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A hypertonic pelvic floor occurs when the muscles in the pelvic floor become overly tense and are unable to relax. While there is no one cause of a hypertonic pelvic floor, several factors can lead to the muscles tightening up. For example, people who spend a lot of time exercising and engaging their core muscles can develop tension in their pelvic floor because they keep these muscles switched 'on' without allowing them to relax. Similarly, those who have a history of holding their bladder or bowels may also experience pelvic floor tension due to the act of holding on, which causes the pelvic floor muscles to tighten to prevent the loss of control. High levels of stress, fear, or anxiety can also cause muscles to reflexively tighten, leading to a hypertonic pelvic floor. Pelvic health and abdominal health conditions, such as endometriosis or irritable bowel syndrome, can also contribute to pelvic floor muscle tension.
| Characteristics | Values |
|---|---|
| Pelvic health and abdominal health conditions | Endometriosis, irritable bowel syndrome, interstitial cystitis, pudendal neuralgia, vulvodynia, birth trauma, scar tissue |
| Posture | Leg crossing, tailbone tucking, sucking in stomach, tucking pelvis |
| Psychological factors | Anxiety, stress, trauma |
| Holding bladder or bowels | Uncomfortable using public toilets |
| Overdoing pelvic floor exercises | Kegels, childbirth, menopause |
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What You'll Learn
Stress, fear, and anxiety
While there is no single cause of a hypertonic pelvic floor, high levels of stress, fear, or anxiety can cause muscles to reflexively tighten, leading to a hypertonic pelvic floor.
People who feel uncomfortable using public toilets, for example, may hold onto their bladders for hours until they return home. The act of holding on means the pelvic floor muscles are tightening to prevent the loss of control. This can happen during social activities, at school, or at work.
In addition, people who spend a lot of time working out and engaging their core muscles can develop tension in their pelvic floor. This is because they keep these muscles switched 'on' without giving them time to relax and let go.
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Posture and postural habits
Additionally, the alignment of the spine and pelvis while standing or sitting can affect pelvic floor function. A forward pelvis tilt, also known as swayback, causes an excessive arch in the lower back, constricting the range of motion for the pelvic floor and tightening the corresponding muscles and ligaments. This posture strains the hamstrings and gluteal muscles and can exacerbate issues such as incontinence or pelvic organ prolapse.
To optimize sitting posture, it is recommended to maintain a slight inward curve in the lower back, sit with weight evenly distributed between both sit bones, and avoid crossing the legs. When sitting unsupported, a small roll or cushion can be placed in the small of the back to support the inward curve. For standing posture, it is advised to distribute weight evenly between both legs, maintain a slight inward curve in the lower back, place feet hip-width apart, and pull shoulders back in line with the hip bones. It is also recommended to avoid wearing heels, as this can affect pelvic alignment.
Postural habits, such as leg crossing and tailbone tucking, can result in deep pelvic floor tension. Additionally, psychological factors such as anxiety, trauma, and stress can contribute to muscle tightening. It is important to be mindful of one's posture throughout the day and adopt good habits for sitting, standing, and resting positions. Physical therapy can provide individualized guidance on improving posture and reducing pelvic floor tension.
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Pelvic health and abdominal health conditions
Pelvic floor muscles can become tight due to a variety of factors, including nerve tension, posture, and stress. For example, people who spend a lot of time exercising and engaging their core muscles can develop tension in their pelvic floor because they keep these muscles switched 'on' without allowing them to relax. Similarly, those who have a history of holding their bladder or bowels may also experience pelvic floor tension due to the act of holding, which causes the muscles to tighten to prevent the loss of control.
Additionally, high levels of stress, fear, or anxiety can cause muscles to reflexively tighten, leading to a hypertonic pelvic floor. This psychological aspect can result in the tightening of pelvic floor muscles due to anxiety, trauma, or stress.
Birth trauma and scar tissue are further causes of pelvic floor muscle tightness. Women who experience perineal tearing or vaginal tearing may be at higher risk as the pain and scarring can cause protective muscle tightening. Unilateral pelvic floor tears can cause the opposite side of the pelvic floor to tighten due to overactivity.
It is important to note that pelvic floor discomfort can vary and may be caused by a combination of factors. Consulting a healthcare professional, such as a gynecologist, urologist, or pelvic floor physical therapist, is recommended to receive a proper diagnosis and appropriate treatment.
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Overdoing pelvic floor exercises
While pelvic floor exercises are important for strengthening the muscles under the uterus, bladder, and bowel, it is possible to overdo them. Overdoing pelvic floor exercises can lead to a condition called hypertonic pelvic floor, where the pelvic floor muscles become too tense and are unable to relax.
People who spend a lot of time working out and engaging their core muscles can develop tension in their pelvic floor. This is because they keep these muscles switched 'on' without allowing them to relax and let go. Additionally, those who have a history of holding their bladder or bowels may also develop tension in their pelvic floor muscles. For example, someone who feels uncomfortable using public toilets may hold their bladder for hours until they return home. The act of holding on causes the pelvic floor muscles to tighten to prevent the loss of control.
High levels of stress, fear, or anxiety can also contribute to a hypertonic pelvic floor. These emotions can cause muscles to reflexively tighten, including the pelvic floor muscles. Furthermore, certain postural habits, such as leg crossing or tailbone tucking, can result in deep pelvic floor tension. Additionally, activities that put pressure on the pelvic floor, such as high-impact exercise, sit-ups, and lifting heavy objects, can also contribute to tension in the pelvic floor muscles.
Pelvic health and abdominal health conditions can also lead to a hypertonic pelvic floor. For example, women with endometriosis may develop tense pelvic floor muscles due to chronic pain and inflammation in the pelvis. A history of irritable bowel syndrome with abdominal pain and cramping can also result in pelvic floor muscle pain and cramping. Other conditions linked to a hypertonic pelvic floor include interstitial cystitis, pudendal neuralgia, and vulvodynia. Birth trauma and scar tissue are additional causes of tightness in the pelvic floor muscles.
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Holding in bladder and/or bowels
Holding in your bladder or bowels can cause tension in your pelvic floor muscles. The pelvic floor muscles support the bladder, bowel, and uterus, and help control the release of urine and faeces. When you contract these muscles, they lift the internal organs of the pelvis and tighten the openings of the vagina, anus, and urethra. Relaxing the pelvic floor muscles allows urine and faeces to pass.
When you hold in your bladder or bowels, the pelvic floor muscles are tightening to prevent the loss of control. This can lead to a hypertonic pelvic floor, where the muscles become too tense and are unable to relax. People who feel uncomfortable using public toilets, for example, may hold in their bladders for hours, causing the pelvic floor muscles to tighten.
A hypertonic pelvic floor can cause several issues, including constipation, painful sex, pelvic pain, back or hip/leg pain, and difficulty urinating. It can also lead to urinary urgency and frequency, meaning you feel a frequent and urgent need to urinate.
To address a hypertonic pelvic floor, it is recommended to see a continence or pelvic physiotherapist, who can help identify the root cause and provide tools to manage the condition. Pelvic floor exercises, such as Kegel exercises, can be beneficial in strengthening the pelvic floor muscles and improving bladder and bowel control. These exercises involve tightening or squeezing the pelvic floor muscles to gain better control. However, it is important to ensure you are performing these exercises correctly to avoid discomfort or targeting the wrong muscle groups.
In addition to pelvic floor exercises, other treatments for a hypertonic pelvic floor may include vaginal weights or Kegel balls, medical devices such as a vaginal pessary, and, in more severe cases, surgery.
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Frequently asked questions
A hypertonic pelvic floor occurs when the muscles in the pelvic floor become overly tense and are unable to relax.
Symptoms of a hypertonic pelvic floor include pelvic pain, constipation, painful sex, and urgency. The pain can be felt in the pelvic bones, vagina, bladder, and anus, and can also radiate to the thighs, groin, lower back, buttocks, or abdomen.
There are several factors that can contribute to a hypertonic pelvic floor, including anxiety, stress, trauma, posture, nerve tension, and certain postural habits like leg crossing or tailbone tucking. Additionally, activities such as regularly holding in your bladder or bowels, and overdoing pelvic floor exercises can also lead to tightness in the pelvic floor muscles.
If you are experiencing symptoms of a hypertonic pelvic floor, it is recommended to consult a healthcare professional, such as a gynecologist, urologist, or pelvic floor physical therapist, who can provide a proper diagnosis and recommend appropriate treatment options. Treatment may include gentle stretching, stress management, nerve mobilizations, and other exercises prescribed by a specialist.
