Tight and weak pelvic floor muscles might sound contradictory – but it’s a surprisingly common, often misunderstood, and frequently overlooked condition among women of all ages. Understanding how this dual issue affects your body is the first step toward effective treatment and lasting recovery.

Can You Have a Tight and Weak Pelvic Floor at the Same Time?

Yes – you absolutely can have a tight and weak pelvic floor at the same time. In fact, many women suffer from this dual dysfunction without even realising it. Here’s how it works:

A tight pelvic floor means your muscles are in a state of constant tension or overactivity.
A weak pelvic floor means the muscles lack the strength or endurance to support your organs and control bladder or bowel function.

When your muscles are always contracted or unable to fully relax, they become fatigued, shortened, and inefficient – resulting in weakness.

What Causes a Tight and Weak Pelvic Floor?

Several life events and habits can lead to this condition:

Stress or anxiety, which can cause muscle clenching
Postural imbalances and overuse of abdominal muscles
Chronic constipation or straining
Trauma or scar tissue (e.g., from childbirth or surgery)
Overtraining Kegels without learning how to release the muscles

It’s important to understand that pelvic floor health isn’t just about strength – it’s also about balance, coordination, and the ability to relax.

Symptoms You Shouldn’t Ignore

Women with a tight and weak pelvic floor often report symptoms like:

Pain or discomfort during sex
A constant urge to urinate, or difficulty starting the flow
Incomplete emptying of the bladder or bowel
Pelvic pain or heaviness
Leaking despite doing regular pelvic floor exercises
Difficulty using tampons or pain during pelvic exams

If this sounds familiar, doing more Kegels may make things worse – not better.

What the Experts Say

According to the Pelvic, Obstetric and Gynaecological Physiotherapy (POGP) group, pelvic floor dysfunction often includes both overactivity (tightness) and underactivity (weakness), and the treatment should begin with a full pelvic health assessment.
Read the POGP patient guide here

The NHS also recognises that not all pelvic floor issues are solved with strengthening alone. In some cases, the muscles first need to be taught to relax.
See NHS guidance on pelvic floor dysfunction

How to Fix a Tight and Weak Pelvic Floor

Get a Specialist Assessment
Book with a pelvic health physiotherapist who can assess muscle tone and function internally and externally.
Learn to Relax the Muscles
This can involve breathwork, stretching, and biofeedback. Try diaphragmatic breathing while lying down to encourage relaxation.
Release Before Strengthening
Always learn how to let go of tension before you begin any strengthening programme.
Tailored Exercises
Mothercore’s expert therapists are here to guide you through stretches, pelvic drops, or internal release techniques before progressing to strengthening.
Avoid Overdoing Kegels
Kegels are not a one-size-fits-all solution – especially if your muscles are already overactive.

How Mothercore Can Help

At Mothercore, we follow best practices from the Royal College of Obstetricians and Gynaecologists (RCOG) and work only with qualified professionals.

Our digital triage helps match you with the right therapist – give it a go today.

Explore RCOG’s pelvic health resources

Final Thoughts

Having a tight and weak pelvic floor is more common than you think – and it’s entirely treatable with the right approach. Don’t assume all pelvic floor issues can be fixed with strength alone. Understanding your body’s needs is the first step toward lasting recovery.

With the right education, support, and tailored physiotherapy, most women can experience significant improvements in symptoms and quality of life.

We understand that every woman’s experience is unique, which is why our approach is personalised, supportive, and rooted in evidence-based care for long-term pelvic health.

Curious where to start? Book your first consultation today here.