We frequently ignore the possibility of having a pelvic floor that is excessively tight because we place so much emphasis on developing a strong, tight pelvic floor (for good reason—it’s crucial). In a way, this information kind of blew our heads.
Has this situation been Kegel-ed into existence? What does it mean to have an overly tight pelvic floor? And how can we even determine if we have this?
So many inquiries.
We enlisted Aleece Fosnight, urologist and Medical Advisor at Aeroflow Urology, to help us make sense of everything.
What is a pelvic floor that is overly tight?
According to Aleece, “high-tone or tight pelvic floor muscles” indicate that the muscles are never at rest but rather are always engaged. “Consider it as a lift. Your pelvic floor muscles should be at rest on the floor, ready to contract whenever necessary. The lift is stuck on the first or first floor with tense pelvic floor muscles. Conversely, consider that the lift tends to congregate in the basement or lower levels when there is pelvic organ prolapse or weak pelvic floor muscles.
What typical symptoms are present?
Aleece lists the following symptoms as some of the more typical ones:
- Constipation
- Pelvic discomfort
- Dyspareunia, often known as pelvic pain during inserted intercourse
- Inserting a tampon causes pain
- Urinary symptoms include frequent urination, frequent voiding, poor urine flow, pee retention, and incontinence
- Prostatitis
- Lower backache
- Leg pain that spreads down them.
“Some AFAB individuals will even complain of ovarian pain when it is actually their pelvic floor,” she continues.
What could trigger it?
Aleece explains, “Overall, we notice that fear, tension, and anxiety are overriding themes that cause a reactive pelvic floor and, consequently, tight muscles.
(Those three are involved, of course.)
She cites forced sexual activity and having to “hold” their urine or stool for longer than necessary as behaviours that promote tight pelvic floor muscles. Endometriosis, interstitial cystitis, irritable bowel syndrome, pregnancy and delivery (both vaginal and caesarean birth), genitourinary syndrome of menopause, performance anxiety with premature ejaculation, and bad posture are a few illnesses that might result in a high-tone pelvic floor.
How should it be handled?
The response is a resounding “pelvic floor physical therapy.” That’s because a professional will be able to determine precisely which pelvic floor muscles are causing your difficulties.
“Modalities are very specific to the individual in order to isolate the involved muscles and guide the patient to their overall goals,” explains Aleece. Stretching exercises and diaphragmatic breathing are terrific places to start. Before strengthening can take place, the stiffness in certain muscles must be reduced.
Specifically, “No kegels! This will simply make the issue worse and make the agony worse,” she claims.
Additionally, pelvic floor physical therapists may employ vaginal dilator therapy to assist train those muscles using biofeedback. Vaginal dilator therapy should be carried out in conjunction with pelvic floor physical therapy, according to the expert.
She adds that trigger point injections with lidocaine or Botox/Dysport, as well as dry needling, may also be helpful. (Clearly, these should also be done by a doctor!)
She departs with the following observations:
You’re not by yourself. High-tone pelvic floor muscles are a common problem, but there are healthcare specialists who wish to help you live a life full of joy and happiness instead of pain.
