What Is Pelvic Floor Tension?
Pelvic floor tension is sometimes referred to as having an overactive pelvic floor or a "tight" pelvic floor. This means that your muscles are likely in a constantly contracted state, and you probably have a hard time relaxing them.
What causes pelvic floor tension?
We will never know the exact cause of your pelvic floor tension, but there are some things that are likely to contribute to it. Pregnancy and childbirth, pelvic pain conditions such as endometriosis and interstitial cystitis, trauma, abdominal surgery, persistent low back pain, poor bladder and bowel habits, and generalized core weakness can all contribute to pelvic floor tension. It can develop after any sort of traumatic incident to the pelvic area, or can be something that comes on gradually over time. The majority of people I see in my practice have pelvic floor tension.
What are some signs of pelvic floor tension?
Pain with sex
Pain with tampon usage (or with other menstrual products)
Bladder leakage
Constipation
Pain with urination
Urinary frequency
Hip pain
Low back pain
To note - these are signs that you COULD have pelvic floor tension, they are not signs that you DO have pelvic floor tension. Some people could check all these boxes and still not have pelvic floor tension. My goal is to describe these to you in a little bit more detail to help explain what could be happening in your body so you can seek help if you need it. Alrighty - here we go!
Pain With Sex & Pain With Tampon Usage
If you're having significant pain with sex there is a very high liklihood that you have pelvic floor tension somewhere within your pelvic floor. If you have more pain with initial penetration and tampon use, then the muscles right at the opening of the vagina are probably not relaxing and stretching well to allow for comfortable penetration. If you have pain with deeper penetration, then it is probably the third, deepest layer of pelvic floor muscles that are tense. Your third layer is more of your support layer, so it can be common for these muscles to be overactive and/or weak if you also have back or hip pain.
Bladder Leakage
Bladder leakage can occur as stress incontinence or urge incontinence. Stress incontinence happens if you leak with coughing, sneezing, laughing, jumping or running. Urge incontinence happens when you have an intense need to go to the bathroom, maybe you're on your way to the toilet, and you can't make it in time. Leakage occurs when the muscles are weak, and when any muscle is weak it can develop tension or tightness. If you've been doing kegels trying to stop bladder leakage and your symptoms 1) haven't gotten better or 2) have gotten worse - stop now. Try these exercises to release tension in the pelvic floor, read up on normal bladder habits, and seek help from a Pelvic Physical Therapist!
Constipation
If you're not pooping 1x/day - you're constipated. If your poop isn't smooth and somewhat soft, like the texture of a banana, and instead it is hard and rocky - you're constipated. If you need to sit on the toilet for longer than 10 minutes (which you shouldn't do!) or if you need to hold your breath and bear down to push your poop out - you're constipated. A lot of this can be diet related, but your pelvic floor also plays a HUGE role in constipation. One of your pelvic floor muscles wraps around your rectum and changes the angle at which your poop exits your body. If it's too tight and the angle is too sharp, you're going to have a very hard time getting anything out! Get yourself a squatty potty ASAP!
Pain with Urination
Have you ever felt like you had a urinary tract infection, but then went to the doctor and your results came back negative? Well, it could be your pelvic floor muscles. I see a lot of people with painful urination who have pelvic floor tension. In order to pee comfortably, your pelvic floor muscles need to relax and stretch.
Urinary Frequency
Are you ALWAYS in the bathroom? Do you feel like you need to go and then once you get there, nothing comes out? This can happen for a number of reasons. First, as I described above, your pelvic floor muscles need to relax for your to completely empty your bladder. If you aren't able to completely empty, you might get an urge that you need to go back a short while later. Second, even if you are emptying your bladder all the time, having pelvic floor tension in general can create the sensation that you have to pee even if you don't.
Hip Pain
If you have hip pain, especially pain with squatting or when your knees are towards your chest in a stretch, you could have pelvic floor tension. One of your most important hip muscles is right smack-dab next to your pelvic floor muscles and is often overlooked by traditional PT. If you have hip pain and have tried traditional PT and haven’t gotten the results that you want, it's time to have your pelvic floor looked at. I have had a number of patients with hip symptoms or labral tears who resolved their symptoms with pelvic floor treatment.
Low Back Pain
Raise your hand if you've had low back pain!! Seriously the most common thing EVER. I could go on a tangent about how the pelvic floor and low back pain are related, but let's keep it brief - if you're having low back pain, you've tried traditional PT and still haven’t improved, please see a pelvic PT. ALSO - if you have low back pain AND have one of these other signs listed above, please see a pelvic PT right now! It's always best to treat these things together. Your pelvic health PT should be assessing and treating your ENTIRE body!
How Do You Treat Pelvic Floor Tension?
Well of course my #1 piece of advice is to see a pelvic health PT. You’ll get an expert evaluation and plan that is unique to you. There are a lot of things you can do at home as well. See my 8 minute video HERE for a routine that includes specific stretches to release your pelvic floor. Diaphragmatic breathing works wonders for pelvic floor tension. In general, try to become more aware of your pelvic floor and notice if you clench it throughout the day. Check in with your body every hour and relax your pelvic floor muscles.
There you have it! Your intro to pelvic floor tension, description of some of the common signs and a brief guide to start treating yourself at home. I hope you learned something new! As always, PLEASE contact me with questions or if you need more guidance.
- Mar