Are Kegels Enough? What Your Pelvic Floor Actually Needs.
When someone mentions the pelvic floor, what's the first exercise that comes to mind?
Kegels.
Squeeze. Hold. Relax. Repeat.
Kegels can absolutely be part of pelvic floor training. But your pelvic floor has a much bigger job than simply squeezing as hard as possible.
So, are Kegels enough?
The short answer: not necessarily.
First: What Exactly Is a Kegel?
A Kegel is a voluntary contraction of your pelvic floor muscles.
Your pelvic floor forms a muscular support system at the bottom of your pelvis. These muscles contribute to bladder and bowel control, support the pelvic organs and play a role in sexual function.
Learning how to correctly contract these muscles can therefore be very useful.
But here's the important part:
A good pelvic floor needs to do more than contract.
It also needs to relax, coordinate and respond to what the rest of your body is doing.
Stronger Isn't Always the Whole Answer
Imagine walking around all day with your fist clenched.
Would you call that hand strong?
Maybe.
But would it be functioning well?
Probably not.
You need to be able to close your hand and open it again.
Your pelvic floor also needs both contraction and relaxation.
In fact, pelvic floor muscle training isn't defined only as strengthening. Research describes it as training aimed at improving aspects such as strength, endurance, power, relaxation—or combinations of these.
So doing more and more contractions isn't automatically better.
Your Pelvic Floor Needs Coordination
Your pelvic floor doesn't live in isolation.
It has to work while you:
breathe
cough and sneeze
lift your baby or child
squat
walk
exercise
run
jump
That means timing and coordination matter.
You might be able to perform a pelvic floor contraction while lying quietly on your back—but what happens when you pick up a heavy laundry basket?
Or when you sneeze unexpectedly?
Or when you're doing squats?
Ultimately, we want your pelvic floor to respond as part of movement, not only during isolated exercises.
And Then There's Breathing
Your breathing and pelvic floor are connected through changes in pressure and movement within your trunk.
As you breathe in and out, your diaphragm moves and your pelvic floor normally participates in this coordinated movement.
That's one reason I spend time teaching breathing and body awareness in my pelvic floor classes.
Before we start worrying about doing 50 Kegels a day, I want you to understand:
Can you find your pelvic floor?
Can you contract it?
Can you let it go again?
Can you breathe without constantly bracing?
Then we can build from there.
What Does the Research Say?
Pelvic floor muscle training is well established as a conservative treatment for urinary incontinence.
A Cochrane review of 31 trials involving 1,817 women found that women with stress urinary incontinence who performed pelvic floor muscle training were more likely to report improvement or cure than women receiving no treatment or inactive treatment.
The review also found improvements in leakage episodes, symptoms and quality of life.
So yes—pelvic floor exercises matter.
But that doesn't mean there is one perfect Kegel routine for every woman.
Research comparing different pelvic floor training approaches has found that we still don't have strong answers about the ideal exercise type, amount or method for everyone.
Your pelvic floor training should have a purpose—not just a number of squeezes to complete.
“But I've Been Doing Kegels for Years!”
I hear versions of this often.
If you've been doing pelvic floor contractions for months or years but still experience symptoms, simply adding another 20 contractions may not be the answer.
You may need to look at:
Technique. Are you actually contracting the intended muscles?
Relaxation. Are you letting the pelvic floor fully release between contractions?
Endurance. Can the muscles maintain an appropriate contraction when needed?
Coordination. Can your pelvic floor work together with breathing and movement?
Progression. Have your exercises actually become more challenging as you've improved?
Function. Can you use what you've learned while lifting, exercising, coughing, running or jumping?
Pelvic floor training should be training, not simply repetition.
What About Pelvic Floor Apps and Devices?
Technology can be useful, especially when it helps someone understand what their pelvic floor is doing.
But you don't necessarily need an expensive device to have effective pelvic floor training.
A 2025 Cochrane review looked at adding feedback or biofeedback devices to pelvic floor muscle training for women with urinary incontinence. It found that adding biofeedback made little or no difference to several important outcomes compared with pelvic floor training alone.
So don't assume that the fanciest gadget automatically means the best training.
Understanding your body and following an appropriate, progressive program still matters.
What Should Pelvic Floor Training Include?
Rather than thinking:
“I need to do more Kegels.”
Try thinking:
“I want my pelvic floor to function well.”
That may involve:
Awareness → Breathing → Contraction → Relaxation → Endurance → Coordination → Movement → Progression
And that's much closer to how I approach pelvic floor education at Cochrane Mama.
The goal isn't to become amazing at Kegels.
The goal is to help your pelvic floor support the things you actually want to do.
Run.
Lift.
Exercise.
Play with your kids.
Laugh.
Sneeze.
Jump.
The Takeaway
Kegels aren't useless.
But Kegels are only one piece of the pelvic floor puzzle.
Your pelvic floor needs strength, but it also needs the ability to relax, coordinate with your breathing and respond appropriately during movement.
So instead of asking:
“How many Kegels should I do?”
A better question may be:
“What does my pelvic floor need to do better?”
And that's where pelvic floor training becomes much more interesting.
Want to Learn More About Your Pelvic Floor?
At Cochrane Mama, my pelvic floor classes focus on helping you understand how your pelvic floor works and how to incorporate breathing, awareness, coordination and progressive exercise into your training.
Pelvic floor training is about more than squeezing. It's about learning how your body works. ♡
Sources & Further Reading
Cochrane: Pelvic floor muscle training for urinary incontinence in women
Cochrane: Comparisons of approaches to pelvic floor muscle training for urinary incontinence in women
Cochrane: Pelvic floor muscle training with feedback or biofeedback for urinary incontinence in women