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Kegel exercises for women are powerful, but I believe we’ve been teaching only half the story. A true Kegel isn’t just a squeeze. It’s a lift and a let-go. After 21 years working in pelvic health and helping 22,000 women, I’ve learned that the order matters because some pelvic floors need to release before they’re ready to strengthen.
By Isa Herrera, MSPT, CSCS
I want to say something right at the beginning that may surprise you.
I love Kegels.
I teach Kegels. I’ve taught them for more than two decades. I’m not interested in joining the internet chorus telling women to throw away an exercise that can be incredibly powerful.
But I do believe we’ve oversimplified the Kegel.
Most women were taught some version of this:
Squeeze.
Hold.
Repeat.
And when that doesn’t seem to be giving you what you hoped for, the answer is often more. More squeezes. Longer holds. Another Kegel workout. Another video.
But there’s a question that has to come first:
What is your pelvic floor doing before you ever ask it to squeeze?
That question changes everything.
Because a Kegel isn’t simply a squeeze.
It’s a lift and a let-go.
And after working with 22,000 women, I’ve become convinced that the order in which we train those two abilities matters just as much as the exercise itself.
That’s especially important during and after menopause, when so many women are navigating changes down there while also being told that leaking, pressure, discomfort or changes in intimacy are simply part of getting older.
I went through menopause myself at 41 and 42. I experienced dryness, leaking and pain.
I know what it feels like when the body you trusted suddenly seems to be speaking a language nobody taught you.
So I want to teach you that language.
Sometimes the issue isn’t that you need more Kegels. Your pelvic floor may need a different starting point.
Think about making a fist.
Close your hand tightly.
Now imagine keeping it clenched all day.
If I wanted that hand to become stronger, would my first instruction automatically be, “Squeeze harder”?
Probably not.
First, I’d want to know whether you could actually let go.
Your pelvic floor deserves the same curiosity.
Some pelvic floors are underactive and benefit from strengthening. Others may be carrying more tension than we realize. And sometimes there can be a combination of patterns.
That’s why two women with similar symptoms may not benefit from beginning in exactly the same place.
This is also why I don’t want you judging your pelvic floor by whether you leak when you sneeze or feel pressure or heaviness.
Your symptoms are information.
They aren’t your identity.
And they don’t tell us the entire story about what those muscles are doing.
Kegel Tension Syndrome is my name for a pattern I see when a woman’s pelvic floor is already gripping and she keeps focusing primarily on more squeezing.
I want to be careful here.
I’m not telling you that Kegels are the problem.
I’m telling you that not every pelvic floor starts in the same place.
Your body may have learned to hold tension for all kinds of reasons over the years. Stress. Bracing. Posture. Pregnancy. Birth. Surgery. Pain. Habits. The way you breathe and move.
Sometimes holding becomes so familiar that you don’t even recognize it as holding anymore.
That’s why this line from my book Ending Female Pain remains so important to me. Letting go “is the hardest exercise to do because many women are not even aware of the tension” they are holding.
That changes the conversation.
Instead of asking only:
How strong is my pelvic floor?
I want women asking:
Can my pelvic floor move through its full range?
Can it respond?
Can it lift?
And can it let go?
That’s a much more intelligent way to think about pelvic floor exercise.
A Kegel has two sides: the contraction and the release. I call that letting-go side the reverse Kegel.
Most women know the first half.
Very few were ever taught to pay attention to the second.
Try something with me right now.
Don’t perform an exercise.
Don’t try to fix anything.
Just notice.
Are you clenching your jaw?
Are your shoulders lifted?
Are you holding your belly in?
Are your buttocks tight?
Are you holding your breath?
And what happens when you simply give your body permission to soften?
That noticing matters.
Because your pelvic floor doesn’t live alone.
It’s part of you.
This is one reason I’ve spent so much of my career moving women away from the idea that pelvic health is one isolated muscle that simply needs to become stronger.
Your body is a connected system.
And sometimes the most powerful first step isn’t asking your body to work harder.
It’s understanding what it’s already doing.
In Female Pelvic Alchemy, I wrote:
“Not all goddesses are created equal. Some need to release and let go…”
I still believe that.
One woman may be ready to build strength.
Another may need to reconnect with release.
Another may eventually work with both.
The question isn’t whether Kegels are good or bad. The question is where your body should begin.
And that’s the part I don’t want you trying to figure out by stitching together 20 random videos on the internet.
A thoughtful Kegel workout should support a pelvic floor that can respond, lift and let go, not simply squeeze on command.
That distinction is enormous.
Pelvic floor strength matters.
So does coordination.
So does awareness.
So does your ability to release.
I’ve met so many women who are trying incredibly hard.
They’ve read the books.
They’ve watched the videos.
They’ve done the pelvic floor exercises for women they found online.
And when their bodies don’t respond the way they expected, they quietly decide something must be wrong with them.
I want you to replace that thought with a better question:
What if I’ve simply been missing information about my own body?
That’s a very different place to begin.
It replaces judgment with curiosity.
And curiosity gives us somewhere to go.
This is why I don’t believe pelvic floor training should begin with an exercise prescription.
It should begin with understanding your starting point.
Once you understand that, strengthening becomes more intelligent. Release becomes more intelligent. Your entire approach becomes more personal.
And this is exactly where I want to take you next.
If this article has you thinking, “Isa, how do I know where my body should start?”, that’s what I want to help you understand inside my free live Pelvic Floor CPR Masterclass.
CPR is the framework I created around three stages:
Remove. Repair. Rejuvenate.
I’ll take you deeper into how I think about pelvic floor patterns and help you understand why a one-size-fits-all approach can leave women endlessly searching for the next exercise.
The live classes happen:
When you attend live, you’ll also receive the workbook and be able to join my Epic Q&A, where I’ll be doing hot seats and answering questions.
And yes, we’ll have some Rootganic supplement giveaways too.
But what I most want you to walk away with is something much bigger:
A new understanding of your body.
Because you shouldn’t have to keep guessing.
As I wrote in Female Pelvic Alchemy, “at the end of the day you are the one in charge.”
I want to help you become the Chief Health Officer of your own body.
Not necessarily. I teach Kegels and believe they can be an important pelvic floor exercise. What matters is understanding whether strengthening is the right starting point for your body and whether you’re also allowing the pelvic floor to fully let go.
Symptoms alone can’t tell you exactly what your pelvic floor muscles are doing. Pelvic floor tension can show up differently from woman to woman, which is one reason I encourage women to move beyond labeling themselves as simply “strong” or “weak.”
A reverse Kegel is the letting-go or release side of pelvic floor training. I think of it as the other half of the Kegel because healthy pelvic floor function isn’t only about contraction. It also includes the ability to release.
Kegel Tension Syndrome is the term I use for a pattern I’ve observed when a woman’s pelvic floor is already gripping while her pelvic floor training remains focused primarily on more squeezing. It isn’t a medical diagnosis. It’s a framework I use to help women understand why their starting point matters.
Menopause can bring changes that affect how a woman experiences her pelvic floor, bladder and lady parts. That doesn’t mean you should assume every change is “just aging.” I want women to look at their individual starting point rather than automatically doing more of the same exercise.
Isa Herrera, MSPT, CSCS, is a pelvic floor physical therapist, author and founder of Rootganic and Pelvic Pain Relief. For 21 years, she has dedicated her work to helping women understand their pelvic health and become active participants in their own care.
After experiencing her own pelvic health challenges during menopause, Isa made it her mission to give women the education, tools and language she wished every woman had.
Her philosophy is simple:
Your body isn’t something to fight.
It’s something to understand.
And when you understand it, you become powerful.
These statements have not been evaluated by the Food and Drug Administration. This content is educational and is not medical advice.
Isa Herrera, MSPT, CSCS is a licensed physical therapist, international best-selling author, and a leading pelvic floor and women's health specialist.
She holds a BA in Psychology and Biology from Fordham University and a Master of Science in Physical Therapy from Hunter College.
Over the course of her career, Isa has helped more than 21,000 women heal from pelvic floor dysfunction, vaginal pain, incontinence, and intimacy challenges.
She pioneered integrative modalities including Maya Abdominal Massage, Low Level Laser Therapy, Sound Healing, and Andean Energy Techniques at Renew Physical Therapy, her NYC-based healing center, where she has practiced since 2005.
Isa is the author of five books on pelvic health, including the international best seller Female Pelvic Alchemy and Ending Female Pain: A Woman's Manual.
She is the founder of PelvicPainRelief.com, an online school dedicated to helping women and health professionals access evence-based pelvic floor education.
