
In these cases, the pelvic floor is already working too hard — and adding more contraction increases the problem.
Relaxation work (downtraining, breathwork, stretching, and nervous system regulation) helps these muscles let go so they can function normally again.
How to Tell the Difference
A quick rule of thumb:
Weak + low tone = strengthening
Tight + overactive = relaxation
But the truth is, many people have a mix — a tight pelvic floor that’s also weak.
That’s why a pelvic PT assessment is so valuable: we look at tone, coordination, breath mechanics, posture, and functional patterns to determine exactly what your body needs.
The Bottom Line
Doing Kegels just because you heard they’re “good for you” can actually backfire.
Your pelvic floor needs the right intervention — strengthening, relaxation, or a combination — based on its unique presentation.
If you’re not sure what your pelvic floor needs, a pelvic physical therapist can help you get clarity and build a plan that supports your symptoms, your lifestyle, and your long-term pelvic health.
