Why You Still Leak Even If You’ve Been Doing Kegels (San Luis Obispo Pelvic Health Insight)

If you’ve been doing Kegels consistently—during workouts, at red lights, or guided by a pelvic health physical therapy app—and you still leak, you’re not alone. In our San Luis Obispo pelvic floor clinic, we see many people frustrated when their incontinence won’t resolve. Good news: Kegels aren’t always the full answer.

🧠 Understanding the Pelvic Floor: Weak vs. Tight

The pelvic floor is a sling of muscles supporting the bladder, uterus, and bowel. It plays a central role in bladder control, core stability, posture, and overall pelvic health. Just like any other muscle group, it can be either underactive (hypotonic) or overactive (hypertonic)—and either imbalance can lead to urinary leakage and incontinence.

1. Hypotonic Pelvic Floor: The “Too Weak” Scenario

This is what most people think of when they hear “pelvic floor weakness.” The muscles aren’t strong enough to hold urine during everyday movements such as coughing, laughing, or exercising.

Common signs:

• Leaking when sneezing, jumping, or lifting

• Pelvic heaviness or low pressure

• Difficulty maintaining pelvic floor contractions

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Even here, Kegels can be helpful—but only if done correctly. Studies show that up to 50% of people do Kegels incorrectly without professional guidance (Bo et al., 2017).

2. Hypertonic Pelvic Floor: The “Too Tight” Dilemma

Less known but equally common, an overactive pelvic floor can be chronically tense and unable to coordinate properly—leading to leakage symptoms.

Common signs:

• Leaking despite consistent Kegel routines

• Pelvic or sexual pain

• Trouble fully emptying your bladder or bowels

• Sense of clenching or tightness in hips or lower abdomen

In this case, doing more Kegels can make things worse, increasing tension and reducing coordination. You actually need release and retraining techniques—think diaphragmatic breathing, gentle stretches, and hands‑on therapy.

🎯 Why a San Luis Obispo Pelvic Floor Assessment Matters

Every body is unique. Whether your pelvic floor is hypotonic, hypertonic, or somewhere in between, a personalized pelvic health assessment by a qualified pelvic health physical therapist is essential. At Top Notch Physical Therapy in San Luis Obispo, we evaluate muscle tone, core strength, posture, and neuromuscular coordination to create a customized treatment plan. No guessing—just results.

✅ Ready to Stop Leaking and Regain Control?

Book a pelvic floor assessment with our San Luis Obispo pelvic health specialists today. Whether you're struggling with incontinence, pelvic pain, or core stability, we can help you build a stronger, more coordinated pelvic floor that truly works.

We proudly serve clients across San Luis Obispo, Paso Robles, Santa Maria, and surrounding Central Coast communities.

👉 Call us at (805) 600-3525 to book your appointment now for personalized pelvic health physical therapy to help get you leak free and back to the activities you love.