Isolated pelvic floor strength isn’t the key to pelvic health.

In Part 2 of the Great Kegel Debate, we dive deeper into why we come down firmly on the anti-Kegel side—and why we believe pelvic health is about so much more than isolated strength.

The single biggest reason? Strength has no reliable correlation with symptoms.

👉 We’ve all seen patients with objectively weak pelvic floors who have no symptoms at all.
👉 And others with strong pelvic floors who are dealing with significant dysfunction.

If isolated strength doesn’t predict symptoms, why would it be the primary focus of treatment?

We also share why we aren’t blindly rejecting Kegels—we understand both their pros and cons. In fact, we hold these two ideas at the same time:
💡 Someone could need pelvic floor strengthening… AND it’s not the most important thing to do right now.
💡 You can have weak pelvic floor muscles… AND be totally symptom-free.
💡 A muscle can have volitional control… AND still work primarily involuntarily.
💡 Something can be proven 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 Kegel exercises are incredibly important and the most effective tool for a patient...AND recognize these times are rare and the exception that proves the rule.

We also explain how testing voluntary muscle strength at the initial evaluation can lead us down the wrong treatment path—and what to focus on instead.

This is a must-listen for anyone rethinking how we approach pelvic floor strength in our evaluations and treatment!

Not Your Mama's Kegels Course - Cohort #3

We're opening up Cohort #3 of Essential Pelvic Strengthening: Not Your Mama's Kegels course, starting next Monday (3/10)! We've already had nearly 600 pelvic rehab providers go through it and get more practical and functional with their strengthening for patients.

Starting next Monday it's open for registration - get $50 off and access to an exclusive Q&A when you join this cohort! All the details at www.pelvicptrising.com/kegels

About Us

Nicole and Jesse Cozean founded Pelvic PT Rising to provide clinical and business resources to physical therapists to change the way we treat pelvic health. PelvicSanity Physical Therapy (www.pelvicsanity.com) together in 2016. It grew quickly into one of the largest cash-based physical therapy practices in the country.

Through Pelvic PT Rising, Nicole has created clinical courses (www.pelvicptrising.com/clinical) to help pelvic health providers gain confidence in their skills and provide frameworks to get better patient outcomes. Together, Jesse and Nicole have helped 600+ pelvic practices start and grow through the Pelvic PT Rising Business Programs (www.pelvicptrising.com/business) to build a practice that works for them!

Get in Touch!

Learn more at www.pelvicptrising.com, follow Nicole @nicolecozeandpt (www.instagram.com/nicolecozeandpt) or reach out via email (nicole@pelvicsanity.com).

Check out our Clinical Courses, Business Resources and learn more about us at Pelvic PT Rising...Let's Continue to Rise!