Why Kegels Alone Don’t Always Work

The Revelation That Changed My Relationship With My Body

Picture this: You're six months postpartum, finally feeling ready to get back into running. You lace up your shoes, step outside, and within the first few strides, you feel it – that uncomfortable sensation like your vagina is literally falling out of your body.

This was my reality. And like so many women, I thought something was fundamentally wrong with me. I convinced myself that running just "wasn't for me anymore," that my body had permanently changed in ways that would forever limit what I could do.

If only i'd known what was actually happening in my body. If only I'd understood the truth about my pelvic floor – not the oversimplified version we're usually given, but the real, complex, fascinating system that it actually is.

Understanding the Pelvic Floor: More Than Just Muscles

Here's what most of us were taught about the pelvic floor (if we were taught anything at all):

"It's that muscle down there. Just do your Kegels. Squeeze and release. Problem solved."

This reductive explanation has led millions of women to believe their pelvic floor is just one simple muscle that they can "fix" with a few daily “squeezes”. But this couldn't be further from the truth.

Your pelvic floor is NOT just one muscle.

It's actually a sophisticated, multi-layered system of muscles, ligaments, fascia, and connective tissues all working together like an intricate hammock to support your entire pelvic region. This hammock is literally what's keeping your bladder, uterus, and rectum from slipping down and out of your body.

Let that sink in for a second...

Let's take a look at the anatomy:

Your pelvic floor is composed of multiple muscle layers:

Superficial layer: Includes muscles like the bulbospongiosus and ischiocavernosus, which are involved in sexual function and perineal stability.

Deep layer: The levator ani group (puborectalis, pubococcygeus, iliococcygeus) provides primary support for pelvic organs. The ischiococcygeus (also called coccygeus) is part of the pelvic floor but is often considered separately from the levator ani due to its role in stabilizing the sacroiliac joint and coccyx rather than direct pelvic organ support.

Supportive Ligaments

• Uterosacral ligaments
• Cardinal ligaments
• Round ligaments
• Pubourethral ligaments

These ligaments work with the muscles to create a comprehensive support system that maintains the proper position of your pelvic organs.

Fascial Connections

The fascia (connective tissue) creates a web of support that connects your pelvic floor to your deep abdominal muscles, diaphragm, and spinal stabilizers. This is why pelvic floor dysfunction often shows up as back pain, hip tension, or breathing issues.

Nerve Pathways

The pudendal nerve, along with branches from the sacral plexus, provides sensation and motor control to this entire region. When these neural pathways are disrupted (through birth trauma, surgery, or chronic tension), the entire system can malfunction.

It's Not Just About Strength...

Understanding your pelvic floor as a complex system rather than a single muscle explains so much about why simple approaches often fail:

Why Kegels Alone Don't Always Work

If your issue is with the ligamentous support system, or if your muscles are already too tight, doing more Kegels is like trying to open a stuck jar lid by twisting it even tighter.

Why Symptoms Seem Unrelated

When I felt like my vagina was falling out during running, it wasn't just a "pelvic floor problem" – it was a sign that this entire hammock system wasn't coordinating properly with my breathing, core stability, and impact forces.

Why Hormonal Changes Affect Everything

Estrogen receptors are found throughout this entire system. During pregnancy, postpartum, and perimenopause, changing hormone levels affect not just the muscles, but the ligaments, fascia, and nerve sensitivity too.

The Importance of Breathing

Here's what makes this even more fascinating: your pelvic floor doesn't work in isolation. It's part of what we call the "deep core system" – a coordinated team that includes:

• Your diaphragm (primary breathing muscle)
• Your pelvic floor (the hammock we've been discussing)
• Your transverse abdominis (deepest abdominal muscle)
• Your multifidus (deep spinal stabilizers)

These four components are designed to work together in perfect coordination. When you breathe in, your diaphragm descends, your pelvic floor lengthens slightly, and your deep abdominals expand. When you exhale, your diaphragm rises, your pelvic floor lifts, and your transverse abdominis gently engages.

This pressure system is the foundation of all functional movement – from picking up your child to lifting weights to simply standing up from a chair.

When this intricate hammock system gets weak, dysfunctional, or uncoordinated, you might experience:

• Prolapse symptoms (that falling-out feeling I experienced)
• Stress incontinence (leaking when you laugh, sneeze, or exercise)
• Urgency (sudden, intense urges to urinate)
• Pain during intercourse
• Lower back pain
• Hip tension
• Constipation
• That heavy, pressure sensation

But the good news is that this coordinated system can be retrained, strengthened, and restored at virtually any age or stage of life!

Working WITH Your Pelvic Floor:

Understanding your pelvic floor as the complex system it truly is changes everything about how you approach healing and strengthening:

Release Before You Strengthen

Many women need to learn how to properly relax and lengthen their pelvic floor before they can effectively strengthen it. Just like any muscle group, if it's chronically tight, it can't generate appropriate force when needed.

Coordinate Before You Challenge

Before adding load or intensity to your workouts, you need to reestablish the coordination between your breathing, core, and pelvic floor. This isn't about doing more reps – it's about rebuilding the neural pathways that control this system.

Address the Whole System

Isolated pelvic floor exercises have their place, but lasting change comes from addressing how your pelvic floor coordinates with your breathing, posture, and movement patterns.

Respect Your Hormonal Reality

Your pelvic floor function changes throughout your menstrual cycle, during pregnancy and postpartum, and through perimenopause. Working with these changes rather than against them accelerates your progress.

A Simple Exercise:

1. Sit on an inflatable pilates ball with your feet tucked underneath you and your knees apart, (or sit tall on a chair if this doesn’t feel available to you)
2. Place your hands on your lower ribs
3. Inhale slowly and deeply through your nose, expanding your ribcage in all directions
4. As you exhale, imagine your pelvic floor gently lifting up and away from the ball (or chair) like an elevator from the ground floor to the first floor (not all the way to the top!)
5. On your next inhalation, and as the ribcage expands, imagine your pelvic floor lowering back towards the ball.
6. Focus on the coordination between your breath and this gentle lifting and lowering.
7. Exhale on the lift, inhale on the lower
8. Practice for 10 breaths, 2-3 times daily
9. Note: if doing this causes discomfort or a strained sensation in your pelvic floor, (or even if you can’t feel it at all) this could be due to hypertonicity. Stay tuned because we’ll talk about this in a separate post.

This simple practice begins to reestablish the connection between your brain and this complex system – the foundation for all other progress.

The Knowledge That Changes Everything

When I finally learned the truth about my pelvic floor – that it wasn't broken, just uncoordinated – everything changed. I wasn't destined to live with limitations. I didn't have to accept dysfunction as my new normal.

With proper understanding and progressive training, I not only returned to running but discovered I could be stronger and more functional than I'd ever been before.

Your pelvic floor isn't just one muscle you need to squeeze harder. It's a sophisticated system that deserves to be understood, respected, and properly supported.

This understanding is the first step toward reclaiming your body and your confidence!

Whether you're navigating postpartum recovery, cycling through hormonal changes, or experiencing the shifts of perimenopause, understanding your pelvic floor as the complex system it truly is opens the door to real, lasting change. Your body isn't broken – it just needs the right approach to function optimally again.

Ready to dive deeper? This foundational understanding is just the beginning. In my comprehensive programs – The Mama Method, The Sync Method, and The Meno Method – we build upon this knowledge with progressive, science-backed approaches tailored to your specific life stage and hormonal reality.

Because when you understand how your body actually works, you can work with it instead of against it. And that makes all the difference.