Kegels vs. Reverse Kegels: Which Do You Need?

If you’ve ever Googled "pelvic floor exercises," you’ve probably been told to do your Kegels. But what if I told you that Kegels aren’t always the answer — and sometimes what you really need is the opposite?

Welcome to the world of reverse kegels or pelvic floor lengthening and relaxation.

To Kegel?

A Kegel is the contraction of your pelvic floor muscles. Think: "lift and squeeze" — like you’re trying to stop the flow of urine or hold in gas.

✅ Kegels help if your pelvic floor muscles are weak and need strengthening. 

✅ They improve support for your bladder, uterus, and rectum. 

✅ They can help manage urinary leaking, mild prolapse, fecal incontinence and core stability.

But here’s the catch: Not everyone with pelvic issues has a weak pelvic floor. Some people have tight, overactive pelvic floors — and doing endless kegels can actually make things worse.

Or Not to Kegel?

A reverse kegel is a conscious relaxation and gentle lengthening of your pelvic floor. Think: "release and drop" — like letting the muscles soften and widen naturally.

✅ Reverse kegels help when your pelvic floor muscles are tight, tense, or guarded.

✅ They are key for relieving pelvic pain, constipation, painful intercourse, and difficulty with urination or bowel movements.

In short: If Kegels are lifting and tightening, then Reverse Kegels are relaxing and lengthening.

How Do You Know Which One You Need?

Sometimes It’s more straightforward and easy to know which one you need and other times the same symptom could be caused by either weakness or tension.

If You Have...	You Might Need...
Tightness or pressure in the pelvic region	Reverse Kegels
Pain with intercourse, tampons, or pelvic exams	Reverse Kegels
Difficulty starting your urine stream	Reverse Kegels (relaxation)
Pelvic pain (hips, low back, tailbone)	A mix of both or neither
Poor core engagement after childbirth	A mix of both, depending on assessment

Important: Self-assessment is a starting point — but working with a pelvic health physical therapist is the BEST way to truly know what’s happening with your pelvic floor.

We can do a detailed internal and external exam to figure out:

• Are your muscles weak, tight, or a combination?

• Is there nerve involvement?

• Are there compensations elsewhere (hips, back, abdomen)?

• What's your breathing pattern like (this matters a LOT!)?

Why Doing the Wrong Exercise Can Backfire

👉 If you only do Kegels when your pelvic floor is already tight, you could increase tension and pain.

 👉 If you only do Reverse Kegels when your muscles are weak, you might worsen leaking or pelvic instability.

It’s all about balance. Healthy pelvic floors are strong and flexible — they know when to contract and when to relax.

Bottom Line

🌟 If you have symptoms like leaking, heaviness, or weakness?

 You might need Kegels (with good technique — not just random squeezing).

🌟 If you have symptoms like pain, tension, or trouble relaxing?

 You might need Reverse Kegels to gently open and lengthen those muscles.

🌟 If you’re not sure?

 It’s absolutely worth getting evaluated by a pelvic health PT — because the right plan can make a world of difference in how you feel and function.