It’s a muscle involved in almost every move you make. Flex your ankle, and your pelvic floor switches on. Raise your arm, and the pelvic floor stabilises you. Jump, and your pelvic floor activates to protect your organs from the extra pressure[1].
But, in the case of pelvic floor strength, there can be too much of a good thing.
It’s called hypertonic pelvic floor and research suggests it affects at least 1 in 10 women.
So, what are the signs that you might have a hypertonic (too tight) pelvic floor? And, what can you do about it?
Well, let’s start with a pelvic floor 101.
Your pelvic floor is a basin-shaped muscle group that connects to either side of your pelvis (left and right) and your pubic bone and tailbone (front and back). One of its big jobs is to help support your pelvic organs, but it does so much more[2].
Your pelvic floor plays a role in your posture, athletic performance, and ability to remain continent (wee and poo!) and is key when it comes to your sex life[3].
And, although you’ve probably heard about pelvic floor weakness, its cousin – the hypertonic pelvic floor – is often overlooked.
Here are 7 signs you have hypertonic pelvic floor
- Your bathroom breaks take forever
When you head off to take a toilet break, do you find it takes ages to empty your bladder or bowels? Or maybe your urine sounds less like a gush and more like a slow, dripping tap. These are signs that you may struggle to relax your pelvic floor[4].
- Pain when there should be pleasure
Do you experience pain during sex? Oftentimes an overly tight pelvic floor means that any penetration becomes uncomfortable – or even unbearable. If you do experience painful penetration, please don’t ‘grit your teeth and think of England’ – it can actually make things worse. My advice? Stop and try other pleasurable things with your partner instead[5].
- Butt clenching
Do you constantly clench your butt cheeks? Your glutes are connected to your pelvic floor, and chronic butt gripping can lead to chronic pelvic floor gripping too! This type of posture can be from spending long hours sitting down (hello, office workers!) or even from pregnancies and carrying around babies and toddlers[6].
- Hard stools
And, we’re not talking about the kind of stools you sit on… Constipation, hard poos or regular straining on the toilet are all signs that your too-tight pelvic floor is blocking the back door exit. Your pelvic floor’s job is to relax when you’re on the toilet to allow you to easily empty your bowels[i].
- Pelvic pain
Whether it’s sharp pelvic pain after sitting for too long, or even pelvic pain post-orgasm, this is a sign that your pelvic floor and perineum are too tense and are working too hard[7].
- UTIs that keep coming back
Do you get symptoms of a urinary tract infection – like urgency to pee and a burning sensation – but you keep testing negative for infection? It could be the fault of hypertonic pelvic floor muscles. The excess tension in your pelvic floor can stop your bladder from emptying properly, creating irritation or infection[8].
- Leakage
I know you’re probably thinking – how can an overly tight pelvic floor lead to leakage? It sounds counterintuitive, but a hypertonic pelvic floor can weaken over time – which can lead to incontinence. Overactive muscles fatigue really easily, which means sometimes when you need it to activate (like when you’re jumping or skipping), it doesn’t have any fuel in the tank to contract effectively[9].
How can I fix a too-tight pelvic floor?
There are ways to treat hypertonic pelvic floor, so it’s important to remember that you don’t have to live with pain or discomfort.
- Movement and stretching
Yoga and stretch classes are a great way to help release the pelvic floor muscles. Poses like child’s pose, happy baby and butterfly sits are great beginner options to try at home.
- Diaphragmatic breathing
Learning how to correctly activate your pelvic floor and diaphragm with each breath is another excellent starting point. If you’re at home, try lying with your knees bent towards the ceiling. Place one hand on your lower belly and the other on your chest. With every inhale (through the nose), I want you to let your belly and rib cage expand – imagine your core is a balloon that you’re filling with air. Feel the imaginary air filling up your pelvis – and release your perineum towards your ankles. Now, exhale through your mouth as if you are blowing out birthday candles and imagine that ‘core’ balloon is deflating, bringing all the muscles back into a contracted state. Continue this diaphragmatic breathing 10 times each night – truly focusing on the inhale with the pelvic floor lengthening and relaxing.
- Use a massage ball
You can release a tight perineum and pelvic floor at home by using a massage ball, tennis ball or other sturdy ball! Place the ball on a chair (make sure it has a harder surface) and position yourself to sit on the ball – aiming to have the ball hitting the perineum. Spend 2-3 minutes in this position moving your hips around the ball and being aware of any spots that feel more tender or uncomfortable. It can also help to inhale and imagine your pelvic floor melting over the ball.
- Get help
Reach out to a pelvic floor physio or the Core Restore Co team for personalised advice and assessments. Like many other muscle conditions, it’s important to get treatment sooner, rather than later! In our clinics we use a combination of Emsculpt to strengthen the core muscles (undoing the compensatory muscle pattern and reducing the load the pelvic floor is carrying), along with stretches and habit-changes to help release your pelvic floor.
This article was originally published on Women’s Health Magazine Au.
[1] Lee K. Activation of Pelvic Floor Muscle During Ankle Posture Change on the Basis of a Three-Dimensional Motion Analysis System. Med Sci Monit. 2018 Oct 10;24:7223-7230. doi: 10.12659/MSM.912689. PMID: 30301876; PMCID: PMC6192454.
[2] Chaudhry SR, Nahian A, Chaudhry K. Anatomy, Abdomen and Pelvis, Pelvis. [Updated 2023 Jul 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482258/
[3] Jórasz K, Truszczyńska-Baszak A, Dąbek A. Posture Correction Therapy and Pelvic Floor Muscle Function Assessed by sEMG with Intravaginal Electrode and Manometry in Female with Urinary Incontinence. Int J Environ Res Public Health. 2022 Dec 26;20(1):369. doi: 10.3390/ijerph20010369. PMID: 36612691; PMCID: PMC9819097.
Faucher S, Déry-Rouleau G, Bardin M, Morin M. Investigating the role of the pelvic floor muscles in sexual function and sexual response: a systematic review and meta-analysis. J Sex Med. 2024 Feb 27;21(3):217-239. doi: 10.1093/jsxmed/qdad175. PMID: 38303662.
[4] Hashim, H., & Abrams, P. (2006). Is the bladder a reliable witness for predicting detrusor overactivity? The Journal of Urology, 175(1), 191-194.
[5] Morin, M., Carroll, M. S., & Bergeron, S. (2017). Systematic review of the effectiveness of physical therapy for the treatment of dyspareunia. Journal of Sex & Marital Therapy, 43(4), 353-369.
[6] Reif, M., Hammoud, H. A., Bachrach, L. E., et al. (2016). Pelvic floor dysfunction: A systematic review. Physical Medicine and Rehabilitation Clinics of North America, 27(3), 433-447.
[7] Hetrick, D. C., & Glazer, H. I. (1996). Pelvic floor muscle biofeedback in the treatment of pelvic pain. Journal of Reproductive Medicine, 41(5), 355-360.
[8] Peters, K. M., Carrico, D. J., & Ibrahim, I. A. (2008). Diaphragmatic breathing for chronic pelvic pain. Urology, 72(4), 709-712.
[9] FitzGerald, M. P., & Kotarinos, R. K. (2003). Rehabilitation of the short pelvic floor. The Journal of Pelvic Medicine and Surgery, 9(5), 286-289.
[i] Bharucha, A. E., Dorn, S. D., Lembo, A., et al. (2013). American Gastroenterological Association technical review on constipation. Gastroenterology, 144(1), 218-238.
