Is It Bad To Have A Tight Pelvic Floor?

A tight pelvic floor occurs when the pelvic floor muscles have increased tone and difficulty fully contracting and relaxing. This can contribute to pelvic pain, urinary and bowel symptoms, pain with intimacy, and other concerns that can significantly affect daily life.

This article explains common signs and potential causes of pelvic floor tension, what to expect during an evaluation, and how pelvic floor physical therapy can help address muscle tension and related symptoms.

What a Tight Pelvic Floor Means

A tight pelvic floor means that the pelvic floor muscles have increased tone and are shortened in length. While we want our muscles to be able to shorten and lengthen, excessive tightness can make it difficult for the muscles to go through their entire range of motion. Pelvic floor tension results in difficulty being able to contract and relax the muscles. This increased tone in the pelvic floor can lead to pelvic pain, urinary symptoms, bowel symptoms and issues with intimacy. Usually someone with severe excessive pelvic floor tone will have difficulty inserting a tampon, will not be able to have a gynecologic exam, and will have difficulty or will be unable to have penetrative intercourse.

Signs of a Tight Pelvic Floor

-          Pain with intimacy

-          Increased urinary urgency and frequency

-          A feeling of incomplete emptying with peeing

-          Burning sensation

-          Pelvic pain

-          Stress or urge incontinence (Leaking right before making it to the bathroom or leaking with coughing, sneezing, running, jumping or laughing)

-          Pain with bowel movements

-          Referred pain to the low back or hips

What Causes Pelvic Floor Tightness

There are some conditions that make it more likely that pelvic floor tension will occur. However, for some patients, a clear cause is not identifiable. This is frustrating and hopefully more research will occur in the future so we can better understand other contributing factors.

-          Chronic health conditions that present with abdominal pain such as endometriosis, Crohn’s disease, severe menstrual cramps, interstitial cystitis

-          Chronic stress or anxiety

-          Pregnancy and childbirth

-          Abdominal or pelvic surgeries

-          Increased straining or constipation. Poor bathroom habits such as chronic holding of urine

-          Individuals with increased hypermobility are more likely to have pelvic floor tension

How a Tight Pelvic Floor Can Affect the Body

A tight pelvic floor can affect many aspects of our body since it will likely lead to urinary, bowel, intimacy and pelvic concerns. It can have a profound impact on our quality of life. Tension in these muscles can cause pelvic pain, distressing urinary symptoms, difficulty having bowel movements and pain with intimacy.

For example, conditions like urinary urgency, frequency result in patients not participating in activities such as sports or socializing. Pelvic pain can lead to missed days of work or school. Issues with intimacy can cause profound effects on our closest relationships. Not being able to use the bathroom can cause other chronic health conditions. A tight pelvic floor can also contribute to chronic pain in our pelvis, low back and hips.

Since the pelvic floor is involved with many daily essential functions, a dysfunction in the system has a significant effect on our bodies and our lives.

How Pelvic Floor Therapy Can Help

Both a tight or weak pelvic floor can present with similar urinary, bowel, intimacy and pelvic symptoms. Since both increased tone and reduced tone can cause these symptoms, it is very important to get a correct diagnosis. Pelvic floor therapy is the gold standard for diagnosis for determining pelvic floor muscle tone and coordination. More importantly, pelvic floor therapy can effectively treat pelvic floor muscle tension.

Pelvic floor therapists can perform an internal examination of the pelvic floor muscles to help evaluate tone, coordination, strength and organ position. This exam is explained initially using a pelvic model and is only performed with the full and enthusiastic consent of the patient.

If the evaluation indicates pelvic floor tension, the therapist can recommend a variety of treatment options based on what is right for you as a patient and what your goals are.

This can include

-          At home dilator therapy or pelvic wand use

-          Lifestyle changes to reduce constipation and straining

-          A bladder and bowel diary to further evaluation bladder and bowel patterns

-          Nervous system downtraining such as stretching, progressive relaxation and breath work

-          Hip and core strengthening

-          Manual therapy in clinic

-          And more!

What to Expect During an Evaluation

During your first appointment, we will go over your personal history, concerns and goals. We will discuss your symptoms, past medical and surgical history, lifestyle and more.

 The next part of the appointment will involve an internal or external assessment. Often, the pelvic floor physical therapist will use a pelvic model to explain anatomy. The model is also used to explain what an internal pelvic floor assessment involves and to answer any questions. Then the therapist and patient decide together if an internal assessment is appropriate for the first visit. Remember an internal assessment is never required and the choice is fully yours as the patient!

Otherwise, an external assessment can be performed. This may involve watching you walk, squat, lunge, hinge or stand on one leg. It can also include testing specific muscles for strength and endurance. There may be some hands-on treatment including gentle manual therapy techniques. Therefore, it is important to choose clothing that is comfortable enough to move around in.

The last part of the appointment will include a summary of the therapist’s findings and next steps. The therapist will outline future treatment and what will be most beneficial for the patient to reach their goals.

When to Seek Professional Evaluation

If you are experiencing any bladder, bowel or intimacy symptoms, you should definitely seek the help of a pelvic floor therapist. It can also be helpful to consult your primary care physician, urologist or gynecologist depending on what is going on in order to first rule out any medical causes to your symptoms.

Where to Find Pelvic Floor Physical Therapy For A Tight Pelvic Floor In Queens, NYC

If you are experiencing symptoms of a tight pelvic floor, help is available! Pelvic floor physical therapy is the gold standard treatment for this condition. If you are in the Forest Hills, Queens, NYC area and you are looking for help today, reach out to us! Give us a call or fill out our contact form today!

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