Imagine you are clenching your jaw. The muscles around your jaw will likely tense and tighten, creating tension and pain in your jaw, neck, and head.
Well, just like any other muscle, your pelvic floor muscles can become tight or go into spasm from overactivity. This common condition is known as a “hypertonic pelvic floor”, because the pelvic floor has “too much tone” and cannot relax. It’s also known as an ”overactive pelvic floor.”
What are the signs and symptoms of a hypertonic pelvic floor?
Women with a hypertonic pelvic floor may present with different symptoms such as:
Constipation
Urinary incontinence
Painful sex
Pelvic pain
Low back pain
Hip pain
Coccyx pain
Incomplete emptying of the bowels
Need to strain when emptying the bowels
Incomplete emptying of the bladder
Slow flow of urine
Hesitancy or delayed start of the urine stream
Urinary urgency
Urinary frequency
Painful urination
If you suffer from any of the symptoms outlined above, I recommend booking an appointment with your Women’s Health Physio for a pelvic floor exam. She will then be able to determine whether your pelvic floor muscles are indeed overactive.
Why a “tight” pelvic floor isn't the same as a “strong” one
The difference between “tightness” and “strength.”
Women have been obsessed with “tightness” down there for a long time. So let’s use the famous kegel exercises to explain the difference between a tight pelvic floor and a strong pelvic floor.
These exercises (pelvic floor squeezes) are often promoted to assist in achieving this tightness. But when muscles tighten too much, they can’t work correctly.
Just like any other muscle in our bodies, the pelvic floor muscles need to be able to lengthen and relax too. Chronic tension and tightness are never good for any muscle group!
Kegels only work the muscle in one way (tightening), which causes muscles to shorten, but they don’t do enough to lengthen them and keep them supple.
If you want to have real strength in your pelvic floor, it must be able to stretch or elongate and release, as well as tighten
In other words:
A muscle that’s too tight is a weak muscle - It can’t do its job properly.
A strong muscle can both fully contract and fully release.
What causes a hypertonic pelvic floor ?
9 things that you may do in your daily life that can lead to a hypertonic pelvic floor, or make one worse
Being constantly stress and anxious
Hypertonic pelvic floor #1
Stress is a widespread cause of hypertonic pelvic floor. When you are stressed, you hold tension in your pelvic floor. You may know the “fight or flight” response. Imagine a dog being afraid – it runs away with its tail between its legs. Well, we have a similar reaction: we tuck our tailbone under! The pelvic floor muscles are attached to the tailbone, and this causes the muscles to shorten and tighten over time.
Shallow breathing
Hypertonic pelvic floor #2
Shallow breathing is characterized by movements that are contrary to what is expected of the chest and abdomen when breathing: drawing air into the chest area (instead of the abdomen) using the your intercostal and upper chest muscles (instead of your diaphragm).
In other words, if you’re a shallow breather: you can see your chest rising and stomach moving inward upon inhalation (air in), and the chest falling and stomach moving out upon exhalation (air out).
This paradoxical breathing activates upper chest muscles and increases our cortisol levels, which increases stress and feelings of anxiety. Not only does it makes stress a normal state in our body, but it also prevents our pelvic floor from softening on the inhale (the pelvic floor and diaphragm can’t work together).
“Kegeling”
Hypertonic pelvic floor #3
A healthy pelvic floor should be able to contract and RELEASE, like any other muscle in our body. Kegels won’t do that, and “squeezing” can make the issue worse.
Suppose you have a hypertonic pelvic floor, and you keep “doing your Kegels” without focusing on “letting go.” In this case, you’re just tightening muscles that are already too tight, which can only aggravate the situation.
Neglecting your Transverse muscle
Hypertonic pelvic floor #4
The transverse muscle (deepest ab layer) is in charge of stabilizing the spine and pelvis. If they don’t do their job, other muscles, which can include the pelvic floor muscles, will jump in and attempt to compensate. The body is very resilient, and it usually figures out a way around. However, compensation patterns will only work for so long before issues result. When a muscle does more than its job, it eventually develops tension, tightness, pain, and dysfunction. A comprehensive core rehab program is key to regaining balanced muscle recruitment.
Spending too much time in a poor alignment
Hypertonic pelvic floor #5
You sit and stand for the majority of the day, and you probably used to think nothing of it, but HOW you do it has a surprisingly huge impact on your body.
Things like leg crossing, tailbone tucking, slouching or leaning back while seated often result in deep pelvic floor tension.
It decreases the space in your pelvis by putting direct pressure onto your sacrum and tailbone - pushing these bones toward the pubic bone at the front. This reduced space requires the pelvic floor muscles to shorten passively, even though they are not contracting.
Sucking your belly in
Hypertonic pelvic floor #6
Are you drawing your belly button in all day long to look thinner?
When we pull our belly button in, we increase intra-abdominal pressure. This excessive intra-abdominal pressure can cause a bearing down of pressure onto the pelvic floor, forcing it to bulge down. The pelvic floor can respond to this constantly higher pressure with two ways: either letting the leaks happen, or fighting back by getting tightened. That’s why some women unconsciously tighten their pelvic floor muscles.
Wearing tight clothes around the waist
Hypertonic pelvic floor #7
Wearing overly tight clothing can restrict breathing which affects digestive and pelvic health.
Here again, to resist against the added downward pressure of tight high waisted leggings or hight waisted jeans, some women unconsciously tighten their pelvic floor.
As a result, the pelvic floor muscles become unable to relax, leading to a hypertonic pelvic floor.
Wearing high-heels
Hypertonic pelvic floor #8
High-heels push your center of gravity forwards onto the balls of your feet, which will throw off your pelvic alignment, forcing you into unnatural positions.
Our muscles have to work hard to compensate, increasing the tightness of your calf and hamstring muscles, which will continue to pull your pelvis into that tucked under position.
Holding on to your bladder or bowels for long periods of time
Hypertonic pelvic floor #9
Some women feel uncomfortable using toilets outside of their home, which leads them to holding their bladders for hours! To hold on to urine or bowels, their pelvic floor muscles tighten considerably to prevent the loss of control. These muscles aren’t designed to hold on for so long, which is why it can develop tension in your pelvic floor muscles.
baby steps and progress
All these habits can contribute to, or exacerbate pelvic floor dysfunctions, among other issues. Keeping the pelvic floor muscles in the shortened position constantly prevents them from performing their function optimally. As our body adapts to the way we use it, we gradually end up with shortened pelvic floor muscles.
It can take some time to break bad habits that have developed over years.
You will likely have to “check-in” regularly, and there will be times when you forget and find yourself doing something you meant to avoid. But that’s ok. Just keep at it. Eventually, you'll exhibit better habits more frequently and feel the benefits of your efforts!
TAKE THE NEXT STEP
Connecting the Breath and the Pelvic Floor
A better way than “Kegels” to exercise your pelvic floor
We need to see the bigger picture and approach the pelvic floor muscles as a part of a system.
A system that includes:
the diaphragm (at the top),
the pelvic floor (at the bottom),
the deep abs (on the front and sides),
and spinal stabilizers (in the back)
In daily life, all these muscles should work together as a team.
So it sounds normal to me to recruit them all as a team during pelvic floor exercises! Just like any other muscle in your body, your pelvic floor can be retrained to function optimally.
The pelvic floor muscles should work synergistically with the diaphragm:
As you inhale, the diaphragm lowers down (to make room for the expanding lungs), the tummy expands, and the pelvic floor falls, expands, and lengthens.
As you exhale, the diaphragm lifts (as the lungs get smaller), the tummy drifts inward, and the pelvic floor muscles contract automatically, lifting up as well.
That is why, to me, abdominal breathing exercises are the best exercises to improve your inner core function. The breath connects everything.
Learn more about pelvic floor exercises.