While Kegels are widely recommended for strengthening, physical therapists and medical experts emphasize that overly tight muscles are increasingly common, requiring targeted stretches and reverse Kegels rather than additional contractions.
The pelvic floor functions as a supportive sling of muscles at the base of the pelvis. This muscle group supports the bladder, rectum, and reproductive organs while regulating abdominal pressure, core stability, and continence. Despite handling daily demands, many of us don’t know these muscles exist,
according to pelvic floor physical therapist Sara Reardon, author of Floored: A Woman’s Guide to Pelvic Floor Health at Every Age and Stage. Because the area remains widely misunderstood, dysfunction often goes unrecognized.
Pelvic floor issues affect both women and men. Sara Reardon notes that more than 50 percent of women will encounter pelvic floor dysfunction during their lifetimes. Meanwhile, research suggests that pelvic floor dysfunction impacts 16 percent of men.
Why Heavy Lifts and Constant Bracing Cause Pelvic Tightness in Men
While popular fitness routines build strength and lower cardiovascular risks, certain lifting habits can inadvertently harm pelvic health. Personal trainer Toby King explained that heavy loads, poor breathing techniques, and constant core bracing force pressure downward into the pelvic floor. Exercises such as squats, deadlifts, and ab-focused routines cause gym-goers to subconsciously tense those muscles without adequate rest.
When these muscles remain chronically overloaded, they can restrict blood flow and compress nerves vital for arousal and erections. King compared this constant tension to working the biceps every day with zero rest until the muscle simply stops cooperating. Downstream consequences include erectile dysfunction, ejaculation pain, pelvic discomfort, and bladder issues.
When Kegels Make Things Worse: Recognizing Hypertonic Muscles
A widespread assumption holds that all pelvic floor issues stem from weakness and that standard Kegels solve them. However, many individuals suffer from an overactive or hypertonic pelvic floor where the muscles are already tightly contracted. Dr. William Winkelman, fellowship program director in the urogynecology and reconstructive pelvic surgery department of obstetrics and gynecology at Mount Auburn Hospital and assistant professor at Harvard Medical School, noted that patients attempting unsupervised Kegels can actually exacerbate their condition.
“Sometimes we get patients who have tried doing Kegels or other pelvic floor exercises on their own and have actually made things worse. When people have a hypertonic pelvic floor, we recommend stretches aimed at tight hips or lower backs. Exercises such as yoga can help relax those muscles.”
Dr. William Winkelman, Mount Auburn Hospital
For these patients, physical therapists recommend lengthening exercises, diaphragmatic breathing, and reverse Kegels to release tension rather than build it.
Rebuilding Strength After Prostate Issues and Childbirth
For conditions tied to muscle weakness—such as postpartum recovery or prostate issues—targeted conditioning yields documented benefits. Men with prostate issues are especially prone to pelvic floor dysfunction. Performing supervised Kegel exercises helps increase blood flow and strengthens sphincter muscles around the bladder.
For women navigating pregnancy, childbirth, or menopause, physical therapy addresses both weakness and tension.
“Just say no to power peeing. You want to sit, relax and let it flow.”
Sara Reardon, Pelvic Floor Physical Therapist
Specialists emphasize consulting a qualified pelvic floor physical therapist or urologist before starting an independent regimen to determine whether strengthening or lengthening exercises are required.
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