Pelvic Floor Therapy vs. Kegels: What Actually Works?

Why Kegels Aren’t a Cure-All

If you’ve ever been told to “just do your Kegels,” you’re not alone. Many women are taught that squeezing their pelvic muscles is the solution for everything—from leakage to low libido.

But here’s the truth: not every pelvic floor needs strengthening. Some need release, coordination, and awareness before adding any type of contraction. That’s where pelvic floor physical therapy comes in—offering individualized care instead of one-size-fits-all advice.

What Kegels Actually Do

Kegels are voluntary contractions of the pelvic floor muscles, designed to strengthen the muscles that support your bladder, uterus, and bowel. When used appropriately, they can:

• Improve bladder control and reduce leakage

• Support pelvic organ positioning

• Enhance sexual function and circulation

But here’s the catch—Kegels only help if the muscles are weak and underactive. If your pelvic floor is already tense or overactive, more contractions can worsen symptoms like:

• Pelvic pain or pressure

• Pain with intimacy

• Urinary urgency or constipation

The Problem with “Tight” Pelvic Floors

Many people assume tight equals strong—but that’s not true for the pelvic floor.

A chronically contracted pelvic floor can’t generate full strength or coordination. It’s like holding your shoulders up to your ears all day—eventually, tension turns into fatigue and pain.

This is why doing endless Kegels without guidance can lead to frustration or even injury.

What Pelvic Floor Therapy Does Differently

Pelvic floor physical therapy begins with a personalized assessment. A trained therapist evaluates muscle tone, coordination, breathing patterns, and posture to understand what your body actually needs.

Therapy may include:

• Myofascial release to ease restriction

• Breath and core retraining for functional movement

• Biofeedback to improve awareness and control

• Lifestyle and alignment education to support long-term change

Instead of guessing, your therapist tailors treatment—sometimes strengthening, sometimes relaxing, sometimes both—to restore optimal pelvic health.

When to Skip Kegels

You might benefit from focusing on release work rather than contraction if you experience:

• Pelvic pain or pressure

• Pain with intimacy

• Constipation or incomplete emptying

• Difficulty starting urination

• A feeling of “tightness” or anxiety held in the pelvis

In these cases, Kegels can make symptoms worse, and a trauma-informed pelvic floor therapist can help retrain your system toward safety, not strain.

So… What Actually Works?

Healing begins with awareness, balance, and breath—not blind strengthening.

When you combine manual therapy, functional movement, and nervous system regulation, your pelvic floor learns to respond dynamically—to support you when needed and relax when safe.

That’s what true strength looks like: responsive, resilient, and relaxed.

The Takeaway

Kegels are a tool, not a solution. Pelvic floor therapy is the holistic, individualized approach that helps you understand your body’s unique patterns and restore harmony from the inside out.

If you’re tired of guessing—or squeezing without results—professional pelvic floor therapy can help you reconnect, rebuild, and reclaim your confidence.

✨ Begin Your Healing Journey

Ready to find out what your pelvic floor really needs?

🌿 Book a Pelvic Health Consultation at Align Wellness PNW

Heal from pain, trauma, or disconnection—and rediscover your body’s natural intelligence.