Why Leaking, Pressure, and “Tightness” After Birth Mean Your Pelvic Floor Needs More Than Kegels

Introduction: This Isn’t Just “Postpartum”—It’s a Sign Your Core System Needs a Reset

It’s one of the most common things moms say after giving birth:

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“I just feel off down there.”

“Sometimes I leak when I laugh, jump, sneeze or lift.”

“Everything feels tight but weak.”

"I am having pain with intimiacy"

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And yet, most postpartum moms are told: “Just do kegels.”

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But here’s the truth: kegels aren’t the first step for everyone postpartum. In fact, for many women—especially those with symptoms like pelvic tightness, pressure, or pain—kegels can make things worse.

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Postpartum pelvic floor dysfunction isn’t always about weakness. More often, it’s about imbalance, lack of coordination, and unaddressed tension. And before you strengthen a muscle, you need to make sure it can actually move through a full range of motion.

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In this post, we’re breaking down:

• Why kegels aren’t a one-size-fits-all solution for postpartum healing
  
  
• The difference between hypertonic (too tight) and hypotonic (too weak) pelvic floors
  
  
• What to do before pelvic floor strengthening postpartum
  
  
• How postpartum symptoms like leaking, heaviness, and pressure are signals—not something to ignore
  
  
• And yes, how postpartum ymptoms like acid reflux during running may also tie into pelvic floor dysfunction!
  
  

We’ll also show you how our Ab Rehab program inside the Natal app takes you step-by-step through rebuilding function, strength, and confidence—safely and effectively.

The Problem Isn’t Just Weakness—It’s Disconnection

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During pregnancy, your body adapts to carry a growing baby. Your pelvic floor, TVAs, and diaphragm all get pushed, stretched, or overloaded.

After birth—whether vaginal or C-section—that system doesn’t automatically self correct.

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The pelvic floor may be:

• Over-tight and guarding (hypertonic)
  
  
• Underactive and lax (hypotonic)
  
  
• Or simply out of sync with your core and breath
  
  

Pressure begins to leak out the wrong way—either down (causing leaking, heaviness) or up (causing reflux, bloating).

Hypertonic Pelvic Floor: Why Tight Doesn’t Mean Strong

A hypertonic pelvic floor is one that is too tight or overactive. It’s constantly holding tension—even when it should be relaxing.

Common signs of a hypertonic pelvic floor include:

• Pelvic heaviness or pressure
  
  
• A “tight but weak” feeling
  
  
• Pain with intercourse
  
  
• Constipation or straining to poop
  
  
• Urinary urgency without full control
  
  
• Difficulty starting a stream or fully emptying the bladder
  
  
• Lower belly bloating or poor digestion
  
  

Many women think these symptoms mean they need to “strengthen” their pelvic floor—but if the muscle is already over-engaged, adding kegels is like telling someone with a clenched jaw to bite harder.

We can't strengthen what your body won't first release. If your pelvic floor is struck in a tight state the first step is learning to lenghtnen and let go before we build strength.

So What’s the First Step? Learning to Let Go

Before you start strengthening your pelvic floor, you need to restore full range of motion.

This means:

• Learning how to inhale fully and allow the pelvic floor to expand and relax downward
  
  
• Releasing chronic tension through proper diaphragmactic breathing, pelvic floor lengthening postures, and intentional awareness
  
  
• Avoiding clenching, bracing, or sucking in the abs
  
  

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Natal’s Ab Rehab Phase 1 focuses specifically on this:

• Ab Rehab Moves: Deep Activation + Breath Work Sequence
  
  
• Core-pelvic floor coordination
  
  
• Guided mobility for lengthening and relaxing
  
  
• Nervous system down-regulation
  
  

This step is critical for anyone with hypertonic symptoms—and it’s the one most postpartum programs skip!

Hypotonic Pelvic Floor: When the Muscles Need Strength + Support

On the flip side, a hypotonic pelvic floor is underactive or overstretched.

Common hypotonic pelvic floor signs include:

• Leaking with sneezing, laughing, jumping, or running
  
  
• Pelvic organ prolapse (feeling like something is “falling out”)
  
  
• A persistent lower belly pooch
  
  
• Poor glute or core activation
  
  
• Low back instability or pain
  
  

Here, pelvic floor strengthening is appropriate—but still needs to happen in sync with breath and deep core muscles.

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In Ab Rehab, we rebuild strength from the inside out, using:

• Timed exhales to activate pelvic floor and deep core together
  
  
• Slow, intentional movement focused on alignment and control
  
  
• Posture-based strength work with progressive load
  
  

We don’t just “do kegels”—we rebuild your entire pressure system!

Why Kegels Alone Don’t Work

Let’s be clear: kegels are not bad—they’re just not always helpful on their own.

Kegels are often:

• Over-prescribed for hypertonic pelvic floors
  
  
• Done incorrectly (with bearing down instead of lifting)
  
  
• Disconnected from breath or real movement
  
  
• Too isolated to translate into functional strength
  
  

If you’re sitting in the car doing 100 kegels a day, but still leaking during squats or feeling pelvic heaviness, it’s not you—it’s the strategy. Optimizing and healing the pelvic floor must happen by addressing the whole body, both movement and breathing.

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And that’s exactly what Natal’s Ab Rehab delivers: real, coordinated, movement-based pelvic floor strengthening that meets you where you are.

How Pressure Moves Matters—And Most Often, It Goes Down

Most postpartum symptoms aren’t just from a “weak core”—they’re from mismanaged intra-abdominal pressure (IAP).

When your system can’t handle load (like lifting a toddler, carrying groceries, or exercising), pressure leaks out.

The most common direction?

Downward.

This overwhelms the pelvic floor, leading to:

• Leaking
  
  
• Pelvic pressure or heaviness
  
  
• Prolapse
  
  
• Vaginal bulging or “something feels off down there”
  
  

Fixing this requires teaching the body how to manage pressure again—starting with breath, posture, and core-pelvic floor coordination. Only after that can we apply progressive overload through strength training.

When Pressure Goes Up: Acid Reflux, Running, and Core Dysfunction

While less common, some moms also experience pressure escaping upward—especially during running, high-impact exercise, or poor breath strategies.

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This often results in:

• Acid reflux
  
  
• Indigestion during cardio
  
  
• Shortness of breath
  
  
• Chest tightness or discomfort
  
  

Here’s why upward pressure causes issues postpartum:

If your pelvic floor is tight and non-responsive, and your core lacks coordination, the diaphragm can’t expand downward fully. Instead, pressure gets trapped and pushes upward into the esophagus.

This can cause reflux even in the absence of digestive issues.

Running increases IAP significantly, so without proper core-pelvic floor function, these symptoms can appear suddenly—even in women who never had reflux before.

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How Natal’s Ab Rehab Solves This (Without Guesswork)

Inside Natal’s Ab Rehab, we take the guesswork out of postpartum recovery. Whether you’re leaking, feeling pressure, struggling with reflux, or just feeling disconnected—we’ve mapped out exactly how to rebuild.

Here’s what you’ll find:

Phase 1: Core Connect

• Ab Rehab Moves: Deep Activation + Breath Work Sequence
• Pelvic floor relaxation + coordination
  
• Postural retraining
• Reprograming muscle recuiting strategies and motor skills
  
  

Phase 2: Strength Surge

• Deep core, pelvic floor progressive strengthening
  
  
• Timed exhales for pressure control
  
  
• Functional movement patterns
  
  

Phase 3: Dynamic Power

• Movement under load with progressive overload
  
  
• Stability + coordination with impact
  
  
• Preparing for real-life strength
  
  

Phase 4: Peak Performance

• Endurance + resilience
  
  
• Return to full confidence in movement
  
  
• Core that’s not just flat—but functional
  
  

This method is grounded in rehab science and trusted by over half a million women—and it works whether you’re six weeks or six years+ postpartum!

Final Thoughts: Function, Strength, Confidence—Rebuilt From Within

Pelvic floor dysfunction isn’t just about leaking. It’s about pressure. It’s about coordination. It’s about a system that needs to be retrained, not rushed.

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If you’re feeling pressure, tightness, or leaking—don’t settle.

If you’re being told to “just do kegels”—ask for more.

If you’re running and refluxing—your body is giving you a message.

You deserve a recovery plan that addresses the root cause.

You deserve to feel strong, supported, and confident again.

You deserve Ab Rehab!

Ready to start your postpartum pelvic floor recovery the right way?

Download the Natal app and begin Ab Rehab today.

It’s time to rebuild your body—from the inside out.

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