The pelvic floor muscles function best when their resting tone is normal. These muscles will not keep it to themselves if this changes, and becomes either too low (lack of tone, soft, lax, weak) or too high (tense, rigid, overactive, short, also weak).

In most cases when incontinence or prolapse presents, the issue is loss of tone. Less frequently the cause is the opposite, “too much tone,” resulting in non-relaxing or hypertonic pelvic floor dysfunction.

How do you know if your pelvic floor is too tight?

Listed below are the signs and symptoms:

• Chronic pain anywhere in the pelvis, including pain or discomfort when inserting a tampon, during or after intimacy (vaginismus), or when you are sitting.
• Sometimes described as a “headache in the pelvis”.
• Soreness, tightness, throbbing, aching, stabbing, spasm.
• Difficulty or pain when emptying the bladder or bowels, the need to strain, incomplete emptying.
• Constipation/bloating.
• Urinary frequency, urgency – sometimes associated urge incontinence.
• Lower back pain radiating to the thighs or groin.
• Kegels make things worse.
• Unable to perform or feel Kegels (pelvic floor exercises).

What can result in pelvic floor tension?

Often, the cause or provocation for non-relaxing or hypertonic pelvic floor dysfunction is never identified. A series of events or a combination of factors may contribute to the development of the condition, including the following:

• Dysfunctional bladder or bowel emptying carried on from childhood or developed as an adult.
• Excessive holding onto the bladder and/or bowels due to habit, lifestyle or occupation.
• Constant muscle contraction to avoid bladder or bowel incontinence.
• Certain conditions may be triggers, for example, atrophic vaginitis, vulvodynia, irritable bowel syndrome, endometriosis, and interstitial cystitis or painful bladder syndrome.
• Continued penetrative sex despite pain.
• Injury to the pelvic floor from a surgical procedure, trauma or childbirth.
• Postural or movement abnormalities.
• Skeletal asymmetry.
• Prolonged sitting with pelvic floor tension.
• Sexual abuse.

Sleep disturbance, depression, and anxiety can trigger the onset of hypertonic pelvic floor dysfunction.

Can Kegels make you too tight?

Often, women wonder if Kegels can result in muscles that are too tight. The answer is no. When performed correctly, pelvic floor exercises do not have adverse effects.

They can, however, trigger already tight/tense/overactive muscles, causing pain or spasms.

I view this as a protective reaction from the body, communicating that exercise is not appropriate for the present muscle condition. This is why all women participating in Discreetly Fit offerings are screened for tense pelvic floor muscles via our pre-course questionnaire.

What can you do if your pelvic floor is too tense?

Think of them as any other tight muscle. For example, when your neck is sore from tension, what can you do to relieve it? What feels good? Warmth, relaxation, stretching, and massage can help, right?

Consider how you can apply these to your pelvic floor muscles. For example:

• Pop something warm on your base.
• Practice “letting go” or “dropping” your pelvic floor. Think of it like its butter melting away – expending. You can even do this in a warm bath.
• Good stretches include the happy baby pose, child pose, butterfly knees lying on your back, or the bum-to-floor squat I posted a little while ago with my dog Eddie.
• Relax and breathe expending the base of your ribs, tummy, and pelvic floor. A 2-minute practice will start you off.
• Don’t persist on things that give you pain, for example, penetrative sex or Kegels.
• Massage.

You can also use these measures for prevention, or simply because they feel good.

What is the treatment for pelvic floor muscle tension?

First up, if you experience chronic pelvic pain reproductive, urologic, and gastrointestinal sources of the pain must be ruled out so have a chat to your general practitioner.

The treatment of physical therapists with training in techniques for a non-relaxing pelvic floor can result in a marked improvement or complete pain relief in up to 80% of women experiencing this issue.

Your treatment plan needs to consider if you experienced physical, sexual, or emotional abuse. So, share these details with the members of your treatment team, including a sex therapist if appropriate, particularly if your symptoms are unresponsive to physical therapy.

In some cases, muscle relaxants (although with a side effect of drowsiness), local anaesthesia, or Botox trigger point injections administered by your doctor may be helpful.

I hope this helps you to fully participate in your own pelvic health care.