Pelvic Floor Tightness
The pelvic floor muscles are a group of muscles that attach to the front, back and sides of the pelvis and sacrum. They are like a hammock or a sling, and they support the bladder, uterus and bowel. They also wrap around your urethra, rectum, and vagina.
These muscles must be able to contract to maintain continence, and to relax allowing for urination and bowel movements, and in women, sexual intercourse.
When these muscles have too much tension (hypertonic) they can cause the following symptoms:
· Urinary frequency, urgency, hesitancy, leaking, stopping and starting of the urine stream, painful urination or incomplete emptying
· Constipation, straining, pain during or after bowel movements
· Unexplained pain in your low back, pelvic region, hips, genital area or rectum
· Pain during or after intercourse, orgasm or sexual stimulation
When your pelvic floor muscles are tight and weak, the tension is treated before the weakness. Once the muscles have reached a normal resting tone, and are able to relax fully, their strength is reassessed and pelvic floor strengthening exercises are prescribed if appropriate.
There are a number of ways to manage pelvic floor tightness:
1) Self-care is an important part of treatment. Avoid pushing or straining when urinating and ask your doctor about how to treat constipation if necessary. Using methods such as warm baths twice daily can also be helpful.
2) Anxiety, stress and our thoughts, attitudes and beliefs can perpetuate the pain and tightness in our pelvis. Managing these will help in pelvic floor relaxation.
3) Regular deep breathing is an important part of learning to relax tension in all of your muscles, but particularly the pelvic floor. The pelvic floor muscles form the bottom of the cylinder of core muscles, and the diaphragm is the roof. Therefore, there is an important coordination that occurs between the diaphragm and the pelvic floor. If you do not do deep diaphragmatic breathing during the day, then your pelvic floor will stay tense and rigid, which may lead to pain. During deep diaphragmatic breathing your shoulders should be relaxed and down and your abdomen should expand on the breath in.
4) Deep breathing exercise: Lie on your back with your arms relaxed by your side. Lying down is most relaxing, but you can also take a mini-breathing break throughout your day in any position that you find yourself in. Take a deep breath in through your nose. Breathing in through your mouth sends a panic signal through your system, so it is preferable to breathe in through your nose. You can breathe out through your mouth, making an “S” sound as you exhale. This sound is one of the ways to strengthen your diaphragm by making you more aware of your exhalation. Repeat for 5-10 minutes several times per day.
5) Reverse Kegels: lying on your back with knees bent. As you take a deep breath in, visualize that the muscles between the pubic bone and tailbone lengthen by gently moving your pubic bone towards the ceiling and gently move your tailbone towards the surface you are lying on. Imagine that the pelvic floor muscles are getting longer as this happens creating more space in your pelvic floor. Don’t tilt your pelvis as you do this and keep your spine still and let the movement occur in your pelvic floor. Be patient. This takes some time to feel the letting go or lengthening of these muscles. This can be practiced in sitting and standing as well.
As well as practicing your relaxation techniques, the pelvic floor often requires some massage and trigger point release from your physiotherapist.