Before You Buy That Kegel Exerciser:

What Your Pelvic Floor Really Needs to Heal

If you’ve been scrolling through your feed lately, you’ve probably seen ads for a cute little device that promises to gamify your Kegels — turn pelvic floor exercises into a game on your phone, squeeze your way to a stronger pelvic floor, and finally fix those leaks, that prolapse pressure, or those intimacy issues you’ve been quietly living with.

I love that more companies are paying attention to pelvic floor health. Women deserve solutions, and any product that gets people thinking and talking about this incredibly important part of the body is doing something right.

But here’s what I want you to know — what I need you to know, as a physical therapist who has worked with thousands of women: squeezing more is not always the answer. In fact, for many women, it may actually be making things worse.

Let me share the full picture — once you know your anatomy better, you will see your options.

First, Let’s Talk About What Your Pelvic Floor Actually Is

Your pelvic floor is a group of muscles — a hammock-like basket — that sits at the base of your pelvis and holds up your bladder, uterus, and rectum. These muscles support your internal organs, wrap around your sphincters to help control bladder and bowel function, and provide internal pelvic stability so your body can move through the world without everything flopping around.

Here’s what people don’t realize: the majority of your pelvic floor muscles are slow-twitch, endurance muscles — just like the postural muscles in your neck that hold your head up all day long without clenching and tensing constantly.

Think about your neck for a moment. Those muscles work all day to support your head. But they don’t do it by gripping. They do it with the right amount of gentle, functional tension — enough for what you need, and no more. When there’s too much tension in your neck muscles, you feel it immediately: pain, stiffness, headaches. Something is off.

Your pelvic floor works exactly the same way. It’s not designed to squeeze. It’s designed to lift, support, and respond — dynamically, intelligently, in coordination with the rest of your body.

So What’s a Kegel, Really?

Kegels were developed by Dr. Arnold Kegel in the 1940s as a way to isolate and identify weakness in the pelvic floor muscles. They were a diagnostic and early strengthening tool — not intended to be the entire solution.

Here’s how I think about it: imagine you’re trying to strengthen your hand. You start squeezing a ball — over and over — to build grip strength. That makes sense at first. But if that’s all you ever do, and you never practice opening your hand, extending your fingers, or moving your hand in all the ways hands are meant to move, eventually you won’t be able to fully open your hand at all. The squeezing muscles become tight and dominant while the opening, lengthening, and stabilizing muscles fall behind.

That’s what repeated Kegel-only training can do to your pelvic floor.

I want to be clear: I am not anti-Kegel. I am anti-ineffective Kegel. Kegels can play a helpful role in helping you identify and connect with these muscles — but they are a small part of a much bigger picture.

The Missing Piece: Hypertonic Pelvic Floor

Here is the most important thing I need to tell you, and it may surprise you:

Many women who experience leaking, pelvic pressure, prolapse symptoms, or pain with intimacy don’t have weak pelvic floor muscles. They have pelvic floor muscles that are too tight — what we call a hypertonic pelvic floor.

I know. I know what you’re thinking: “How can my muscles be too tight if they’re not holding things in properly?”

Think about your hamstrings. You can have chronically tight hamstrings and still not have strong hamstrings. Tightness and strength are not the same thing. A tight muscle is typically a desperate muscle that is stuck in a contracted state — it has lost its ability to go through its full range of motion. It can’t fully relax, and because of that, it can’t generate its best strength either. Tight does not mean strong. Strong means the ability to contract fully and relax fully.

So why do pelvic floor muscles become hypertonic? There are several common reasons:

• Muscle imbalance and compensation. After birth, for example, if one side of the pelvic floor was more affected than the other, the stronger side may start working overtime to compensate — until it’s so tight that it no longer knows how to let go.
• Overtraining with Kegels. Squeezing, squeezing, squeezing without equal attention to lifting, relaxation and release  creates excessive tension and can lead to actual knots in the pelvic floor muscles.
• Muscle guarding from pain or trauma. Chronic pelvic pain, difficult births, injuries, or even a history of repeated UTIs or kidney stones can cause your body to brace and guard those muscles — a protective response that, over time, becomes its own problem.
• Hypermobility and joint laxity. If your pelvic joints are loose — whether from pregnancy, genetics, or general hypermobility — your pelvic muscles may over-fire to compensate for that instability, creating hypertonicity.
• Chronic stress and “powering through” life. Many of the women I work with are high achievers: multiple kids, demanding careers, competitive athletes. They’ve trained themselves to push through everything. That chronic stress response lives in the body — often as jaw clenching (TMJ), shallow breathing, and tension held deep in the pelvic floor.

If you have a hypertonic pelvic floor and you are repeatedly squeezing and squeezing with a Kegel exerciser — gamified or not — you are asking an already overworked muscle to grip harder. That’s not rehabilitation. That’s adding fuel to a fire.

“But Can’t I Just Relax the Muscles?”

This is one of the most common questions I get, and the answer is both yes and also: it’s more complicated than that.

Tight muscles are tight for a reason. You can’t just tell a muscle to relax if that muscle believes it has a job to do. A muscle that is guarding, compensating, or working overtime to support a body that is misaligned or unstable is going to keep holding on — because it needs to. Telling it to relax is like telling a person who is holding up a collapsing ceiling to take a break. They can’t until there’s another support structure in place.

What actually works is this: identify what’s missing in your alignment, stability, and whole-body strength. Restore what is missing. And then, with that proper support in place, the pelvic floor muscles can finally let go — because they no longer have to do everything alone.

What Functional Pelvic Floor Rehab Actually Looks Like

Your pelvic floor was designed for multi-directional, dynamic, upright function. It was built to work while you’re walking, squatting, lifting, running, laughing, coughing, and carrying your kids. Not just while you’re lying on your back doing a pull-and-squeeze exercise.

Functional pelvic floor rehab means:

• Learning to properly connect with and activate those deep internal muscles
• Training the pelvic floor alongside the deep core, diaphragm, and whole-body movement
• Balancing contraction with equally intentional relaxation and release
• Applying that strength in real-life movements — not just isolated squeezes
• Addressing the alignment and stability issues that may be causing the pelvic floor to over-work in the first place

Functional Core and Pelvic Floor Rehab is the specialty of The Tummy Team. We have created a step-by step clinically proven process to heal this complex muscle imbalance. Often it starts with the core so we have both Core Foundations and Floor of Your Core— because women deserved a comprehensive approach that treats the pelvic floor like what it actually is: part of a whole, intelligent, beautifully designed system.

How to Know What YOU Need

Before investing in any device that focuses solely on Kegel-type squeezing, I’d encourage you to ask yourself a few questions:

• Do you feel tightness, tension, or pain in your pelvic region or with intimacy?
• Do your pelvic floor symptoms seem worse when you are stressed or overwhelmed?
• Have you tried Kegels faithfully and still aren’t seeing improvement — or things have gotten worse?
• Do you hold tension in your jaw, shoulders, or low back?
• Were you told you have prolapse but also have tightness or pain?

If any of those resonate, you may be dealing with hypertonicity rather than — or in addition to — weakness. And a squeeze-based device isn’t going to give you what you need. In fact, it may deepen the pattern that’s already causing you pain.

The most important first step is to do an honest self-assessment and stop powering through symptoms. In person pelvic floor physical therapy is so valuable but often not available or affordable for everyone. The Tummy Team meets you where you are at and can give you empowering and effective strategies to heal your own pelvic floor from the privacy of your home on your timeline. And you deserve care that actually addresses what is going on inside your specific body.

You Deserve the Full Picture

I want to end by saying this: if you have been struggling with pelvic floor symptoms — leaking, pressure, pain, or intimacy issues — please know that you are not broken, you are not weak, and there is absolutely a path forward. But that path needs to be built on accurate information about what is actually going on.

Your pelvic floor is not a squeeze toy. It’s a beautifully complex group of muscles that, when properly trained and supported, can give you the strength and freedom to live the life you were made for.

At The Tummy Team, we are here to give you that full picture — and a step-by-step process to get there.