Pelvic floor tightness is a common issue that can affect your overall wellbeing. If you are postpartum, heck if you are an adult women, there is a good chance you are dealing with some type of pelvic floor dysfunction. We often hear of pelvic floor weakness postpartum but have you considered the consequences of a tight pelvic floor?
Pelvic dysfunction is either weakness, tension, impaired coordination or some combination. And pelvic floor dysfunction can cause symptoms that negatively affect your mental and physical wellbeing. Pelvic health is health. It plays into our physical, mental, and emotional health and really can not be separated from them.
These problems are far too common but are not normal. According to NIH nearly a quater of the US female population is affected by pelvic floor dysfunction. The percentage is of pelvic floor dysfunction is significant in postpartum women when it is estimated that 35% have urinary incontinence and between 17-36% report painful sex at 6 months postpartum.
What is a tight pelvic floor tension and what are signs and symptoms to look out for and what can you do about it? Let’s take a look.
What is your pelvic floor?
Your pelvic floor is made up of the muscles that support your pelvic organs. It is made up of 14 muscles, fascia and ligaments. It really isn’t a floor at all and acts more like a hammock or even a trampoline. The pelvic floor is dynamic, there needs to be some give and take, some shock absorption.
The roles of the pelvic floor is to support the organs and to maintain continence and sexual function.
What does it mean to have pelvic floor tightness
Pelvic floor tension or having a tight pelvic floor means the muscles of the pelvic floor are unable to relax fully. The muscles remain in a semi-contracted state shortening the muscle length and increasing the tension and therefor the straining of the muscle. When a muscle is too tight it can develop knots or tigger points causing pain. It can cause asymmetry in the body. It can lead to weakness as a shortened muscle can not generate as much force.
What causes pelvic floor tension
Or more accurately what are risk factors of pelvic floor tension as there is correlation but not always causation.
- Trauma: such as slip and falls, car accidents, some child birth experiences
- Pregnancy and child birth: even uncomplicated and routine pregnancies and child births
- Poor posture or inefficient movement patterns and habits
- Stress, depression, anxiety: a 2001 study showed increased pelvic floor tension with images of threatening nature compared to those that are considered neutral.
- Holding stool or urine for too long or on the flip side going “just in case”
- Constipation. straining or pushing when you urinate or have a bowel movement
- History of sexual abuse
- Nerve damage
- Obesity
Signs and symptoms of increased pelvic floor tightness
- Bladder issues
- Bowel issues
- Sexual pain and/or disfunction
- Low back pain
- Pelvic pain
1-4 Bladder issues can be caused by a tight pelvic floor:
- Retention: Difficulty starting to urinate or unable to fully empty
- Phantom UTI: Burning and discomfort with urination, frequent urination and a urinary tract infection has been ruled out (meaning not present)
- Urgency: Needing to urinate often, not able to go 2 hours or longer between times in the bathroom Or feeling like you need to run to the bathroom so you do not have an accident.
- Incontinence: leaking urine this can be overnight or with stress such as when laughing, sneezing, coughing or with physical activity such as running or jumping.
5- 7 Pelvic tension can lead to bowel issues:
- Bloating and constipation: feeling constant pressure in your bowels or lower abdomen, straining to have a bowel movement or going only a few times a week.
- Difficulty wiping clean: taking more than 4-5 wipes for the paper to appear clean
- Incontinence: Unable to hold in stool or leaving skid marks on your under pants
8- 11 Sexual dysfunction is common with pelvic floor tightness:
- Painful intercourse: unable to tolerate or having discomfort with vaginal insertion – due to trigger points and inability to relax to allow for penetration
- Decreased orgasm: orgasms are weaker and less intense then they used to be for you
- Inability to orgasm: Unable to achieve orgasm at all or very infrequent
- Nerve pain and Hypersensitivity (burning sensations or discomfort with even light touch) leading to avoidance of sexual experiences – when the muscles are too tight they can put pressure on nerves causing these symptoms.
12. Pelvic pain as a sign of tight pelvic floor:
Pelvic pain is a broad term and can encompass any number of areas in the pelvis. This can be pain at the tail bone pain, sacroiliac joint pain (the area where your sacrum and back of your pelvis meet), pubic symphysis pain (the space in line with your belly button at the front of your pelvis where the two halves meet.) This can be pain in any of the number of muscles in the pelvis, at the joints, vaginal pain or a broader sense of pain. If unaddressed this pain can become chronic pain. Pelvic pain is very common postpartum and is even more common with postpartum runners.
13. Related pains
Related pain can stem from pelvic floor tightness. This can be back pain particulartly lower back pain or hip pain. When these pains present themselves without other causes it is important to consider it might be from pelvic floor tension.
What can you do about it:
The good news is while pelvic floor tightness is common and can cause a lot of issues there absolutely something you can do about it!
First address the potential causes. Practice good bowel and bladder hygiene: stay hydrated, avoid constipation with diet and movement, relax with some deep breathing instead of straining and use a step stool or squatty potty so your knees are higher than your hips. Avoid going too long between using the bathroom, build bathroom breaks into your day and stop going just in case.
Make sure you are addressing your mental health and wellbeing. You may need some external support for this and that is more than OK.
Gentle 360 breathing can help visualizing the breath expanding into your back and side ribs and not just your belly or chest.
Gentle stretches such as happy baby, deep squats, knee to chest and even hip flexor stretches can help.
Physical Therapy and postpartum support can help
Physical Therapy is extremely beneficial when dealing with pelvic floor dysfunction. Your therapist can assess the causes (tightness, weakness, coordination ext) and work towards a treatment plan with you and your goals in mind. This is also a great way to address some of the postural risk factors and habits you have that need to be addressed. Keep in mind the longer you have had your symptoms the longer for treatment to work and you may need a multidisciplinary approach that may include medications and injections if the cause of symptoms is significant pelvic floor tightness.
Being proactive is always better than being reactive so revisit bowel and bladder hygiene is a good idea for everyone and since postpartum women have a high risk of pelvic floor dysfunction proactive care that allows for pelvic floor healing and rebuilding is vitally important postpartum. If you are looking for support postpartum check out some of my additional resources and programs.
