The piece of advice that my clients find most surprising in my practice revolves around a fundamental principle: before we strengthen your pelvic floor, we focus on lengthening it. In fact, strengthening might not even be necessary in certain cases. 

Allow me to explain.

Pelvic floor muscles function much like any other muscles in our bodies; there’s a delicate balance between their length and tension. Muscles perform optimally and generate the most force when they are at an ideal midpoint length. Picture it as finding the Goldilocks position—not too short and not too long. When they deviate from this balance, either becoming too short or excessively stretched, they lose their efficiency and have less power to generate a strong contraction. 

While many people are aware that their pelvic floor muscles might be weak if they experience symptoms like urinary incontinence, pelvic organ prolapse, or increased urinary urgency/frequency, what they might not realize is that the weakness could be due to tight or shortened pelvic floor muscles. 

Several factors can lead to pelvic floor muscles becoming tense, including muscle imbalances, compensation patterns, postural misalignment, childbirth, bladder/bowel habits, breathing patterns, trauma, or stress and anxiety. Emotions, stress, and anxiety often manifest in the pelvic floor through a heightened sympathetic nervous system which can cause the muscles to become tight over time. The pelvic floor is a topic that is rarely addressed in healthcare settings or society at large. However, when it does come up, the most commonly known exercise associated with it is the Kegel – assuming the muscles are long and weak and need to be strengthened. Contrary to popular belief, this exercise isn’t necessary for everyone.

In cases where the pelvic floor muscles are tight and weak, the most effective approach is to learn how to lengthen these muscles, returning them to their ideal Goldilocks state. Once achieved, pelvic floor muscle contractions become significantly stronger, and symptoms can begin to alleviate in certain cases. 

The key to releasing pelvic floor tension lies in diaphragmatic breathing exercises. As you take a deep diaphragmatic inhale, your diaphragm descends, elongating your pelvic floor muscles. This enables the pelvic floor muscles to move through their entire range with fluidity, contracting and lengthening seamlessly. Developing this awareness also helps you recognize moments during the day when you might inadvertently tense these muscles. These ‘pelvic floor check-ins’ serve as corrective measures—while perfection isn’t always attainable, mindfulness and adjustment certainly make a difference. 

If you’re experiencing any pelvic floor symptoms, I urge you not to rush into kegel exercises. Instead, seek an assessment from a pelvic health physiotherapist who can guide you in releasing the tension in your pelvic floor muscles. Understanding how to elongate these muscles might be the key to resolving your discomfort. Remember: we need to learn to lengthen before we can strengthen. 

If you have any questions or are curious to understand if pelvic health physiotherapy is right for you, feel free to book a complimentary discovery call to learn more.

Flourish is a beautiful physical and online space for women and mothers led by a team of experts in women’s health collaborating together. Our passion is to support women to achieve their peak level of physical and mental health so they can effectively make their impact on the world. Nisha Patel is one of our two Physiotherapists, specializing in pelvic health at every stage.