Isolated pelvic floor strength isn’t the key to pelvic health.
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In Part 2 of the Great Kegel Debate, we’re taking a firm stance: we are anti-Kegel—at least in the way they’ve traditionally been used in pelvic health.
Why?
The biggest reason is simple:
👉 Isolated pelvic floor strength doesn’t predict symptoms.
We see it all the time:
✔️ Patients with significant weakness who have zero symptoms.
✔️ Patients with strong pelvic floors who are struggling with severe dysfunction.
If strength doesn’t correlate with symptoms, why would we make it the foundation of pelvic health treatment?
This isn’t about throwing out Kegels entirely—it’s about using them in context.
We believe:
💡 "Someone could need pelvic floor strengthening…AND it's not the most important thing to do at that time."
💡 "You can have significant weakness and poor recruitment in the pelvic floor…AND have the pelvic floor be so functional in the system that you have no symptoms at all."
💡 "You can have a muscle group with volitional control…AND have that not be the primary way it works in real life."
💡 "Something can be proven effective in the literature…AND there can still be a better way to do it."
💡 "We can value what research says…AND realize research always lags behind (often by decades) clinical practice."
💡 "There are times when Kegels are incredibly important…AND these times are rare and the exception that proves the rule."
We also share why testing voluntary pelvic floor strength at the initial evaluation can lead us down the wrong road—and what we recommend doing instead.
P.S. – Not Your Mama’s Kegels – Registration Opens Next Monday!
If you want to learn how to strengthen the pelvic floor more functionally and within the whole system, registration for Cohort #3 of Not Your Mama’s Kegels opens next Monday!
Nearly 600 providers have already gone through the course to transform how they approach strengthening—and registration will only be open for 3 days.
Get all the details at www.pelvicptrising.com/kegels, and watch your inbox next Monday (3/10) when registration officially opens!
Learn more about pelvic health with our Clinical Courses
All of the Rising clinical courses are designed to:
Challenge the way you think
Make you more confident in your clinical practice.
Allow you to go-at-your-own pace (all online!)
Let you go back to your work: you'll have lifetime access to the lectures and handouts. Check out all the clinical courses we offer (www.pelvicptrising.com/clinical).
Curious about private practice? Check out our Business Resources
We've now helped more than 200 cash-based pelvic health practices start and grow.
We want to make sure you're building a business that works for you (instead of vice-versa) and actually enjoy the process along the way!
See all the business resources we offer (www.pelvicptrising.com/business), tailored specifically to pelvic health!
Nicole Cozean, PT, DPT, WCS
Founder of Pelvic PT Rising and PelvicSanity Physical Therapy in Southern California.
Dedicated to forever changing pelvic health with online clinical courses to help you be more confident in your practice and business resources to help start and grow pelvic health businesses.
Jesse Cozean, MBA
Co-founder of the Pelvic PT Rising and the Rising Podcast.
Jesse uses his business experience to help pelvic health business owners start and grow their practices so they can build a practice that truly works for them. From website design, SEO, conversions, marketing, finance and money mindset, he wants to make the process of owning your own practice easier and fun.