Should You Strengthen Or Relax Your Pelvic Floor? A PT Explains
We lift weights to build muscles, head to pilates class to tone them, and foam roll or use a massage gun to help relieve tension. But there's a muscle that many women don't know they need to pay attention to until something goes awry—the pelvic floor.
Like any muscle, the pelvic floor needs to be able to contract (for support and control) and relax (for release and comfort) when needed. But women who bring up concerns like bladder leaks, painful sex, or pelvic heaviness to a doctor are often met with generic (and in some cases, completely wrong) advice of doing Kegels.
“The idea that every woman should be doing Kegels is outdated,” says Sara Reardon, PT, DPT, who’s treated thousands of patients as a board-certified women’s health and pelvic floor therapist.
In reality, some women need strength, others need relaxation, and many need a combination of both to support their pelvic health. The key is knowing which camp you fall into before deciding what exercises are actually going to help.
On the mindbodygreen podcast, Reardon breaks down everything you need to know about how the pelvic floor works, what symptoms to look out for, how to strengthen (and relax) your pelvic floor.
First, a quick anatomy refresher: What is the pelvic floor?
The pelvic floor is a group of muscles that sit at the base of the pelvis, acting like a hammock to support your pelvic organs, including the bladder, uterus, rectum, and more. These muscles control some of your body’s most essential functions, like peeing, pooping, orgasming, and giving birth.
Despite all that responsibility, Reardon says most people don’t even know these muscles exist, let alone how to take care of them. This lack of awareness means that issues like incontinence, constipation, painful sex, or pelvic pain often get brushed off as “normal,” when in fact, they’re signs of dysfunction that can be treated.
Why Kegels get prescribed so often (& why they’re not for everyone)
A Kegel is a pelvic floor contraction, a squeeze and lift of those hammock-like muscles. They’re often recommended as a one-size-fits-all fix for urinary leakage, sexual health, and core weakness.
But here’s the catch: Kegels are only helpful if weakness is your issue. For many people, the problem isn’t that their pelvic floor is too loose or weak—it’s that it’s too tight and unable to relax properly.
“It’s like telling someone with back pain to just do crunches,” Reardon explains. “For some, it might help. For others, it makes things worse.”
In fact, doing Kegels with a tense pelvic floor can exacerbate symptoms like:
- Frequent or urgent urination
- Straining with bowel movements
- Painful intercourse
- Difficulty initiating urination or emptying the bladder
- Pelvic or tailbone pain
If you’re experiencing any of these issues, Kegels may be the last thing you need. In these cases, relaxation techniques and breathwork are often much more effective.
How to know what your body needs: Strength vs. relaxation
According to Reardon, most people with pelvic floor dysfunction fall into one of two categories:
- The strength category: These individuals may experience leakage with sneezing or exercise, pelvic organ prolapse, or a sense of “heaviness” in the pelvis. For them, Kegels and core strengthening can help.
- The tension category: This group tends to deal with pain—pain during sex, tailbone discomfort, hip tightness, or issues with fully emptying the bladder or bowels. These people usually benefit more from techniques that promote relaxation and lengthening, not contraction.
The underrated tool for pelvic floor health: Your breath
If you're not sure where to begin, Reardon recommends starting with your breath. Your diaphragm and pelvic floor work together in a rhythm: when you inhale, your pelvic floor relaxes; when you exhale, it lifts. This movement is crucial for building both flexibility and control.
Holding your breath during workouts (or during stressful moments) creates more tension in the pelvic floor. That’s why Reardon teaches her clients to exhale on exertion—whether you're lifting weights, doing a crunch, or simply going to the bathroom.
She explains that your breath is your best starting point because it teaches your pelvic floor to move the way it was designed to.
The takeaway
Pelvic floor health isn’t one-size-fits-all. While Kegels can be helpful for certain issues, they can also make symptoms worse if your muscles are already too tight.
The smartest thing you can do? Get curious about your own body, tune in to your symptoms, and when in doubt, work with a pelvic floor therapist who can guide you in the right direction.
Because your pelvic floor isn’t just about managing symptoms, it’s about building a foundation of strength and ease that supports you through every stage of life.