A tight pelvic floor is not a strong pelvic floor
You might think that having a tight pelvic floor is a good thing. After all we are always being told to squeeze those muscles! This is a misconception that many people have and actually a tight pelvic floor is a dysfunctional pelvic floor.
It basically means that the muscle cannot fully release and it is held in a degree of constant tension. Any muscle in the body needs to be able to contract fully and relax fully to allow it to properly function. A tight muscle is effectively a weak muscle because it can’t move through its full range. If it has not relaxed fully, it will struggle to contract fully and with constant increased tension, it will fatigue. This can lead to bladder and bowel problems as the pelvic floor muscle needs to contract and relax to control the continence mechanism.
You contract your pelvic floor muscles to help you to hold on when you need to empty your bladder or bowel. Contracting a muscle that isn’t fully relaxed is very difficult and you may experience urgency and in some cases leakage. You may also notice you leak with certain activities like coughing or exercise because the muscles can’t contract with enough force to withstand the increase in tummy pressure that occurs with such exertion.
It can also affect how the bladder and bowel empty. You may find it difficult to initiate the flow of urine and your flow rate may be reduced. Difficulty with bowel movements is very common and you may experience pain, the need to strain and incomplete emptying. Straining will cause further tightening of the pelvic floor muscle and set off an ongoing cycle of pain and dysfunction.
Unfortunately problems from a tight pelvic floor don’t stop here. One of the most commonly reported symptoms is pain. You may notice pain in the back or pelvic area, or you feel it in the genitals or the rectum. Some people even describe pain in the legs, groin or abdominal area. Pain can vary from pressure, to a dull ache, to sharp and burning pain. Many women will also experience pain with intercourse (dyspareunia) and men may struggle to gain or maintain and erection. This can have a significant impact on quality of life as it may mean they are unable to have sex. If they can, it will not be an enjoyable experience for them.
There are many potential causes of pelvic floor dysfunction and sometimes there is no reasonable explanation and this can be very frustrating. If you overload the core by using a poor technique for pelvic floor or abdominal exercises and your breathing pattern is incorrect this can increase tightness. You may simply be doing too many exercises or doing them too quickly and not allowing the muscle to relax. Poor posture and muscle imbalance around the pelvis can lead to compensation of other muscles including the pelvic floor. If you suffer with chronic low back pain the pelvic floor is often affected.
Trauma around the pelvis or vaginal area can lead to a reflex response of the muscles and cause a tightened state. Examples include childbirth, pelvic surgery, or a painful sexual experience. If you have recurrent urine infections or thrush, it is thought that the muscles tighten in response to the constant need to urinate. Emotional factors can play in pelvic floor activity. An emotional trauma can initiate increased tension in the muscles and stress and anxiety is often displayed through pelvic floor tension.
Poor bladder and bowel habits play havoc with the pelvic floor. If you frequently hold on for too long, the muscles become overactive and if you hover over the toilet seat they do not relax fully. Conditions like endometriosis, vulvodynia, interstitial cystitis and IBS are often associated with overactive pelvic floor.
A pelvic health physio can help you to learn how to release these muscles with breathing techniques, muscle down-training, stretches, muscle conditioning and massage. They can also support you in improving your core exercise technique (pelvic floor and abdominal) once it is appropriate. You can also take steps to help yourself. Stop pelvic floor exercises, improve bladder habits, think about your exercise intensity and work on stress management with breathing and meditation. The important thing to remember is listen to your body!