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.