What Actually Work Tips From A  Pelvic Expert

Kegel Exercises Don’t Strengthen Your Pelvic Floor

February 28, 20244 min read


I know, this makes no sense. We have heard most of our adult lives from friends, family, and health care providers that any pelvic floor issues need to be addressed with Kegel exercises. 

Leaking urine? Kegel’s 
Pain with sex? Kegel’s 
Pelvic Pain? Kegel’s 
Pregnant? Kegel’s
Postpartum? Kegel’s


But it’s not working… all of our moms are still leaking… 

Aging and preparing for the future isn’t just Botox and a 401k it is addressing issues as they arise so they don’t snowball and become an issue with a drastic effect on the quality of your life. 

Clinically we see that women aged 40-70 are struggling with all of the issues that come with a weak pelvic floor regardless of the decades of Kegel’s they did. Issues that started postpartum and now their kids are having kids of their own and they’re still not fully healed.

But because Kegel exercises have been the answer for decades the only alternatives being presented are medications or surgeries which both have intense side effects and don’t guarantee relief but are the expected next step for women who haven’t seen improvement by doing Kegel’s. 

In today’s day we see products; ben wa balls, kegel weights, wands, even kegel video games… or clench to the beat… or services; mona lisa, biofeedback, etc. 

But the root of the issue is a tight pelvic floor and Kegel exercise and any service that encourages contractions of the pelvic floor are contributing to what is called a hypertonic pelvic floor. 

Imagine you’re trying to improve your bicep strength but you do mini contractions, never fully extending your arm. Imagine doing that daily for years… that muscle starts to lose blood flow and atrophies. That’s what doing Kegel’s with a tight pelvic floor is like. A pelvic floor contraction is an automatic reaction in the body we should not ever need to consciously contract these muscles. 

The pelvic floor is commonly tight for women because we store stress in these muscles, whether it’s physical or mental stress combined with our more sedentary lifestyle these muscles are affected. 

So if not Kegel’s, what? 

RELAXATION. I know doesn’t seem revolutionary but truly a strong, healthy, dynamic pelvic floor can relax, contract and bulge. A healthy pelvic floor should have a neutral state as well. It can be difficult to know if you’re relaxing when your natural state options have been tight or tighter. 

So here are the exercises that I, a pelvic expert physical therapist, owner of two pelvic floor physical therapy clinics, an author of 1 book with 1 on the way focused on pelvic health and a mom of 3, insist you do. 

  1. Diaphragmatic Breathing
    These are DEEP belly breaths, which help restore optimal core pressure. A deep breath makes the diaphragm descend which increases downward pressure onto the pelvic floor helping it to relax and bulge which is essential for anyone with a tight pelvic floor.


    diaphragmatic breathing


    2. Transverse Abdominal Activation
    The T.A. muscles cross your belly and attach to your hips, activating these muscles helps restore core strength and decreases the tension in the pelvic floor

t.a. activation
  1. Deep Squats known as a garland pose in yoga 

Deep Squats that you hold for several seconds help the pelvic floor relax. This isn’t your standard squat this is a relaxing low impact movement. 


Those are the only 3 pelvic floor exercises you should be doing if you are struggling with pelvic floor issues. Especially if you haven’t worked with a Pelvic Expert and are trying to follow along with rando’s on Youtube. 


Common signs of Pelvic Floor Dysfunction are;

  • Leaking Urine ANYTIME there is never an acceptable reason to be peeing your pants

  • Having to pee all the time 

  • Dribbling on the toilet seat when you stand up

  • Feeling like something is in your vagina

  • Sharp pain that comes out of nowhere in your pelvic floor or vagina

  • Constipation, this one always surprises people

  • Discomfort with penetration during sex 

  • Vaginal Dryness 

  • Painful periods

  • Low back Pain 

  • Hip Pain 

  • Knee pain, this is also surprising to a lot of people


If you are dealing with 1 of those symptoms your body is giving you a sign, be proactive when addressing pelvic floor issues. Because yes, we can all ignore leaks and just wear panty liners and black pants, yes we can grab lube to make sex a bit better, and yeah pop an Aleve after a walk. These are all temporary solutions to issues that will lead to chronic pain, surgeries, and injections down the line. Unfortunately, these issues are reasons why many women lose their independence in later life.

kegel exercisespelvic floor exerciseskegelspelvic floor strength

Dr. Allison Feldt, PT, DPT

Owner of Body Motion Physical Therapy + Best Selling Author

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