What is Pelvic Floor Muscle Tightness?
PLEASE NOTE: following information and associated clinical care relates to female patients only. We are not offering pelvic health care to male patients at this time.
Many people with pelvic pain have pelvic floor dysfunction, but specifically hypertonic muscles, or muscles that are too tight. The pelvic floor muscles are a group of muscles that attach to the front, back and sides of the bottom of the pelvis and sacrum. They are like a hammock or a sling, and they support the bladder, uterus, prostate and rectum. They also wrap around your urethra, rectum, and vagina (in women).
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 will often cause pelvic pain, or urgency and frequency of the bladder and bowels. When they are low-tone (hypotonic) they will contribute to stress incontinence and pelvic organ prolapse. You can also have a combination of muscles that are too tense and too relaxed.
Hypertonic muscles can cause urinary frequency, hesitancy, painful urination, urgency, stopping and starting of the urine stream, or incomplete emptying of the urinary bladder. Hypertonic muscles can also cause constipation, straining, pain during bowel movements, or even pain afterwards. Otherwise unexplained pain in the lower back, hips, pelvic region, rectum or genital area can also be due to tight pelvic floor musculature. Hypertonic muscles may cause pain during or after intercourse, during sexual stimulation or during orgasm.
Pelvic floor muscle dysfunction can best be assessed and diagnosed by specially trained doctors and physiotherapists using internal and external techniques which are manual, or hands-on, in order to evaluate the function of these muscles. A pelvic health physiotherapist will assess your ability to contract and relax these muscles. Their evaluation will also feel for tight bands or trigger points in the muscles. The bones and muscles of your lower back, hips and sacro-iliac joints will need to be assessed as well since poor alignment and poor function of these joints can stress your pelvic floor muscles. Conversely, if your pelvic floor muscles are tight or weak they can also stress the joints of your back and hips, and lead to persistent low back and hip pain. It is important for people who have unresolved low back and hip problems who also have pelvic floor to seek out a pelvic floor assessment. Their pelvic floor dysfunction could be the reason that their low back and hip pain is not getting better.
If an internal examination of the muscles is too painful, the connective tissue of your abdomen, thighs, groins and low back are often very tight. The connective tissue forms the container of the muscles, and these often need to be relaxed before any internal work can be done. The connective tissue dysfunction becomes the priority before the trigger points, or tight muscles can be effectively treated.
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.