When we think of the pelvic floor, we often think of it being too weak.
Lots of people talk about the importance of having a strong pelvic floor, but what if your pelvic floor is too strong? AKA overactive.
While kegals (pelvic floor squeezes) are a good tool, sometimes it is overused.
So how would you know if your pelvic floor is overactive? This would be when the pelvic floor muscles are tight at rest, with voluntary or involuntary contractions, as well as an inability to relax.
What causes a hypertonic (tight) or overactive pelvic floor?
There is no one cause of pelvic floor hypertonicity, but there are a few things that increase the incidence of this happening.
For example, when people clench their core muscles all the time, this can often cause over contraction of the pelvic floor muscles. Sometimes a high level of stress can lead to the pelvic floor muscles to tighten as a reflex.
Conditions such as endometriosis, IBS, vaginismus, bladder pain syndrome/interstirital cystitis, chronic UTIs, vulvodynia can be associated with hypertonic pelvic floor.
Birth trauma and scar tissue can be another cause of pelvic floor muscle tightness.
After a hysterectomy for women or prostate cancer radiotherapy for men, the pelvic floor can often show signs of tightness.
What signs or symptoms occur with a hypertonic pelvic floor?
It is often associated with pelvic pain, but symptoms can include:
- Constipation and/or bloating
- Unable to empty bowels fully
- In women, pain with inserting tampons or sex
- Urinary urgency or frequency
- Low back pain
- Hip pain
- Coccyx pain
- Painful urination
- Pelvic Pain in women and men
- Erectile dysfunction in men
Treatment and techniques to help often include:
- Breathing techniques (belly breathing, diaphragmatic breathing, blossom breathing)
- Pelvic floor muscle relaxation techniques
- Hip and lower back stretches
- Bladder and bowel habit advice (no straining, using a foot stool)
- Pelvic floor release if needed
- Use of TheraBand if needed
If you would like to read more about hypertonic pelvic floor, these resources are great.
- https://www.pelvicpain.org.au/
- https://bladderhealthuk.org/interstitial-cystitis
- https://www.rcog.org.uk/for-the-public/browse-our-patient-information/long-term-pelvic-pain-patient-information-leaflet/
Pooja Guria
Pelvic Health Osteopath
