A hypertonic pelvic floor might not be a term you hear every day, but for many, it is a daily reality that brings discomfort, pain, and a host of other challenging symptoms.
In this comprehensive guide, we seek to understand what are the causes, the symptoms, and how you or a loved one can get effective treatment for it. We hope that this information will empower you to better manage your pelvic health and get long-term relief.
What Is A Hypertonic Pelvic Floor?
This term refers to a pelvic floor disorder where the muscles in this area are under constant tension and unable to relax. These muscles, located at the base of the pelvis, support the pelvic organs, assist in urinary and bowel control, and contribute to sexual function.
When they are overactive or in spasm, they can lead to a range of symptoms including urinary, bowel, and sexual dysfunction which impacts an individual’s daily activities and overall quality of life.
Common Causes
Understanding the underlying causes of the condition is the first step toward effective management and treatment. Below are some of the most prevalent factors that contribute to this condition.
Chronic Stress and Anxiety
Stress and anxiety can manifest physically in various ways, one of which is the tightening of muscles. Imagine a dog, when the dog is excited, happy, or friendly, the dog's tail is up and wagging back and forth; when the dog is scared, anxious, or frightened, the tail is tucked under and often stiff. While we do not have tails, we do have a tailbone! Many of the pelvic floor muscles attach directly to the tailbone and when contracted, pull the tailbone inward, much like a dog! Over time, chronic stress and anxiety, combined with other factors we’ll review below, may manifest as pelvic floor tension. Therefore, managing stress and addressing anxiety are important components to address in those suffering from pelvic pain or pelvic floor dysfunction.
Poor Posture and Ergonomics
The way you sit, stand, and move can significantly impact your pelvic floor muscles. Poor posture, such as slouching or consistent forward-leaning, can put continuous pressure on the pelvic area, leading to muscle tightness. Muscles work best when they are not too tight and not too stretched. When we spend too much time in either of the above postures, the muscles become unbalanced and do not work optimally.
Bladder and Bowel Habits
Many people develop poor bathroom habits such as waiting too long to go pee, especially teachers and nurses, others develop habits from a young age where they ‘just in case pee’ or strain to have a bowel movement. Poor bowel and bladder habits such as regular straining due to constipation, holding our urine for too long, or forcing ourselves to urinate for convenience can lead to pelvic floor dysfunction. These strenuous habits force the muscles into a state of ongoing tension and dysfunction, which over time can become a default state.
Trauma or Surgery
Trauma to the pelvic area, which can be both emotional or physical trauma including, but not limited to, surgery, traumatic falls, sexual abuse, or even allowing penetration despite pain, may result in muscle guarding, tightness and in some cases scar tissue. The body's natural response to injury or threat is to tighten the muscles to guard against movement. Think about if you were to touch a hot stove, your body’s immediate reaction would be to pull your hand away from the burner, this is similar to what happens to the pelvic floor muscles. Unfortunately, repetitive or constant threats (real or perceived) can persist long after the initial trauma has healed.
Intense Exercise Routines
High-impact sports or intense exercise routines that focus heavily on core strength can sometimes contribute to pelvic floor dysfunction. Activities such as heavy lifting, gymnastics, or any exercise that puts excessive strain on the pelvic area can cause the muscles to become overly tight.
Symptoms of Hypertonic Pelvic Floor
The symptoms of a hypertonic pelvic floor can vary widely from one person to another but typically include the following.
● Pelvic Pain
- One of the most common symptoms is ongoing or intermittent pain in the pelvic region. This pain might be described as dull, aching, throbbing, or burning and can occur in the lower back, hips, genitals, or rectum.
● Urinary Issues
- Problems with urination, such as urinary urgency or frequency, painful urination, or incomplete emptying of the bladder, often accompany the condition. Some report feelings of a urinary tract infection (UTI), despite having negative cultures.
● Bowel Dysfunction
- Similarly, the condition can affect bowel movements, leading to constipation or straining during bowel movements or painful bowel movements. When this happens, it further exacerbates the tension in the pelvic muscles.
● Sexual Dysfunction
- For many, a hypertonic pelvic floor can lead to discomfort during intercourse, alterations in orgasm ability, reduced or hypersensitive sexual sensation, or pain during or after sexual activity.
Treatment Strategies
Addressing this condition requires a comprehensive treatment approach tailored to your specific symptoms and underlying causes. Some initial treatment strategies are listed below.
● Physical Therapy
- Pelvic floor physical therapy is one of the most effective treatments. A physical therapist with specialized training can provide a comprehensive evaluation which will help to develop an individualized plan of care which may include manual therapy, education, and individualized exercises and techniques to relax and stretch the pelvic muscles, improve posture, and alleviate pain.
● Stress Management Techniques
- Since stress and anxiety can contribute significantly to muscle tension, incorporating stress management techniques such as mindfulness, yoga, and meditation can be beneficial. These practices help in relaxing the pelvic floor muscles and also improve overall well-being. This is an important component even if this is not the cause of your symptoms, many individuals experiencing pelvic pain also develop stress and anxiety because of their condition which can further exacerbate one's symptoms.
● Proper Posture and Ergonomics
- Adjusting your daily posture and improving ergonomics at work or at home can reduce undue stress on the pelvic floor muscles. Simple changes like using an ergonomic chair, taking frequent breaks from sitting, and practicing correct lifting techniques can make a significant difference.
● Medication and Pain Management
In some cases, medications can play a key role in managing the symptoms of hypertonic pelvic floor or may help individuals tolerate physical therapy. Here’s how they can help:
-
Pain Relievers & Muscle Relaxants
- Over-the-counter pain relievers such as ibuprofen or acetaminophen can help alleviate the discomfort caused by muscle tension. For more severe cases, your healthcare provider may prescribe muscle relaxants to help ease muscle spasms. These may be oral or a specialized compound made into a suppository for localized relief.
-
Antidepressants
- Low doses of certain antidepressants have been found effective in treating chronic pain, including pelvic pain. These medications can help modulate pain signals and reduce discomfort.
- Before taking any pain medication, remember to consult your healthcare provider to understand the benefits, risks, and potential side effects.
- Hormones
- Estrogen and testosterone are key hormones that can be impacted by a number of factors including birth control or other medications that alter hormone function. Finding a sexual medicine provider can be helpful in assessing if this is contributing to your symptoms. Some individuals may benefit from vaginal (localized) hormones in addition to the other treatments listed in this blog.
● Biofeedback
- Biofeedback is a technique that helps improve your awareness of muscle control; typically focused on relaxing or contracting your muscles. Through biofeedback, individuals can gain better awareness and control over their pelvic floor muscles, learning to relax them effectively. It is important to understand that there are many ways to perform biofeedback.
- Most commonly, sensors are either attached to your body, or a probe is inserted vaginally or rectally, and connected to a machine that provides feedback on muscle activity. This feedback helps you understand how your muscles are working and how you can control them to reduce tension.
- Other forms of biofeedback include working directly with your therapist during internal examinations where they can provide you verbal or tactile cues and give you immediate feedback verbally.
- Newer devices allow you to use a device that connects to an app on your phone, where you can either practice contracting or relaxing. The benefit of these newer devices is that your provider can create individualized programs for you to do at home, where you can measure your progress.
● Dietary Adjustments
What you eat can impact your pelvic floor health. A balanced diet can prevent constipation and reduce strain on pelvic muscles:
-
High-Fiber Foods
- Incorporating a high-fiber diet can help maintain regular bowel movements and decrease the chances of constipation, which can aggravate the condition. Foods rich in fiber include fruits, vegetables, whole grains, and legumes.
-
Hydration
- Staying hydrated helps soften stool, making bowel movements easier and reducing the need to strain. Aim to drink at least eight glasses of water a day or more, particularly if you are active or live in a hot climate.
● Lifestyle Modifications
Making certain lifestyle changes can also significantly impact the health of your pelvic floor:
-
Regular Exercise
- Engaging in regular, low-impact exercise such as walking, swimming, or cycling can help maintain overall muscle tone and reduce stress, which is beneficial for relaxing the pelvic floor muscles.
- Your physical therapist might also recommend a personalized exercise program, tailored specifically to your needs to help in the management of the condition. Such programs focus on strengthening the core and pelvic muscles while taking care not to worsen the symptoms.
- Techniques such as Pilates or tailored yoga routines can improve muscle flexibility and decrease tension. In addition to relieving symptoms, these personalized exercises contribute to overall body awareness, a key aspect in the long-term management of pelvic floor health.
-
Avoid Heavy Lifting
- Heavy lifting can strain the pelvic floor muscles. If your job or daily activities require lifting, focus on using proper form and engaging your core and leg muscles to take the pressure off your pelvic area.
● Mindfulness and Relaxation Techniques
Mindfulness and other relaxation techniques can also be very effective in managing stress and reducing muscle tension:
-
Meditation and Breathing Exercises
- Practicing meditation and deep breathing exercises can help calm the mind and reduce the body’s stress response.
-
Guided Imagery
- This technique involves focusing on peaceful images in your mind to help relax and distract from pain.
Continued Support and Care
Managing a hypertonic pelvic floor often requires ongoing care and attention:
- Regular Follow-UpsRegular appointments with your healthcare provider or therapist can help monitor your progress and adjust treatments as necessary.
-
Support Groups
- Connecting with others who are facing similar challenges can provide emotional support and valuable insights into managing this condition.
-
Personal Care Routine
- Establishing a routine that includes time for exercise, relaxation, and self-care can promote long-term management of symptoms.
Specialized Pelvic Health Tools
Pelvic health tools are designed to directly address the physical aspects of disorders like hypertonic pelvic floor.
● Pelvic Wands
- Pelvic wands are specially designed to help manually release trigger points in the pelvic floor muscles. They come in various materials such as silicone, which is gentle on the body and easy to clean.
- These tools are typically curved to reach tight muscles deep in the pelvic region. Vibrating pelvic wands are particularly helpful in improving symptoms like chronic or intense pelvic pain because the vibration can distract from the pain to allow for a more therapeutic session.
- By applying gentle pressure with a pelvic wand to specific areas of the pelvic floor, you can help release muscle knots and reduce tightness. This targeted approach helps in relaxing the muscles and alleviating pain.DilatorsDilators are another essential tool for dealing with the condition, especially when tightness affects vaginal insertion or intercourse. They come in different sizes and are designed to help by gradually stretching the pelvic floor muscles and vaginal walls.
- Start with a small dilator and slowly work up to larger sizes to increase the muscle's ability to relax and accommodate insertion.
- The use of dilators can be very beneficial in reducing discomfort during sexual activity, improving gynecological examinations, and even aiding in recovery post-surgery. They are an important part of therapy for those dealing with this painful condition.
Personalized Care Tailored to Your Needs
At NewFlora, we understand that managing a hypertonic pelvic floor is a journey filled with challenges. We combine the benefits of professional physical therapy and specialized tools to help you or your loved one get a solution that works for you.
Our personalized care is tailored to fit your unique needs, taking into consideration your specific condition and symptoms. Based on a comprehensive assessment, we recommend a treatment plan that may include the use of pelvic health tools, physical therapy, and/or medication. Our goal is to empower you through education and practical solutions that you can apply in your daily life to regain your joy and confidence.
Understanding and managing a hypertonic pelvic floor often requires a multifaceted approach that includes the use of specialized tools and guidance from specialized pelvic health doctors. The journey to recovery is gradual and requires patience, but with the right support and resources, it is possible to recover and lead a healthy, active life.
