Why a Tight Pelvic Floor Isn’t a Good Thing: Understanding Pelvic Floor Overactivity
Contrary to popular belief, having a tight pelvic floor isn’t a sign of strength or health. In fact, it can actually indicate dysfunction! (Thanks, social media, for spreading that myth!) Pelvic floor overactivity, also known as hypertonic pelvic floor dysfunction, occurs when the muscles in the pelvic floor become overly tight and struggle to relax. These muscles play a crucial role in core stability, posture, and bladder and bowel control. When overactive, they can lead to a wide range of symptoms—some obvious and others less so. If you suspect a hypertonic pelvic floor might be affecting you, keep reading to learn more.
Signs and Symptoms of Pelvic Floor Overactivity
Pelvic Pain
- Pain, burning, or stinging sensations in the vulva, perineum, or scrotum
- Pain during or after sexual activity (dyspareunia), genital arousal, or orgasm
- A “blocked entry” sensation during vaginal insertion (vaginismus)
- Pain with tampons, gynecological exams, or intercourse
Urinary Symptoms
- Frequent, chronic, or recurrent UTI-like symptoms despite negative lab results
- Urinary urgency and frequency
- Painful urination (dysuria)
- Difficulty starting or fully emptying the bladder
- Bladder pressure or discomfort after emptying
- Urinary leakage during exercise (common in runners, performing artists, endurance athletes, and high-impact athletes)
Bowel Symptoms
- Constipation or fewer than three bowel movements per week
- Pain or straining during bowel movements
- Incomplete evacuation
- Hemorrhoids
- Fecal incontinence or leaking
Lower Back and Hip Pain
- Tension in the pelvic floor contributing to lower back, hip, sacroiliac joint, or inner thigh pain
- Weakness or limited mobility in the spine or hips causing compensations that stress the pelvic floor
Post-Surgical Scars
- Abdominal surgery scars restricting movement and affecting the pelvic floor, including:
- C-sections
- Appendectomies
- J-tube placements
- Pilonidal cyst removals (impacting pelvic floor-related nerves)
Menstrual Pain
- Exacerbation of menstrual pain or conditions like endometriosis and polycystic ovarian syndrome (PCOS) due to pelvic floor tension
Jaw Pain
- Temporomandibular joint (TMJ) dysfunction, including pain or difficulty with chewing or opening and closing the mouth
Joint Hypermobility
- Conditions like Ehlers-Danlos Syndrome (EDS), which increase the likelihood of joint dislocations or subluxations and can affect pelvic floor function
While this list might feel overwhelming, remember that pelvic floor overactivity presents differently for everyone. Most individuals only experience a few of these symptoms.
How Pelvic Floor Physical Therapy Can Help
Pelvic floor physical therapy (PFPT) is a proven and effective treatment for muscle overactivity. At Pacer Physical Therapy, our licensed pelvic health physical therapists assess your posture, breathing mechanics, strength, mobility, and coordination to create a customized treatment plan. Here’s how we can help:
Manual Techniques
- Soft tissue mobilization, cupping, and dry needling with electrical stimulation
- Internal therapy to release muscle tension and improve circulation in the pelvic floor
Therapeutic Exercises
- Mobility exercises targeting areas of restriction
- Strengthening exercises to address weak muscles and restore balance
Education and Nervous System Regulation
- Posture retraining and diaphragmatic breathing
- Bladder habit education and pain science principles
- Stress management techniques to support long-term relief
With consistent therapy, many patients experience significant improvements in pain, posture, bladder control, and overall comfort. By addressing muscle imbalances and teaching effective relaxation techniques, pelvic floor physical therapy can restore function and help you reclaim your active lifestyle.
Start Your Journey Toward Relief
At Pacer Physical Therapy, we understand that every person’s experience is unique. That’s why we’re committed to empowering you with a personalized game plan, confidence in your movement, and unwavering support throughout your journey to a pain-free life. Ready to take the next step? Book a complimentary discovery call with us today!
You’ve got this!
Dr. Vera
