We hear the word “weak” thrown around a lot when it comes to describing pelvic floor issues. If you have experienced urgency (having to rush to the bathroom), leakage or heaviness, you might have imagined your pelvic floor like a floppy sheet of cooked lasagne! But did you know that all of these issues could be due to your pelvic floor muscles being too tight, or holding too much tone and unable to relax? This is known as hypertonic pelvic floor, and it can cause a host of problems in addition to symptoms of incontinence.
What is a hypertonic pelvic floor?
Simply put, it refers to high tone within the pelvic floor muscles. Similar to if you have tightness in your neck or shoulders, you can also get muscle tightness in your pelvic floor muscles. Holding too much tone consistently, over long periods of time weakens the pelvic floor. When muscles stay short and tight, they can’t contract and relax in the way they are designed to – they get tired and ultimately can’t do their job. It is important to note that having a hypertonic pelvic floor is not uncommon and affects many women, especially younger women, or women who have not had children (but that doesn’t mean postpartum women don’t have hypertonic pelvic floors!).
Signs of a hypertonic pelvic floor:
- Constipation or difficulty emptying bowels
- Difficulty emptying the bladder
- Pain inserting a tampon
- Pain during penetration/ intercourse
- Urinary incontinence or even overactive bladder symptoms
- Lower back, abdominal, pelvic or coccyx pain
There are specific things that can make it worse. These include stress, pain, and overdoing your pelvic floor exercises and not releasing after each contraction. Sucking your stomach in all day (definitely not required!) or not letting it fully relax can also contribute to your pelvic floor holding too much tone.
Now, let’s talk about what can help alleviate hypertonic pelvic floor:
- Assessment and release: Our team of experienced pelvic floor physiotherapists can assess your pelvic floor and individual concerns, and use therapeutic techniques such as internal pelvic floor release, release of other muscles around the pelvis, relaxation techniques such as meditation and deep belly breathing, down-training the pelvic floor muscles (focusing on the release phase), and specific stretches. But it’s not a one size fits all approach!
- Down-train: Many women focus only on the contraction part of the pelvic floor exercise and don’t give enough attention to the release phase. Practicing deep belly breathing and relaxing the pelvic floor muscles during this phase can help. It’s also important to ensure your entire body is fully relaxed – holding too much tension in your body can make it very challenging to switch off the pelvic floor.
- Stretches: Specific, hypotonic pelvic floor stretches can also be useful in reducing pelvic floor symptoms. An experienced physiotherapist can guide you through a tailored stretching program and develop an exercise routine that will work best for you.
Managing hypertonic pelvic floor can be challenging, but it’s important to know that it’s a common problem and there are effective treatment options. Remember, listening to your body and seeking help from an experienced pelvic floor physiotherapist early on can prevent the symptoms from getting worse. Incorporating relaxation techniques, doing specific stretches, and paying attention to down-training the pelvic floor muscles can all contribute to alleviating hypertonic pelvic floor symptoms.