Overactive Pelvic Floor

A hypertonic pelvic floor occurs when the muscles in the pelvic floor become too tense and unable to relax.  may people with a tense and non-releasing pelvic floor experience pelvic health issues such as constipation, painful sex, urgency and pelvic pain.  A hypertonic pelvic floor may also be accompanied by tension in surrounding muscles such as glutes, inner thighs , tummy muscles and hamstrings.

Having a tight and weakened pelvic floor can cause restricted blood flow and oxygenation to the muscles.  It is not simply diagnosed as it has may different causes and clinical presentations.

What causes a hypertonic pelvic floor?

The main causes are:

• Endometriosis
• Interstitial cystitis
• Prolapse
• Irritable bowel syndrome
• Haemorrhoids
• Anal fissure
• Pudendal neuralgia
• Ankylosing spondylitis
• Fibromyalgia
• Connective tissue disorder with hypermobility
• Labral tear of the hip
• Lumbar radicular pain
• Coccyx injury
• Pregnancy
• Stress/anxiety

Symptoms can include:

• Constipation
• Incomplete emptying of the bowel or bladder
• Straining when emptying
• Slow flow of urine
• Urinary incontinence, urgency or frequency
• Pelvic pain
• Painful sex (dyspareunia)
• Low back pain
• Hip pain
• Coccyx pain

If you are experiencing any of these symptoms, book an appointment with one of our women’s health physiotherapists who will help you get to the root cause of the problem and determine the best treatment plan for you.  Physiotherapy treatment might involve a pelvic floor relaxation exercise programme, manual therapy (internal and/or external), use of dilators and massage wands and voiding and defaecation techniques.

Mariola Stypulkowska MISCP
Senior Women’s Health Physiotherapist