Tight pelvic floor muscles are common among all genders and ages and it takes more than internal pelvic floor therapy to get rid of symptoms. In this blog, you will learn what to look for and how to relax the tight pelvic floor muscles. Please refer to my blogs on pelvic floor dysfunction covering some of the facts and myths related to the pelvic floor including treatment, signs and symptoms of pelvic floor dysfunction, and much more. Here is the number one question I am asked about a tight pelvic floor.
Are Tight Pelvic Floor Muscles Painful?
Tight pelvic floor muscles can cause pain anywhere within the pelvis or in the thighs. Or it can be only painful when doing an internal vaginal or anal treatment. In order to understand why that is, we should go over the anatomy of the pelvic floor to some degree which is explained in detail in my blog: “Are pelvic floor exercises the same as Kegels’.
Some of the muscles can only be reached internally while others can be accessed from outside and frankly are not a part of the pelvis which is the reason why the answer to this question is not a straight yes or no!
The biggest mistake I see in the treatment of pelvic floor dysfunction is that the focus is on the internal muscles of the pelvis, disregarding the hips, lower back, and posture which directly influence the stability of the pelvis. This in turn impacts the integrity of the muscles INSIDE the pelvis.
As explained in my blog. ” Are pelvic floor exercises the same as Kegels‘,
“On the inside, the pelvic wall consists of 2 primary muscles the and obturator internus which are hip stabilizer muscles. When working internally on the pelvic floor, the piriformis is not accessible and the obturator internus may be reached. Frankly, with the internal manual work, the length of the examiner’s index finger determines how far and well these muscles are reached. Working on the muscles of the floor should NOT be first on the order of treatment as strengthening the pelvic floor muscles without the pelvis being strong, and without addressing the ‘influencers’ of its stability is a waste of time long term!”
Pelvic floor muscles are compensator muscles. There are different degrees of tightness or changes in the tone of the muscles in the pelvic floor. Tight pelvic floor muscles can cause trigger points within these muscles inside the pelvis, shooting pain to areas such as the penis or vagina and causing the sensation of fullness in the rectum. When there is pressure on some of the nerves (or branches) inside the pelvis from tight pelvic floor muscles, you can get pain in the vagina or penis, around the anus, or in the space between the two.
What Does A Tight Pelvic Floor Feel Like?
Based on the layer or degree of tightness of the muscles of the pelvic floor, the symptoms can vary. It may feel like your ‘breath’ does not go all the way down and hits a wall. You may feel pain with the insertion of anything in the vagina or anus, it may be a pain in the penis or testicles in men or vagina in women. It may lead to pain with sitting or from sitting to standing up, or pain with walking.
Cramping in the lower portion or side of the pelvis without any other explanations seems to be related to tight pelvic floor muscles as well. If any of these are present, you should consult a pelvic floor therapist (not necessarily a physical therapist) who is an expert in recognizing the external presentations of tight pelvic floor muscles.
Top 3 Exercises For A Tight Pelvic Floor
Breathing:
The one absolutely necessary exercise for tight pelvic floor muscles is breathing. That is biological breathing where your spine is neutral and against the floor or wall and as you breathe, you imagine, your diaphragm is moving down toward your pelvis while your rib cage is expanding. This video really explains it well and you should pay close attention to the details discussed. Without the proper breathing technique, none of the other exercises will be complete and thoroughly accurate.
Squatting:
Squatting allows the muscles of the pelvic floor to relax and if you can’t squat because of bad knees, you can sit on the toilet using a squatty potty. You can also lay on your back with no arch in the spine (neutral spine), bring your knees to your chest, breathe as explained above and relax your vagina/pelvis, anus, and the space in between.
If it is not easy to bend your knees in the position that I just explained, get close to the wall, bend your knees, place your feet on the wall, and try to move your glutes close to the wall to your comfort level. It is like squatting on your back with your feet on the wall. Make sure you are relaxed and breathing correctly.
Quadruped (Table Top Exercise):
This ‘baby’ exercise is what we all did as babies around 7 months old. This exercise requires you to keep a neutral spine when holding the pose and when rocking back and forth. I love this exercise because it not only relaxes the pelvic floor but is also a great practice for posture by working on stabilizing the torso which is not the case in all patients with tight pelvic floor muscles.
Can Tight Pelvic Floor Muscles Cause Frequent Urination?
Frequent urination can be due to many reasons one of which may be tight pelvic floor muscles. The bladder occupies the pelvic inlet and when the muscles of the pelvic floor and the walls of the pelvis are tight, they cause an increase in pressure on the bladder which in turn causes frequent urination. It is important to note that in many cases tight pelvic floor muscles as the cause of frequent urination is typically far down the list of causes and is therefore not attended to in a timely manner.
Tight pelvic floor muscles are more common than most realize and while injuries can lead to tightness, our lifestyle, sports we play, and habits play a much bigger role in how common this condition is. Make sure to visit my blog page for more blogs on pelvic floor dysfunction and subscribe to Core Pelvic Floor Therapy Youtube channel as well.
Dr. Shakib
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