A systematic review published in 2022 in Sexual Medicine Reviews, led by Daniëlle van Reijn-Baggen from the Leiden University Medical Center, showed that focused pelvic floor physical therapy emphasizing relaxation rather than strengthening was effective for patients whose pelvic floor muscles remained tense rather than weak, addressing their symptoms. This result runs counter to the majority of statements about the pelvic floor in ordinary health material, where the usual assumption is to ‘squeeze more’.
Why “squeeze more” isn’t always the answer
Kegel exercises are based on a simple principle: contract the pelvic floor, hold it, then relax it, and repeat. In the case of a pelvic floor that is actually weak, this method is effective. A randomized controlled trial carried out by Grace Dorey and published in BJU International showed that structured pelvic floor training cured erectile dysfunction in 40% of men and resulted in meaningful improvement in an additional 35.5%.
A muscle that is already in a state of partial contraction does not react to additional contraction in the same way as a weak one; instead, it behaves like any muscle that has been overused—showing a reduced range of motion, less blood flow, and reduced function rather than increased function. A randomized trial conducted in 2012 and published in the Journal of Urology, led by Mary FitzGerald, compared manual therapy designed to release tender and taut pelvic floor tissue with a general massage control. The group that received the targeted release treatment showed a significantly greater improvement, thus demonstrating that a tense pelvic floor responds to relaxation rather than to further tightening.
Reverse kegels are the same core idea in a form you can practice at home.
What reverse kegels actually are
A reverse Kegel involves intentionally stretching and relaxing the pelvic floor muscles, which is the opposite of a regular Kegel contraction. Rather than pulling the muscles up and in, you allow them to soften and descend, producing a feeling similar to gently bearing down without strain. Physical therapists refer to this as “down-training,” and it is a standard component of pelvic floor rehabilitation when the aim is to relieve tension rather than build strength.
The main aspect of the technique is breathing. As the diaphragm moves down during inhalation, the pelvic floor should also move down; and when you exhale, both should rise again. If the pelvic floor remains contracted, this coordination is disrupted, which is why so much of the reverse kegel exercise is, in fact, a breathing practice designed to reestablish that up-and-down pattern rather than merely being a separate muscle exercise. Clinical advice from organizations such as the pelvic health section of the American Physical Therapy Association recommends this approach, which is sometimes referred to as diaphragmatic or belly breathing, as the standard starting point for pelvic floor down-training, before carrying out any more specific release exercises.
How to try reverse Kegels
This is general, educational guidance, not a clinical protocol. Assume a relaxed position by lying on your back with your knees bent, or by sitting comfortably with your feet flat on the floor, and keep your belly soft. Inhale slowly through your nose and let your abdomen expand rather than your chest; put a hand on your stomach, and as you do so, imagine the pelvic floor relaxing and dropping as the belly rises. Breathe out without tightening. When you are exhaling, allow all parts to return to a neutral, resting position rather than actively squeezing them back up. The aim during exhalation should be relaxation, not performing Kegel exercises. up. The goal on the exhale is release, not a kegel.
- Keep the soft state for a few breaths, then remain in that relaxed, lengthened position for three to five breaths before returning to your normal activities.
- Repeat it for a few minutes, a few times each day; consistency is more important than the length of time spent. It is faster to establish the pattern with short, regular sessions than with occasional, longer ones.
Signs it’s worth easing off standard kegels
Several patterns point to tension rather than weakness as the more important issue. One sign is that Kegels appear to make matters worse over time. Another is a general feeling of tightness, heaviness, or tension in the pelvic region, which does not disappear when one rests. So too is it the case that urination or a bowel movement seems to require effort or feel incomplete, rather than being urgent or resulting in a leak — this pattern is different from the one that strengthening exercises are designed to correct. A fifth is discomfort that develops after prolonged sitting.
You cannot diagnose anything based on any of these alone; they just indicate that you should reduce your strengthening exercises and notice how the area actually responds, not that they provide a basis for self-diagnosis.
When to see a specialist
If ongoing tension, pain, or discomfort fails to improve with simple breathing and relaxation techniques, it is advisable to see a pelvic floor physical therapist or a doctor. The American College of Obstetricians and Gynecologists considers pelvic floor physical therapy to be a standard treatment for discomfort in the pelvic area, and a specialist is able to determine, something that can’t be established from a written description alone, whether the muscles are actually tight, weak, or otherwise, and can then develop a treatment plan based on that finding. Moreover, a physical examination can identify instances where both tension and weakness are present in different sections of the same muscle group, something that general advice of this kind cannot detect from the outside. While reverse kegels are a sensible initial approach for general tension, they should not be used as a replacement for assessment if symptoms persist.
Relatio and pelvic floor training
Relatio is an app grounded in scientific evidence that offers services for relationships and intimate wellness. Its Men’s Intimate Wellness Program features guided pelvic floor training, which includes both contraction and release exercises, delivered as a structured daily program rather than a one-size-fits-all routine. The sessions consist of audio-led exercises and include progress tracking, so you don’t have to work out on your own to figure out the difference between ‘getting stronger’ and ‘releasing tension’. If you want a more general view of how pelvic floor exercises differ according to sex and aim, refer to our guide on Kegel exercises for men versus women. Pelvic floor tension can also occur together with other factors important for intimate wellness that are worth understanding, such as the relationship between testosterone and desire as men age.
FAQ
What exactly are reverse kegels? A reverse kegel involves intentionally lengthening and relaxing the pelvic floor muscles, which is the opposite of the kind of contraction used in a normal kegel. It is generally performed through breathing, with the pelvic floor softening and sinking during inhalation.
What are the signs that my pelvic floor is too tight? These signs include a persistent feeling of tightness or bracing in the pelvic region, Kegels that worsen your symptoms over time, or difficulty completely emptying your bladder or bowel. A pelvic floor physical therapist can verify this through a physical examination; however, the signs alone do not constitute a diagnosis.
The article is provided for general informational purposes only and should not be regarded as medical advice, a diagnosis, or a treatment plan.
