Kiddipedia
If you’ve had a baby, someone has probably told you to do your pelvic floor exercises. A midwife, your GP, your mother-in-law, an app that pings you at 3pm. Squeeze, lift, hold, repeat.
For a lot of women, that’s exactly the right advice. But here’s what doesn’t get said often enough: not every pelvic floor problem is a weakness problem. Some pelvic floors are doing too much, not too little. And if yours is one of them, squeezing harder can actually make things worse.
As a physiotherapist with a special interest in pelvic health, I see this confusion in clinic every week. A mum who has been doing her Kegels religiously for months, wondering why sex still hurts or why she still can’t wear a tampon comfortably. Nobody ever told her that a pelvic floor can be too tight.
So let’s clear it up.
What does the pelvic floor actually do?
Your pelvic floor is a sling of muscle that runs from your pubic bone at the front to your tailbone at the back. It supports your bladder, uterus and bowel, helps you stay dry when you cough or jump, and plays a big part in sexual sensation and core stability.
Like any muscle, it has two jobs: it needs to contract, and it needs to let go. We talk endlessly about the first job and almost never about the second. A pelvic floor that can’t relax is about as useful as a bicep stuck in a permanent half-curl. It might look “strong” on paper, but it can’t do its actual work properly.
Signs your pelvic floor is weak
A weak, or low-tone, pelvic floor is the version most people know about, and it’s common after pregnancy and birth. Nine months of carrying a growing baby stretches and loads these muscles before labour even starts.
Things you might notice:
- Leaking when you cough, sneeze, laugh or run – even a few drops counts
- A heavy or dragging feeling in the vagina – often worse at the end of the day or after lifting
- Reduced sensation during sex – things feel “looser” or less responsive than before
- Tampons that won’t stay put
One in three women who have had a baby experience some loss of bladder control, according to Continence Health Australia, formerly the Continence Foundation of Australia (2026). That’s common. It isn’t something you have to put up with.
Can a pelvic floor be too tight?
Yes, and this is the half of the story that rarely makes it into the mothers’ group chat. A tight, hypertonic or overactive pelvic floor holds tension all the time and struggles to fully relax, a bit like a jaw that’s permanently clenched.
The symptoms look different on this side:
- Pain with sex – stinging or burning at entry, a deep ache inside, or both
- Difficulty inserting a tampon – or pain trying
- Bladder niggles – a slow stream, feeling like you haven’t quite emptied, going “just in case” constantly, or UTI-like burning when the test keeps coming back clear. And yes, you can still leak with an overactive pelvic floor, which is one reason the two get confused
- Constipation or straining – to empty your bowel comfortably, the pelvic floor needs to relax and lengthen, and a tight one often can’t
- A persistent ache – in the pelvis, hips or tailbone that no stretch seems to reach
Why does this happen after a baby, of all times? Often it’s protective. After a perineal tear, stitches or a caesarean, the body can brace. Add broken sleep, a healing scar, the mental load of a newborn and, for some women, hormone changes during breastfeeding that can affect vaginal tissue, and you have a pelvic floor that has learned to guard.
The part that surprises people most: you can be tight and weak at the same time. A muscle that never relaxes is rarely a strong one. It’s exhausted.
Why doing more Kegels can backfire
If your pelvic floor is already overactive, piling contractions on top is like treating a cramped calf with calf raises. The muscle didn’t need more squeezing. It needed to learn how to let go first.
For a tight pelvic floor, treatment usually starts with the opposite of a Kegel: slow belly breathing, positions that help lengthen the muscles, and learning to release rather than lift. A pelvic health physiotherapist may also use manual therapy and, depending on the cause, may recommend at-home tools to continue the work between appointments. The two most common are graduated vaginal dilators and pelvic wands, used alongside education, breathing and relaxation work. I’ve put together a dedicated range for a tight or painful pelvic floor with guidance on where to start.
One rule above all: never use these tools to push through pain. Slow and gentle wins.
How do you relax tight pelvic floor muscles?
You can’t force a muscle to relax, but you can invite it. A few things I teach in clinic that you can start at home today:
- Slow belly breathing – lie down or sit comfortably with one hand on your belly and one on your chest. Breathe in through your nose and let your belly rise while your chest stays still, imagining the pelvic floor softening as the air comes in, then take a long, slow breath out. Five minutes once or twice a day does more than most people expect. Your pelvic floor moves with your diaphragm, so slow breathing is pelvic floor work, even though it doesn’t feel like exercise.
- Positions that lengthen – child’s pose, lying on your back with knees dropped out and the soles of your feet together, or a deep supported squat. A few quiet minutes in any of these gives the muscles permission to let go.
- Fix your toilet habits – sit fully on the seat (no hovering), with your feet flat on the floor or up on a small stool so your knees sit higher than your hips. Lean forward and rest your forearms on your thighs, let your belly relax completely, and breathe out slowly rather than holding your breath and pushing. Never strain. It pushes down on the pelvic floor and adds to the very tension you’re trying to release.
- Notice your clenching triggers – many women hold tension in their pelvic floor the same way they hold it in their jaw or shoulders: during the school run, over work emails, in traffic. Once you start noticing, you can practise releasing on the spot.
Gentle movement counts too. An easy walk can lower overall tension, though it works alongside the steps above rather than replacing them.
Why does sex hurt after having a baby?
Painful sex deserves its own mention because it’s so common and so rarely discussed. Some women feel a sharp or burning pain at entry, which often traces back to scar tissue, tissue dryness or protective muscle guarding. Others feel a deeper pain that only shows up in certain positions. If that sounds more like you, I’ve written a full guide to what causes deep pain during sex over on the Blossom Pelvic Health blog.
While you work on the underlying cause, comfort matters. Some couples find soft depth-limiting rings, like the Ohnut, helpful for making intimacy more comfortable, since they let you control depth together without interrupting the moment. A good lubricant can also make a real difference, particularly while breastfeeding or if vaginal tissue feels dry, sensitive or easily irritated.
What I’d ask you not to do is grit your teeth and wait for it to fix itself. Pain with sex after birth is common. Pooled research across more than 11,000 women found around one in three mothers experience it in the months after birth (Banaei et al., 2021). It’s not something you owe anyone, and it usually improves with the right help.
What actually helps a weak pelvic floor?
If your symptoms sit firmly on the weak side, such as leaking, heaviness or reduced sensation, strengthening is the right approach. Pelvic floor muscle training is one of the best-researched interventions in women’s health (Dumoulin et al., 2018). Two things make or break it:
- Technique – many women bear down when they think they’re lifting. If you’ve never had your technique checked, that’s the first step, because months of incorrect practice can reinforce the wrong pattern.
- Progression – like any strength training, the muscle needs gradually increasing challenge, not the same ten squeezes forever.
So what does a correct Kegel actually feel like? A squeeze and a lift, as if you’re trying to stop wind and slow a wee at the same time, drawing gently up inside. Your buttocks and thighs should stay relaxed, and don’t hold your breath. If your shoulders rise or you catch yourself bracing, you’re working too hard. And the release matters as much as the squeeze: let the muscles drop fully between each one. A pelvic floor that’s only ever taught to grip is halfway to becoming the tight pelvic floor we covered earlier.
For some women, pelvic floor trainers can help by providing feedback and making it easier to understand whether the muscles are actually contracting and relaxing. The right choice depends on your symptoms, technique and stage of recovery, which is why assessment and individual guidance are so valuable.
The unglamorous extras matter too: don’t hold your breath when you lift, including lifting the capsule or the toddler, sort out constipation rather than straining daily, and give it time. Muscles change over weeks and months. Give them that long.
When can you start after having a baby?
Earlier than most women think. Gentle pelvic floor activation exercises and breathing work can usually start immediately after birth, even after a caesarean, though always follow the guidance of your own care team, particularly after a complicated delivery.
The six-week check is a useful milestone, but it isn’t a magic green light. Treat it as the start of a gradual rebuild rather than a blanket all-clear. If something feels heavy, painful or just not right as you increase activity, that’s your body asking you to scale back and get assessed.
And if your baby is long past the newborn stage, you haven’t missed the window. There’s no expiry date on pelvic floor rehab.
How to tell if your pelvic floor is tight or weak
Honestly? The gold standard is an assessment with a pelvic health physiotherapist. The symptom lists above overlap, plenty of women have a mix of both, and guessing wrong can mean months of effort in the wrong direction. In Australia, you don’t need a GP referral to see one privately, and a single assessment can save you a year of trial and error.
If a clinic visit isn’t possible right now, start by paying attention to your symptoms. Pain, difficulty with tampons and trouble emptying point more towards tight. Leaking, heaviness and low sensation point more towards weak. Either way, your pelvic floor is trainable at any stage, whether your baby is six weeks or sixteen years old.
You carried and birthed a whole human. Your body did something remarkable, and it deserves better than guesswork.
References
Banaei, M., Kariman, N., Ozgoli, G., Nasiri, M., Ghasemi, V., Khiabani, A., Dashti, S., & Mohamadkhani Shahri, L. (2021). Prevalence of postpartum dyspareunia: A systematic review and meta-analysis. International Journal of Gynecology & Obstetrics, 153(1), 14–24. https://doi.org/10.1002/ijgo.13523
Continence Health Australia. (2026). Pregnancy and childbirth. https://www.continence.org.au/about-incontinence/womens-health/pregnancy-and-childbirth/
Dumoulin, C., Cacciari, L. P., & Hay-Smith, E. J. C. (2018). Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database of Systematic Reviews, (10), Article CD005654. https://doi.org/10.1002/14651858.CD005654.pub4
Jade is a physiotherapist with a special interest in pelvic health. She works clinically, combining her love of all things sports physiotherapy and pelvic health, and is the founder of Blossom Pelvic Health, an Australian online store offering physiotherapist-chosen pelvic health products, including support for pregnancy, postpartum recovery and pelvic health rehabilitation, alongside honest, evidence-based guidance.
