Why Kegels Don’t Always Work for Pelvic Floor Dysfunction (2025)

Kegels are often recommended as the go-to exercise for pelvic floor problems, but they aren’t always the right solution. While strengthening exercises can help in some cases, not all pelvic floor dysfunctions are caused by weakness. In many situations, the underlying issue is actually tightness or overactivity.

When Strength Isn't the Problem
Many people assume that a weak pelvic floor is the cause of dysfunction. However, in some cases, the muscles are too tense or overactive, making it difficult for them to function properly. If the pelvic floor is locked in a contracted state, continuously squeezing it with Kegels can make symptoms worse rather than better.

How Overuse of Kegels Can Worsen Symptoms

If your pelvic floor is already hypertonic (overactive), repeated contractions may increase tension instead of providing relief. This can lead to:

• More discomfort and tightness in the pelvis, lower back, and hips.
• Increased difficulty urinating or worsened urinary urgency.
• Pain during intercourse, sitting, standing, or exercising.

Kegels alone don’t address underlying imbalances in posture, breathing, and muscle coordination that are essential for pelvic floor function.

If Kegels aren’t right for your pelvic floor condition, your body will give you warning signs. Pay attention if you experience:

✔ Increased pelvic pain or tension after doing Kegels.
✔ Worsening urinary urgency or incomplete emptying of the bladder.
✔ Pain during sex or daily movements that wasn’t there before.
✔ Feeling "disconnected" from your core rather than stronger.
✔ No noticeable improvement even after months of practice.

If you recognize these signs, it’s time to consider alternative pelvic floor treatments.

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1. Chronic Stress and Muscle Tension

Stress triggers tightness in the pelvic floor, just like it does in the shoulders. If your muscles remain in a constant state of contraction, they become dysfunctional. Kegels reinforce this pattern rather than correcting it.

2. Postural Imbalances

Your posture affects how your pelvic floor engages. If you have excessive tension in your hips, lower back, or core muscles, simply doing Kegels won't fix these misalignments.

3. Nerve Dysfunction

Pelvic floor dysfunction can result from nerve irritation or improper signaling between the brain and pelvic muscles. This leads to pain, miscoordination, and an inability to properly contract or relax the muscles. Kegels don’t retrain nerve function—other techniques, like breathwork and relaxation, are often more effective.

4. Scar Tissue and Fascia Restrictions

The pelvic floor isn’t just muscles—it’s connected by fascia, a web-like structure that holds everything together. If you have scar tissue (from childbirth, surgery, or injury), your pelvic floor might be too restricted to function properly. Kegels won’t address these restrictions, but myofascial release, massage, and hypopressives can.

If Kegels aren’t working for you, don’t worry—there are proven, science-backed alternatives to restore balance to your pelvic floor.

1. Hypopressives: The "Anti-Kegel" Approach

Hypopressives are a breathing and postural technique that reduces pressure on the pelvic floor while strengthening deep core muscles. This method:

✔ Relaxes the pelvic floor while strengthening the core.
✔ Reduces prolapse symptoms without downward pressure.
✔ Improves breathing mechanics and posture.
✔ Lifts and supports internal organs naturally.

Studies have shown that women with prolapse, incontinence, or diastasis recti benefit greatly from hypopressives.

Read more here: Hypopressives for Pelvic Floor Dysfunction: A Complete Guide

2. Functional Breathing

Functional breathing is more than just inhaling and exhaling—it’s about engaging the diaphragm, optimizing oxygen exchange, and supporting core and pelvic health. Many people unknowingly breathe inefficiently, leading to tension, poor posture, and even pelvic floor dysfunction.

A 360° breath, also known as lateral ribcage breathing, expands the front, back, and sides of the ribcage. To practice this:

1. Lie down comfortably with your feet flat on the ground.

2. Place your hands on your ribcage and breathe deeply through the nose.

3. Feel your ribs expand outward with each inhale, rather than just inflating the belly.

4. Exhale smoothly through the mouth without forcing it.

This breathwork stimulates the diaphragm, enhances blood circulation, and supports pelvic floor relaxation and strength. Unlike shallow chest breathing, functional breathing activates deep core stability and reduces unnecessary tension.

By practicing this daily—whether lying down, seated, or standing—you train your body to breathe optimally, promoting better posture, energy levels, and overall well-being. Over time, this becomes second nature, positively influencing both nervous system regulation and muscle coordination.

3. Optimal Posture

Posture is more than just standing up straight—it directly impacts pelvic floor function, core stability, and overall well-being. Many people unknowingly adopt poor postural habits, such as tucking the pelvis or excessively arching the lower back, which can create imbalances and strain the pelvic floor.

To find optimal posture, try this simple wall exercise:

1. Sit against a wall with your sitting bones rooted down.

2. Ensure your lower back has a slight gap (not overly arched or flattened).

3. Press the base of your ribs against the wall while maintaining that natural curve.

4. Align your shoulders and the back of your head with the wall (use a small pillow if needed).

5. Visualize a thread pulling the crown of your head upward, lengthening your spine.

Maintaining this balanced posture supports better breathing mechanics, reduces strain on the lower back, and enhances pelvic floor engagement. Small posture check-ins throughout the day help retrain the body, allowing for a more effortless, pain-free alignment.

By integrating correct posture with functional breathing, you create a powerful foundation for healing, core strength, and optimal movement in daily life.

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4. Relaxation Techniques

Many women unknowingly hold tension in their pelvic floor all day. Try these simple relaxation exercise to promote relaxation:

Do this for 5-10 minutes daily to encourage a more balanced pelvic floor.

5. Scar tissue Release & Stretching

If tight fascia and scar tissue are restricting movement, gentle manual therapy and targeted stretching can help. Some effective poses include dissolving scar tissue or finding a hands-on practitioner

Here is more:

If you’re interested in working with other therapies than Kegels, try our free 7-day Challenge of anti-kegel exercises.

You get 1 exercise emailed to your inbox everyday.

Each exercise is less than 10 minutes and your pelvic floor will thank you for your efforts.

Sign up for free here.

If your symptoms aren’t improving or are getting worse, it might be time to see a specialist. You should consider professional help if:

• You’ve been doing Kegels for months with no results.
• Your symptoms are getting worse (pain, urgency, prolapse).
• You feel disconnected from your core.

A pelvic health professional can assess your unique needs and create a customized treatment plan that works with your body instead of against it.

If you are ready to work with more holistic physical therapy exercises, take a look at our 12-week coaching program called Total Pelvic Freedom.

93% of all participants notice improvements in 12-weeks.

Read more here: Total Pelvic Freedom: The 12-Week Program That Helps Women Heal Pelvic Floor Issues Naturally

Kegel exercises have their place, but they aren’t the right solution for everyone with pelvic floor dysfunction. If you’re struggling with symptoms despite doing Kegels, explore alternative treatments like hypopressives, breathwork, and physical therapy.

Your pelvic health is about balance, not just strength. If something isn’t working, listen to your body and try a new approach.