Open TikTok and you don't have to scroll very far before someone is telling everyone to "do your Kegels." Nothing too new here... There are creators insisting they're the secret to stronger orgasms, no more leaks, better erections, and generally becoming a more "optimized" sexual being, regardless of what kind of genitals you have. The vibe is: if you're not clenching your pelvic floor all day, you're doing sex wrong.

The reality though is way messier. Your pelvic floor is a complicated group of muscles that can absolutely get pissed off if you treat it like a hack.

So what do Kegels actually do, and who, if anyone, should be following along with KegelTok?

"A kegel exercise is when someone contracts and then relaxes their pelvic floor muscles," says Dr. Rachel Gelman, PT, DPT, CSC, a pelvic floor physical therapist. That's it. No magic spell, just a squeeze and a release.

Those muscles sit at the base of the pelvis, and everyone has them -- people with vulvas, people with penises, and everyone across the gender spectrum. They help support your pelvic organs, control pee, poop, and gas, and work with your abs, diaphragm, and back as part of your core.

"All genders have a pelvic floor, so a Kegel is the same movement for everyone; the only difference is usually how we cue someone to engage these muscles," Gelman explains. For someone with a penis, she might say "pulling their penis up and in," while for someone with a vagina, she may cue "closing their vaginal opening." The classic "think about stopping the flow of urine or stop passing gas" also targets the pelvic floor -- though she's clear that actually practicing Kegels while peeing shouldn't become a habit.

Dr. Kristen Lettenberger, a Doctor of Physical Therapy and Certified Strength and Conditioning Specialist, zooms out even more: "The pelvic floor is the base of your core, working alongside your abdominals, deep abdominals diaphragm, and back muscles to create stability and pressure management and support throughout your entire body." It goes past your "down there muscles" to part of the system that stabilizes you when you breathe, laugh, lift, run, or exist upright.

Some are setting themselves up for success. If you want to actually work on your Kegels instead of pretending you're doing them while doom-scrolling, the LELO KegelSmart 2 is one of the few gadgets that makes the whole thing idiot-proof. This little device basically moonlights as a personal trainer for the muscles you forget you have. It uses built-in sensors to gauge your pelvic-floor strength and then serving up a custom routine that meets you where you are (no shame, no guesswork). It guides you with vibration cues so you're contracting and releasing at the right times, instead of clenching random muscles and hoping for the best. In five minutes a day, you're actually building strength that supports bladder control, core stability, and yes, better sex -- without the awkwardness of trying to DIY it.

But it's still important to note: Kegels are marketed like a universal sex upgrade, especially for people with vulvas: get "tighter," be "better," save your relationship. Gelman sees what that mindset does when it collides with actual anatomy.

"A pelvic floor can be both tense and weak, and that is often what I see in my practice," she says. If the muscles are stuck in a shortened, clenched position, they don't have room to contract more, which makes them functionally weak. Her analogy: imagine your hand is stuck in a fist and you're told to squeeze a ball to "get stronger." The problem isn't strength; it's that your hand can't open.

"So if we think about the pelvic floor muscles, if they are tense or overactive, we likely don't want to start trying to contract them further, but instead help someone learn how to relax them," she explains. People who already have pelvic pain, painful penetration, painful orgasms, trouble going to the bathroom, or a constant sense of tension can end up worse when they jump into a high-rep Kegel routine. "Many times people start doing Kegel exercises and notice their symptoms worsen, likely because they are contributing to the underlying tension."

Lettenberger says that's exactly why the "Kegels for everyone" approach is off. "Kegels have been positioned as a one-size-fits-all solution, but they're really only meant for specific situations," she says. They can help people with a genuinely hypotonic (too weak) pelvic floor -- think true muscle weakness after childbirth or surgery, certain kinds of stress incontinence, or mild prolapse. But "some people have a hypertonic pelvic floor, which means muscles that are already too tight and can't relax properly," and in those cases, more Kegels just pour gasoline on the fire.

Here's the fun part (fun for physical therapists, not for you): two people can have the exact same symptom for completely different reasons.

One person leaks when they sneeze because their pelvic floor really is too weak and needs strengthening. Someone else leaks because their pelvic floor is high-tone and overactive, can't lengthen under pressure, and is already clenching for dear life. The symptom -- leaks, in this case -- is the same while the treatment is basically opposite.

"To be honest, I give traditional Kegels to fewer than 10% of the people I see in person and virtually on any given day," says Dr. Laura Glazebrook, PT, DPT, a pelvic floor therapist who also specializes in scoliosis and spinal conditions. Straight-up Kegels mostly go to people with clear, isolated muscle weakness, like a recent surgery or childbirth. "Most people who come in to see me for issues like leaking, chronic low back or genital pain, or sexual dysfunction (yes, pelvic therapy can treat that too!) actually are at risk of worsening their symptoms by doing traditional Kegels," she says.

Instead, their plans are often about restoring normal tension and movement: teaching the pelvic floor to relax with the breath, strengthening hips and core so those muscles stop dumping work into the pelvic floor, and sometimes doing scar tissue or fascia work to free up areas that are yanking on the pelvis.

"All told, because of the nuance surrounding this topic, I spend most of my day telling the people in front of me that Kegels were intended for the smallest subset of people for a very particular issue (straight pelvic floor muscle weakness), and that 'squeeze all day' mentality will likely cause far more issues than it solves," Glazebrook says.

There's another reason blanket Kegel advice is sketchy: your nervous system. The pelvic floor is especially sensitive to stress and "fight or flight" responses. If you're living in a chronic "everything is on fire" state, your pelvic floor muscles often mirror that by gripping.

Glazebrook points out that research shows the pelvic floor is particularly vulnerable to that protective response, which is why some people develop pelvic pain or chronic tension after things like traumatic medical procedures or other pelvic trauma. In that context, "just doing more Kegels" can be the worst thing you could do: you're asking an already-overprotective system to clamp down harder.

And then there's the cultural sex messaging layered on top of all this. Gelman says the "tighter is better" narrative, especially aimed at women, queer folks, and trans and nonbinary people, acts like one exercise is the key to good sex. That ignores literally everything else -- desire, emotional safety, sleep, stress, whether the kind of sex you're having is even what your body likes.

"Someone could have the strongest pelvic floor muscles, but if they are stressed out about something at work or they haven't slept more than 3 hours because their baby keeps waking them up, their olympian level pelvic floor muscles won't really matter because their brain is not going to be in a sexy state of mind," she says.

If you have access, all three experts basically beg you to see a pelvic floor provider -- PT/physio, pelvic-trained OT, or another clinician -- before you decide you're a Kegel person. They can actually assess whether your pelvic floor is weak, overactive, poorly coordinated, or just trying to compensate for something happening in your hips, spine, posture, or nervous system.

If that's not happening anytime soon, there are still safer entry points than clenching along with TikTok.

First, start with breath, not brute force. The pelvic floor should "move with the diaphragm when we breathe," as Gelman notes. Slow, diaphragmatic breaths where your ribs expand on the inhale and soften on the exhale can help the pelvic floor naturally relax and lift, instead of yanking it up as hard as possible.

Then, take notice of what's actually working. A lot of people think they're doing Kegels but are really just squeezing their abs, butt, or inner thighs and holding their breath. If your jaw is tense, your butt is clenched, and your stomach feels rock-hard, you're recruiting everything except what you think you're training.

And always pay attention to how you feel after. Some red flags that your DIY Kegels are not it:

At that point, the move is to stop and get evaluated, not double down.

If the pelvic pros could hijack TikTok's Kegel discourse, they'd make it much less viral and way more honest.

Gelman's version is basically: Kegels "are not that cool," tighter is not always better, and "there are so many other options" to improve pelvic floor and sexual health -- including relaxation, better pooping posture, masturbation, and addressing stress, sleep, hormones, and relationships.

And Glazebrook would love people with complex bodies -- scoliosis, hypermobility, chronic pain -- to know that their pelvic floors don't exist in a vacuum, and that any plan that ignores the rest of their body is missing the point.

Your pelvic floor isn't a TikTok challenge or a moral test of how "good in bed" you are. It's a group of muscles trying to help you stand up, hold in pee until you get to a bathroom, and maybe have a little fun. If you want to do something nice for it, you might start by giving it permission to finally relax for a change.