When Your Body Won’t Let Go: Understanding Pelvic Floor Tension

By Amber Schmitt, OTR/L – Sustainable Pelvic Health

Sometimes the clients who walk into my office expecting to hear they’re “weak” are surprised by what we actually find.

They’ve been told to do more Kegels.

To strengthen their pelvic floor.

To squeeze and hold and build more control.

But when we slow down and really listen to what their body is doing, the story is often the opposite.

Their pelvic floor isn’t weak.

It’s holding on too tightly.

When the Body Gets Stuck in Protection

Your pelvic floor is part of your body’s protective system. When something stressful, painful, or overwhelming happens, your nervous system shifts into a protective response. Muscles brace. Breath becomes shallow. The body prepares to guard itself.

This response is helpful in the moment. It’s how we get through difficult experiences. But sometimes the body never fully gets the signal that it’s safe to soften again.

Over time, the pelvic floor can stay stuck in this protective pattern — holding tension day after day without you even realizing it.

That tension can show up in many ways:

• Pain with sex

• Constipation or difficulty emptying

• Pelvic pain or pressure

• Urinary urgency or leaking

• Low back or hip discomfort

• A feeling of heaviness or tightness in the pelvis

And because tension can look like “strength” from the outside, many people are told to do the exact thing that keeps the cycle going: more tightening.

Why “Just Do Kegels” Isn’t Always the Answer

Kegels aren’t bad exercises. For some people, they’re an important part of pelvic floor rehabilitation.

But if your pelvic floor is already holding tension, asking it to tighten more is a little like asking someone to clench their fist all day and then wondering why their hand hurts.

Healing often begins with something different. Not squeezing harder. But learning how to let go.

The Role of Breath and the Nervous System

Your pelvic floor doesn’t work alone. It’s part of a system that includes your diaphragm, your core, and your nervous system.

Every breath you take creates movement in the pelvic floor.

Every stress response can influence how those muscles behave.

If your breathing has become shallow or your body has been living in a constant state of “brace,” the pelvic floor may follow that same pattern.

One of the first things we often explore in therapy is simply how your body is breathing. Not to force anything to change — but to help your body rediscover a rhythm that allows the pelvic floor to move, soften, and respond the way it was designed to.

Relearning Safety in the Body

When pelvic floor tension has been present for a long time, the goal isn’t to force the muscles to relax. The goal is to help the body feel safe enough to release.

That might include:

• Gentle breathwork

• Movement that supports pelvic floor coordination

• Nervous system regulation strategies

• Education about how the pelvic floor actually works

• Hands-on therapy when appropriate and always with consent

Every body is different, and the path forward isn’t one-size-fits-all. But the common thread is this: healing happens when we work with the body’s protective responses instead of fighting them.

You’re Not Broken

If your pelvic floor feels tight, painful, or difficult to control, it doesn’t mean your body has failed you. It may simply mean your body has been working very hard to protect you for a very long time. And protection isn’t something we shame or force away. It’s something we listen to.

From there, we begin to gently teach the body that it doesn’t have to hold on quite so tightly anymore. And when that happens, healing can begin.