Pelvic Floor Muscle Tightness?

The pelvic floor muscles are a group of muscles that attach to the front, back and sides of the bottom of the pelvis and sacrum. They are like a hammock or a sling, and they support the bladder, uterus, prostate and rectum. They also wrap around your urethra, rectum, and vagina.

These muscles must be able to contract to maintain continence, and to relax allowing for urination, bowel movements and penetration.

Overactivity/hypertonicity, or tightness of pelvic floor muscles, may contribute to various types of pelvic pain and/or incontinence, urgency and frequency of the bladder and bowels.

Overactive/hypertonic pelvic floor muscles can cause the following symptoms:

• Urinary or fecal incontinence
• Urinary or fecal frequency/urgency
• Urinary hesitancy
• Stopping and starting of the urine stream
• Painful urination
• Incomplete emptying
• Constipation and straining
• Pain during or after bowel movements
• Unexplained pain in your low back, pelvis, hips, genital area, or rectum
• Pelvic pain
• Pain during or after sexual penetration, orgasm, or sexual stimulation
• Uncoordinated muscle contractions

Pelvic floor muscle issues are diagnosed by specially trained doctors and physiotherapists using gentle internal and external “hands-on” or manual techniques to evaluate the function of these muscles. They will assess your ability to contract and relax these muscles and also feel for points of tenderness.

The bones and muscles of your lower back, hips and sacro-iliac joints will need to be assessed as well since these joints can affect your pelvic floor muscles. When your pelvic floor muscles are tight or weak, they can contribute to dysfunction in the joints of your back and hips, leading to persistent low back and hip pain.

If an internal examination of the muscles is too painful, the connective tissue of your abdomen, thighs, groins and low back are often very tight. The connective tissue forms the container of the muscles, and these often need to be relaxed before any internal work can be done. This connective tissue dysfunction becomes the priority before addressing the tender points in order for tight muscles to be effectively treated.

When your pelvic floor muscles are tight and weak, the tension is treated before the weakness. Once the muscles have reached a normal resting tone, and are able to relax fully, their strength is reassessed and pelvic floor strengthening exercises are prescribed if appropriate.

Being gentle with your own body is an important part of treatment for pelvic floor muscle problems. You should avoid pushing or straining when urinating and ask your health care provider about how to treat constipation.

Learning how to relax the muscles in the pelvic floor area is crucial, and doing Reverse Kegels may help in lengthening and relaxing these muscles. Regular deep breathing is also an important part of learning to relax tension in all of your muscles, but particularly the pelvic floor. Relaxing self-care practices such as taking warm baths can also be a helpful tool.

Persistent pain education is a critical factor in treating pelvic floor muscle problems, since the pelvic area is one where we often hold our stress. Our thoughts, attitudes and beliefs including our anxiety and stress can show up in our bodies and perpetuate the tension and pain in our pelvis. Understanding how our pain system works has been shown to be an effective way of reducing the threat of ongoing pelvic floor problems.