Quick Answer: Pelvic floor muscles, like any other muscle group, can become overactive and tense with excessive, poorly-timed strengthening exercises, and an already-tense pelvic floor responding to more Kegels can actually worsen symptoms like pain or urinary urgency rather than improving them — the standard advice to “do more Kegels” doesn’t apply to everyone equally.

Pelvic floor exercises get recommended almost universally, but for some people, more of them is exactly the wrong direction to go.

How can strengthening exercises actually make symptoms worse?

The pelvic floor is a muscle group, and muscle groups can become chronically tense or overactive just like any other muscle, not just weak — for someone whose underlying issue is an already-tense, overactive pelvic floor, adding more contraction-based exercise adds to that existing tension rather than resolving it.

This is a well-documented distinction in pelvic floor physical therapy between an underactive (weak) pelvic floor and an overactive (tense) one, which require different, sometimes opposite, approaches.

How would someone know which category they fall into?

Symptoms like difficulty fully relaxing, pain during certain activities, or a sense of persistent tightness can point toward an overactive pattern, distinct from the leaking or heaviness sensations more associated with an underactive pattern.

A pelvic floor physical therapist can assess this directly through a proper evaluation, which is generally a more reliable way to know than guessing based on symptoms alone, since the two patterns can sometimes overlap or coexist.

Common Pelvic Floor Exercise Mistakes Explained

Doing Kegels without ever practicing the release, or relaxation, phase is one of the most common mistakes — many people focus entirely on the contraction and skip the equally important muscular release, which can contribute to building excess tension over time.

Doing high-repetition Kegels throughout the day without proper form or professional guidance is another common mistake, especially for someone whose actual issue would benefit more from relaxation-focused, not strengthening-focused, work.

What does the breathing connection have to do with any of this?

The pelvic floor works in coordination with the diaphragm during normal breathing, and breathing pattern issues can contribute to pelvic floor tension independent of any specific pelvic exercise, meaning breathing retraining is sometimes part of an effective treatment plan alongside or instead of Kegels.

Poor breathing mechanics, like chronic breath-holding or shallow chest breathing, can quietly reinforce pelvic floor tension throughout the day, well beyond any dedicated exercise session.

FAQ: Pelvic Floor Exercise Questions, Answered

Should someone stop doing Kegels entirely if they suspect overactivity?

Not necessarily on their own judgment — a proper evaluation from a pelvic floor physical therapist gives a much clearer answer than stopping or continuing based on guesswork alone.

Is pelvic floor physical therapy only for postpartum people?

No — pelvic floor issues affect people across many different life stages and circumstances, not exclusively postpartum recovery.

How common is the overactive pelvic floor pattern compared to the underactive one?

Both patterns are well-documented and relatively common, and a proper assessment is the most reliable way to determine which applies to a specific individual. This is general information, not medical advice.

TL;DR:

• Pelvic floor muscles can become overactive and tense, not just weak, like any other muscle group
• More Kegels can worsen symptoms specifically for someone with an already-tense pattern
• Skipping the release phase of a Kegel is a common mistake that can build excess tension
• Breathing mechanics are closely tied to pelvic floor tension, independent of dedicated exercises

“Do more Kegels” isn’t universal advice — for a real share of people, the more useful direction is learning to release, not just contract. This is general information, not medical advice.

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