The Frustration: “I’m Doing Everything Right, But Nothing’s Changing!”
It is one of the most common and disheartening experiences in pelvic health recovery. You’ve diligently followed the advice, squeezing and lifting every day, only to find that you still experience that dreaded leak when you laugh too hard or a sneeze catches you by surprise. This lack of progress can make you feel like your body is failing you, but the reality is often much simpler: you might be focusing on the wrong thing. Kegels are a powerful tool, but they are just one tool in the toolbox. True continence and core function depend on a symphony of factors, and if one is out of tune, the whole system can falter. The good news is that these issues are almost always correctable. Let’s explore the most common reasons why your hard work might not be paying off and what you can do about it.
Reason #1: You’re Using the Wrong Form
This is, by far, the most common reason Kegels fail. Studies have shown that up to 50% of women perform them incorrectly based on verbal or written instructions alone. The pelvic floor muscles are internal and subtle, making them difficult to isolate without proper guidance.
Common Form Mistakes:
- Bearing Down: Instead of lifting upwards, many people push downwards, similar to the motion of a bowel movement. This actually increases pressure on the bladder and can make leaking worse.
- Squeezing the Wrong Muscles: It’s very common to compensate by squeezing larger, external muscles. Are you clenching your glutes? Tightening your inner thighs? Sucking in your stomach? If so, you’re not isolating the pelvic floor. The work should be deep and internal.
- Holding Your Breath: If you hold your breath while you contract, you are again increasing intra-abdominal pressure, which works directly against the lifting action of the pelvic floor.
The Fix: To find the right muscles, sit on a rolled-up towel or a firm surface. When you contract correctly, you should feel a gentle lift away from the surface. Your breath should be steady and relaxed. Exhale as you gently lift, inhale as you fully release.
Reason #2: Your Muscles Are Too Tight, Not Too Weak
This is a crucial concept that is often overlooked. We automatically assume leaking is a sign of weakness, but for many people, the opposite is true. Their pelvic floor is hypertonic, meaning it’s in a state of constant, low-grade contraction. It’s already tense, overworked, and exhausted.
A muscle that is always “on” cannot function properly. It lacks the range of motion to contract effectively when needed (like during a sneeze) and it can’t relax fully to allow for normal urination or bowel movements. If you have a tight pelvic floor, doing hundreds of Kegels is like trying to strengthen your bicep by holding it flexed all day—it just leads to fatigue and dysfunction.
Signs of a Tight Pelvic Floor:
- Urinary urgency or frequency
- Pain during intercourse
- Constipation or difficulty emptying your bowels
- Chronic pelvic, hip, or low back pain
The Fix: If this sounds like you, your priority should be relaxation, not strengthening. Focus on diaphragmatic breathing and ‘Reverse Kegels’—the conscious act of relaxing and lengthening the pelvic floor. Stretches like Child’s Pose and Happy Baby can also provide immense relief.
Reason #3: It’s a Coordination Problem, Not a Strength Problem
You might have a perfectly strong pelvic floor, but if it doesn’t activate at the exact right moment, it can’t prevent a leak. As we discussed in our article on ‘The Knack’, stress incontinence is often a problem of timing. The spike in pressure from a cough is instantaneous. Your pelvic floor needs to contract a split second before that pressure hits.
The Fix: Practice ‘The Knack’ consciously. Before you cough, laugh, or lift, perform a quick, strong Kegel. This trains the reflexive pathway between your brain and your pelvic floor, improving coordination so that the contraction becomes automatic over time.
Reason #4: You’re Not Working the Whole System
The pelvic floor does not work in isolation. It is part of the deep core “canister” that includes your diaphragm, transverse abdominis, and multifidus muscles in your back. If you only work on the “floor” of the canister without ensuring the “lid” (diaphragm) and “walls” (abs) are working with it, you won’t get optimal results.
The Fix: Ensure every exercise is a full-core exercise. This starts with the breath. Coordinate your exhale with every exertion (the “work” part of any exercise) to engage the entire core system together. This is a core principle of the exercises in the Pelvi Health app.
Reason #5: Your Lifestyle Habits Are Working Against You
You can do your exercises perfectly, but if certain lifestyle factors are constantly putting strain on your pelvic floor, it’s like trying to bail out a boat with a hole in it.
Common Culprits:
- Chronic Constipation: Straining on the toilet puts immense, repetitive pressure on the pelvic floor.
- Poor Posture: Slouching when you sit or stand misaligns your core canister and puts constant downward pressure on your pelvic organs.
- Bladder Irritants: For some people, caffeine, alcohol, spicy foods, or artificial sweeteners can irritate the bladder lining, leading to increased urgency and leaks.
The Fix: Address these factors head-on. Increase your fiber and water intake, be mindful of your posture throughout the day, and consider keeping a bladder diary to see if certain foods or drinks are triggering your symptoms.