It’s Not Just Kegels: What Pelvic Floor Physiotherapy Really Does

When most people hear the words pelvic floor, they think of one thing: Kegels. Squeeze, hold, release. Repeat forever.

But here’s the truth: pelvic floor physiotherapy is about so much more than squeezing muscles — and for many people, Kegels alone aren’t the answer.

If you’ve ever dealt with leaking when you laugh, pressure in your pelvis, pain with intimacy, or a core that just doesn’t feel strong no matter how many workouts you do, you’re not alone. These experiences are incredibly common. But they don’t have to be something you just “live with.”

Pelvic floor physiotherapy exists to help you feel strong, supported, and confident in your body again — without shame, awkwardness, or one-size-fits-all advice.

Let’s talk about what it really does.

What is the pelvic floor, really?

Your pelvic floor is a group of muscles that sits at the base of your pelvis. Think of it like a hammock that supports your bladder, bowels, and (for many people) uterus or prostate.

These muscles play a role in:

• Bladder and bowel control

• Core stability

• Breathing and posture

• Sexual function

• Supporting your spine during movement

They don’t just need to be strong — they need to be able to contract, relax, and respond quickly when your body needs them.

That means the goal isn’t constant tension. The goal is control.

Why “just do Kegels” isn’t always the solution

Kegels can be helpful — but only if they’re the right tool for your body.

Some people do need to strengthen their pelvic floor.Others actually have muscles that are too tight, tense, or overactive.

When muscles stay tight all the time, they can:

• Cause pain

• Make it harder to empty your bladder or bowels

• Lead to discomfort with intimacy

• Create a feeling of pressure or heaviness

In these cases, doing more Kegels can make symptoms worse — not better.

Pelvic floor physiotherapy looks at the whole picture:

• Strength

• Relaxation

• Coordination

• Breathing patterns

• How your core and pelvis work together

Because your body isn’t one muscle in isolation — it’s a system.

Common signs your pelvic floor might need support

You don’t need to be postpartum or recovering from surgery to benefit from pelvic floor physio. People seek support for many different reasons.

Some common signs include:

• Leaking when you laugh, cough, sneeze, or exercise

• Feeling pressure or heaviness in the pelvis

• Pain during intimacy

• Needing to pee “just in case” before leaving the house

• Trouble fully emptying your bladder

• Ongoing low back, hip, or core weakness

• A feeling that your core just isn’t doing its job

These symptoms are common — but they are not something you have to accept as normal.

Your body is communicating with you. Pelvic floor physio helps you understand what it’s saying.

What pelvic floor physiotherapy actually looks like

If the idea of pelvic floor physio makes you nervous, you’re not alone. Many people worry it will be awkward or uncomfortable.

In reality, it’s often one of the most supportive and empowering healthcare experiences people have.

Your first appointment usually starts with a conversation — not exercises. You’ll talk about:

• Your symptoms

• Your health history

• Your lifestyle

• Your goals

Everything moves at your pace, and your comfort and consent always come first.

From there, your physiotherapist builds a plan that may include:

• Gentle strengthening

• Relaxation and down-training

• Breathing work

• Core coordination

• Education about daily habits that affect pelvic health

It’s not about perfection. It’s about progress — in a way that feels realistic for your life.

Pelvic floor physio is for more people than you think

There’s a myth that pelvic floor physiotherapy is only for people who’ve recently had a baby. While it’s incredibly helpful postpartum, it’s also valuable for:

• Athletes who leak during high-impact sports

• Office workers with chronic pelvic tension

• People in menopause noticing changes in bladder control

• Individuals with pelvic pain or discomfort

• Anyone feeling disconnected from their core

• People preparing for surgery or recovering afterward

If you have a pelvis, you have a pelvic floor — and it deserves care.

The emotional side of pelvic health

Pelvic floor concerns can feel deeply personal. Many people carry embarrassment, frustration, or even shame around these symptoms.

But here’s something important to remember: There is nothing wrong with you.

These issues don’t mean your body has failed you. They simply mean your body needs support.

Pelvic floor physiotherapy offers a space where you can talk openly, ask questions, and feel heard — often for the first time about something you’ve been quietly dealing with for years.

And that alone can be incredibly healing.

Real-life changes people notice

People often come in focused on one problem — like leaking — and leave noticing improvements in areas they didn’t expect.

Some common wins include:

• Feeling more confident exercising

• Better posture and core connection

• Less pain during daily activities

• Improved comfort with intimacy

• A stronger sense of trust in their body

Pelvic floor physio isn’t just about fixing a symptom. It’s about helping you feel at home in your body again.

You deserve support — not silence

If you’ve ever thought:

• “This is just part of getting older.”

• “Everyone deals with this.”

• “It’s not bad enough to get help.”

You’re not alone — but you also don’t have to keep pushing it aside.

Pelvic floor physiotherapy exists so you don’t have to manage these things quietly.

You deserve to laugh without worrying. You deserve to move with confidence. You deserve to feel supported from the inside out.