Pelvic floor disorders are incredibly common. Many women are aware of symptoms that may point towards a weak pelvic floor, pelvic pain is one of those symptoms. What you may not know is that an overactive pelvic floor is also a contributory factor for pelvic pain. In this blog post, I'll explore 10 reasons your pelvic floor may be overactive.
Understanding Underactive Pelvic Floors
First let's understand what are the signs of an underactive or hypotonic pelvic floor, or pelvic floor weakness. This happens when the muscles lack tone and strength and can lead to symptoms like urinary incontinence, pelvic organ prolapse, difficulty emptying the bladder or bowel, pelvic pain and sexual dysfunction. Causes include childbirth, hormonal changes, and sedentary lifestyles.
One in three women will experience a pelvic floor disorder (PFD) in her lifetime (Source: UCLA Health).
10 Reasons Why Your Pelvic Floor May Be Overactive
An overactive or hypertonic pelvic floor occurs when the muscles are constantly tense or contracted. This state of tension can lead to chronic pain, discomfort, and a range of other symptoms. Here are 10 reasons your pelvic floor may be overactive:
1️⃣ Chronic Stress: Stress acts as a primary trigger for pelvic floor dysfunction. The body's response to stress induces heightened tension in the pelvic floor muscles, fostering an environment conducive to pelvic pain and discomfort.
2️⃣ Anxiety and Tension: Anxiety and chronic tension can induce a similar effect, causing the pelvic floor muscles to tighten excessively. Individuals grappling with anxiety disorders or persistent tension may find themselves more susceptible to pelvic pain.
3️⃣ Chronic Pain: Conditions like endometriosis, adenomyosis, interstitial cystitis and irritable bowel syndrome are linked to an overactive pelvic floor due to prolonged periods of pain in which the pelvic muscles are held tight. Any condition causing chronic pain can have a similar effect and cause pelvic tension.
4️⃣ Sexual Dysfunction: Vulvodynia and dyspareunia:- chronically painful intercourse can be both a symptom as well as a cause of hypertonic pelvic floor. For example; painful intercourse can cause over-recruitment of the pelvic floor muscles. Or, a strong pelvic floor can cause tender spots in the vulva and vagina even leading to vaginismus, and becomes a vicious cycle.
5️⃣ Poor Posture & Muscle Imbalance: Maintaining proper posture is vital for pelvic floor health. Prolonged periods of slouching or sitting with poor posture can cause imbalances in the muscles surrounding the pelvis. Hypermobile hips, weakness or tightness in the hip flexors, glutes, or abdominal muscles can disrupt pelvic alignment and function.
6️⃣ Previous Trauma or Injury: Past pelvic trauma or injury, such as childbirth, surgery (e.g. laparoscopy) or accidents, may prompt the pelvic floor muscles to tighten as a protective response. Consequently, chronic pelvic pain and discomfort may ensue.
7️⃣ High Impact or Repetitive Exercise: Activities involving repetitive movements or strain on the pelvic floor, such as running or high-impact exercise can intensify muscle tension. With core-strengthening Pilates exercises, it's possible to build a very strong pelvic floor, so it's important to work with a teacher who will guide you to also fully release and lengthen the pelvic muscles.
8️⃣ Chronic Constipation or Straining: Persistent constipation or straining during bowel movements can exert pressure on the pelvic floor muscles and lead to overactivity.
9️⃣ Urinary Dysfunction: Prolonged delay of urination or defecation or 'holding on' can cause constant engagement of the pelvic floor muscles. Inability to fully empty the bladder or of urinary urgency or pain, may result.
🔟 Emotional Factors: Unresolved trauma or stored emotions in the body, can manifest as physical tension in the pelvic floor muscles.
There can be several contributory factors for an overtly strong pelvic floor. Personally, I can tick 9 out of 10 of the above. How many do you identify with?
First Steps To Healing Your Overactive Pelvic Floor
Here is a simple 2-step mindfulness practise for stress and pelvic release. Try to check-in on yourself throughout the day, whilst making a cuppa, walking the dog, whenever you have a few moments. You can do 1 or 2 in isolation, or both together!
Step 1:
Stress Check: Do you feel stressed? How are you breathing: short. fast and shallow breaths or slow, deep and easy breaths?
Stress Release: Pause to breathe deeply in and out for 5-10 repetitions; perhaps using one of these three calming breathing methods, 4-7-8 breathing or simply breathe in for a count of 5, out to a count of 5. Notice if your shoulders or upper chest are able to stay relatively quiet as you breathe - a sign that you’re engaging your diaphragm (and therefore your pelvic floor) is that your lower abdomen is moving up and down.
Step 2:
Pelvic Floor Check: Do you feel excessive tension in your pelvis, can you sense if you pelvic floor is lifted right up? Try to let it go. This will help:
Pelvic Floor Release: Sitting, standing or anywhere you happen to be, perhaps also closing the eyes, take a deep belly breath in. Send your breath all the way down into the bowl of your pelvis - visualise a balloon fully inflating within the pelvic bowl, feel it expanding to the edges of you in all directions. See if you can sense your pelvic floor dropping and lengthening - perhaps being pushed down by the balloon. On your exhale let the balloon deflate, pelvic floor lifting up, shortening and contracting, pelvic bowl shrinking.
There are many exercises that can be given to assist with pelvic floor dysfunction both in a Pilates studio and a physio setting. In fact, the two modalities are complimentary. In my own healing, I am using the advice of a specialist pelvic health physiotherapist at the Royal Free Hospital in London and have been successfully adapting my personal Pilates practise to incorporate more targeted exercises to relax my pelvic floor and rebalance the surrounding muscles.
If you suspect a pelvic floor dysfunction, a pelvic health physio can be useful to determine whether your pelvic floor is overactive (or underactive) and to what extent. They can provide focused exercises for manual therapy, relaxation and breathing, potentially including internal trigger point release work.
Conclusion
When you are dealing with an overactive or underactive pelvic floor, it's helpful to begin by having an awareness of what are your triggers for pain and pelvic floor tightening and what you notice within your body.
You're not alone on this journey to pelvic health so please reach out to me for further guidance and visit the Moxie Pilates studio in Caterham.
Ali xx
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