Is it Pelvic Floor Tension?

If you have ever experienced pain with vaginal penetration, constipation, or urinary frequency, urgency, or leakage you MAY have underlying pelvic floor tension. Just as many people hold stress in our neck and shoulders, the pelvic floor commonly holds tension as well. When our pelvic floor is in a constant state of tension, it can present in a variety of different ways. 

The most obvious way that pelvic floor tension presents is pain with vaginal (or anal) penetration. Whether it be tampons, a pelvic exam, or sexual intercourse, the inability of the pelvic floor to relax can make one, some, or all types of penetration painful.

Constipation is another condition that can result from pelvic floor tension. A chronically tense pelvic floor can make it difficult for the anal sphincter to relax and allow bowels to evacuate with ease. 

One of the less commonly conditions associated with pelvic floor tension is urinary incontinence. Both stress and urge incontinence can result from chronic tension in the pelvic floor musculature. Stress incontinence, leaking when laughing, coughing, sneezing, running, jumping, etc, can be exacerbated by a pelvic floor that is unable to contract efficiently to stop the flow of urine during these activities. While many associate more kegels being the solution for stress incontinence, a chronically tight pelvic floor is often a weak pelvic floor and kegels will only exacerbate this tightness. Similarly, chronic pelvic floor tension can make it more difficult for your urethral sphincter to relax causing some urine to be retained in the bladder. This retained urine can irritate the bladder resulting in increased frequency and urgency of urination, or urge incontinence. 

So we’ve talked about some conditions that can be caused by pelvic floor tension, but how do we treat it? Well, it depends on the severity and the symptoms, but the over arching theme is to down regulate the tension being held in the pelvic floor muscles.

The first thing I start with with anyone experiencing pelvic floor tension is learning how to perform 360 diaphragmatic breathing. When the diaphragm is functioning well, it naturally causes the pelvic floor to relax and lengthen. Diaphragmatic breathing also stimulates the vagus nerve which helps the body get out of fight or mode, decrease stress, and in turn, allows then pelvic floor to relax.

The second muscle group I typically address is the adductors. Upon examination, it is common to find adductor tightness in those who are experiencing pelvic floor tension. There are significant fascial connections between the adductor muscle group and pelvic floor, so when the adductors contract, it helps the pelvic floor contract. Likewise, when the adductors are able to relax, the pelvic floor can relax as well. 

The last thing I work on during the first visit is both internal and external manual release of the pelvic floor musculature to the individual’s tolerance. Depending on how much pelvic floor tension exists and how reactive their pelvic floor is determines the amount of pressure given. While I want to give enough pressure for the muscles to release (similar to a massage), it is I want to ensure that I am not providing too much pressure that can result in the reverse effect and put the muscles further into spasm.

If you think you are experiencing pain with penetration, constipation, or urinary frequency, urgency, or leaking, it is best to find a pelvic floor therapist near you for a full evaluation and treatment plan to address the root cause of your symptoms.

To learn more, schedule a complementary phone consult today.