Exercises and Self Help for a Tight Pelvic Floor

So you have been diagnosed with having a tight or hypertonic pelvic floor and are looking for exercises and self help advice. We are here to support you. If you suspect overactive pelvic floor, we encourage you to seek an appointment with a health care practitioner to formalise a diagnosis. This can confirm your suspicions and rule out any other possible medical conditions that may be contributing to your complaint. A great place to start with calming your pelvic floor muscles down and allowing them to relax and find ease is to start with some abdominal breathing exercises.

Abdominal / Diaphragmatic Breathing

Lay down in a comfortable position with your knees bent and your back flat on the floor. Gently place one hand on your chest and the other on your belly. Slowly inhale and feel your abdomen expand under your hand, as if your tummy was filling with air like a balloon. Your lower hand should rise while your hand on your chest should remain relatively still. With each breath cycle, gently continue to expand the belly and move the breath down towards the pelvis, allowing it to relax, open and release tension. Keep your breath smooth and avoiding breath holding, as this may reflexively re-tighten the tissue.

Exhale and allow the air to move out of the lungs, while relaxing the abdomen, ribs and pelvis without straining or contracting. Count the number of seconds in and out, to ensure you maintain a long slow flow, we recommend approximately 4 seconds in and 4 seconds out. Maintain your attention without stress or strain, keeping your mind clear from thoughts or worries. Perform for 5 – 10 minutes per day.

Pelvic Floor stretch and release

Start in an all 4’s position on hands and knees. From here gently move your hips backwards to sit on your feet and gently lower the forearms so they are resting on the floor. In yoga this position may be referred to as a modified child’s pose. Rest your head down onto your forearms. Focus your attention onto your pelvic floor region. Inhale into the lung, expand the abdomen and visualise stretching the back of your T-shirt with your ribs and relaxing the muscles around your tailbone. Exhale and let go of any tension without effort. Each breath 3 seconds in and 3 out, without pausing or breath holding between each cycle. Repeat 8-10 cycles of breathing in this position.

Gentle abdominal stretch

Lay on your tummy down on the floor while placing your hands under your shoulders. Gently push up onto the hands, if this is uncomfortable in the wrist, hands or lower back, just gently come up onto your forearms. Inhale and move the breath down thru the lungs, the abdomen and back of the ribs while expanding and letting go in the pelvic floor region. Exhale and gently press the floor away to slightly increase the arch in the lower back. If comfortable, you may come up onto your hands. Keep your pelvis facing the floor. Gently move up and down in conjunction with your breath cycle while staying comfortable in all regions of your body. Continuously breathe slowly in and out without any breath holding for 30 seconds, gently lower towards the floor, and repeat 3 times.

Hip Stretch

Lay on your back with knees bent and feet flat on the floor. Place your foot on your opposite knee. Place one hand between your legs, clasp under the leg which has the foot resting on it. The other hand cradles and supports the outside of the same leg. Gently bring your leg towards your chest while keeping your foot placed on the knee. You should start to feel a light stretching sensation around the outside of the hip on the opposite leg. Breathe into the stretch and maintain a sense of openness of the pelvis and relaxation. You should not strain or hold your breath at any time. Visualise relaxation and moving of the pelvic floor up and down in conjunction with your breathing cycle. Hold for 30 seconds, perform each side twice. Osteopaths with a special interest in men’s and women’s reproductive or urinary health issues can assist you with a whole body approach to relaxing the body and pelvic floor girdle. Feel free to share your thoughts below.

Symptoms of a tight pelvic floor

You may be wondering what are the signs and symptoms of a tight pelvic floor and how this differs to the much more commonly known weak pelvic musculature issue. It is otherwise known as a hypertonic pelvic floor. This occurs when the pelvic floor muscles are too tight and are unable to comfortably relax.

Causes of a tight floor

There is no one defining cause of the issue, however there are some common activities that may predispose you to developing it.

You may be at risk if you spend a lot of time and energy working out (such as in the gym) and inappropriately holding on the abdominal muscles for long periods of time.

This can lead to the muscles switching on and forgetting how to relax.

If you have a history of avoiding going to the bathroom to void, this may be situational conditions such as due to work or avoiding using public bathrooms.

Holding on prevents the loss of control, however this can become a habit to the point of not being able to let go.

In some circumstances, increased stress or anxiety in the whole body can lead to generalised increased body tension.

This too can be a precursor to a tight pelvic floor.

People with certain health conditions may also be at an elevated risk of developing a tight pelvic floor.

This may include women with severe pelvic pain associated with reproductive organs such as endometriosis, fibroids or polycystic ovaries.

If any inflammation or swelling is present in the pelvis or lower abdominal region due to bladder, uterine, or digestive conditions, this too can provide the environment for increased tension to build.

For example, inflammatory bowel conditions such as ulcerative colitis, crohn’s disease, celiac disease or even irritable bowel syndrome can cause increased abdominal and pelvic muscular contraction and tensing.

Other conditions that have been associated with a hypertonic pelvic floor include pudendal neuralgia, vulvodynia and interstitial cystitis.

Trauma including previous surgery, birth related injury, scar tissue or adhesions may also predispose to pelvic floor tightness.

Any of these issues can be associated with increased tension of the surrounding muscles including the hips, pelvis, core or legs.

For example, you may have chronic tightness of the hamstring, coccygeus, piriformis, hip flexor or obturator internus.

Understanding your full medical history is important for any health practitioner when this complaint arises.

People can experience a number of different issues in association with hypertonic pelvic tissue.

You may not have all of these symptoms in order to be assessed as having the problem.

Symptoms of a tight pelvic floor

Some of the concerns that may be experienced include but are not limited to:

• A quick and sudden need to go to void the bladder or bowels.
• Lower back pain.
• Pelvic pain.
• Urinary incontinence.
• Pain on urination.
• An urge to go for a wee, even when the bladder isn’t very full.
• Difficulty relaxing to allow for the flow of urine to pass.
• The sensation of not being able to fully empty the bladder or bowel.
• Inability to empty the bowel completely leading to constipation.
• Pain in the pelvis, particularly focused around the tailbone region, otherwise known as the coccyx.
• Difficulty in relaxing the vagina to allow for penetration.
• Painful intercourse or other types of sexual dysfunction.
• Vaginismus (involuntary muscle spasm or excessive tightness of the vaginal walls).

We can support and assist you to learn how to relax the pelvic floor, however we do also encourage you to seek one on one support with health care professionals, who have experience in this area of practice.

This may include seeing an Osteopath with a special interest in continence issues, a physiotherapist or a continence specialist.  Ask any questions about symptoms of a tight pelvic floor below.

Here are 3 reasons not to do your pelvic floor exercises in cars while sitting at the traffic lights! I’ve heard this so many times, do your pelvic floor exercises while you are sitting in the car at a red light. WRONG – This is terrible advice. And I will admit, I am guilty of giving this advice in the past as well. Here are 3 reasons why I no longer give this recommendation.

REASON 1 – Your Pelvic Position Won’t be Optimised

Sitting in your car seat will tend to hold your pelvis in a specific position. This may not be the ideal position for you to train your pelvic floor. Very commonly, the seat will encourage a posterior pelvic tilt. From this position, it is easier to squeeze the posterior triangle and not the front portion of the pelvic floor. This may over time lead to a discrepancy in the strength of different portions of your muscular tissue. What this means is, your back passage will be getting a stronger workout than the front. In some instances, this may be a good thing, but for many, this is not an ideal situation.

REASON 2 – Your pelvic floor contractions will not be your primary focus

We know that any type of muscular strengthening is improved by having laser focus on the contraction you are trying to perform. This increases the connection between the nerve, muscle and brain, providing greater stimulation and activation of the tissue. In turn, this will supercharge your exercises and increase the returns on your efforts. We want you to get the best results possible, in the shortest amount of time, performing your activations in this way will not guarantee the best outcome. You also want to be contracting the correct muscles and with lack of focus you may start recruiting the help of surrounding structures, which won’t lead to long term change. In addition, if you are driving a car, your focus should be on the task at hand, avoiding accidents and getting you and your family to and from your destination.

REASON 3 – Number of reps and sets

Any type of exercise training program benefits from you performing the correct number of repetitions and sets. In case this is unclear, this is how many times you perform the squeeze in a row and how many times you repeat this in a sequence. If you are only performing the contractions in the car seat, your performance and number of repetitions will be determined by how much time you have sitting at the lights, rather than the beneficial number for you. You are likely to be interrupted, lose count of how many you are up to, or perform an incorrect number of contractions.

REASON 4 – Lack of variety

If you are trying to strengthen any part of the body, it is useful to perform a variation of different exercises that stimulate the same area to maximise results. The pelvic floor is no different. If you are performing them in the same position over and over again, you are stagnating your ability to see progressive improvement. Lets face it, if you are putting your time and energy into performing the exercises, you want to be seeing results. This is improved by doing the exercises in a variety of different positions, with variations in the reps and sets.

REASON 5 – You may squeeze for too long

Getting into the habit of squeezing every traffic light may in fact lead you to doing your pelvic floor exercises too often. According to where you live, the time of day you drive and how much time you spend in the car will all have a massive impact on how often and for how long you are doing the exercise. For some people, especially if you live in the city, you may spend really long amounts of time in static in traffic. This may lead you to doing too many activations. Didn’t know there was such a thing, well there is. This can lead to you developing an inefficient and overly tight pelvic floor. You may turn it on so much, you forget how to turn it off. Basically, you may learn to use it all the time and never relax the tissue. This is just as important as turning it on.

So Here’s a Quick Recap

It is worthwhile and beneficial to stop doing your pelvic floor exercises on the road for a number of reasons including: – Pelvic positioning may be affected – Lack of focus and ineffective training with activation of other muscles – Likely to perform the incorrect number of reps and sets – Lack of variation in your program can lead to a stagnation of results – You may squeeze for too long, leading to overstimulated and under-performing function. In order to safeguard your pelvis and get better results, avoid doing your pelvic floor exercises in cars and make sure you sign up for our free training program.