Told You Have a Hypertonic Pelvic Floor, Now What?
So your doctor told you that have a hypertonic pelvic floor…
You may be thinking: “What is a hypertonic pelvic floor?”, “What is causing my pelvic floor to be hypertonic?”, or “What else has this been impacting that I may not know about?” and most importantly, “How do I treat a hypertonic pelvic floor?”
Well let’s talk about it.
First of all, let’s pause and take a breath—literally. That tightness in your pelvic floor? It’s a little like your muscles are holding onto tension they don’t need, like clenching your jaw when you’re stressed. But instead of your jaw, it’s happening in the group of muscles at the base of your pelvis.
What Is a Hypertonic Pelvic Floor?
Essentially, it just means the muscles of your pelvic floor may be tight, or that the tone is higher than normal.
Your pelvic floor is a hammock of muscles that supports your bladder, bowels, and (if applicable) uterus. When these muscles are too tight or overactive, they’re essentially working overtime, even when they should be relaxed. Think of it as a muscle that’s stuck in a constant state of flexing— not comfortable!
Side note: “Tone” or “tension” are normal to have in your muscles. When we say hypertonic, we’re describing what that tone or tension looks like. Also your muscles can contract or they can have moments of higher tension, and that’s okay. How long your muscles engage in this state, why they are in that state, and during what activities they engage in this hypertension is more important. It’s all just part of the equation to help you feel ease and be able to function optimally day to day.
Common Symptoms of Chronic Hypertonic Pelvic Floor Muscles
A hypertonic pelvic floor can show up in a lot of different ways, including:
Pain with activity: During sex, when peeing, when pooping, or even just sitting
Pain despite activity: In the genitals, groin, anus, low back, hips, etc.
Trouble Peeing: Difficulty starting a urine stream or feeling like you didn’t empty your bladder fully
Urgent or Frequent Need to Pee: If your urge to pee is really strong, you feel like you need to run to get there, or you just feel the urge to pee frequently
Leaking: Urine or stool
Constipation: Yep, those tight muscles can make it harder to poop. This hypertension can often pair with other factors that impact digestion.
Difficulty with Sex: Trouble with arousal, erections, or orgasm; pain with insertion
Pressure or heaviness in the pelvic region
If any of these sound familiar, you’re not alone. and you don’t have to deal with this forever.
Common Causes of Hypertonic Pelvic Floor Muscles
Hypertonic pelvic floors don’t happen out of nowhere. Some common culprits include:
Chronic stress and anxiety: Ever notice how tension creeps into your shoulders or jaw? The same thing can happen to your pelvic floor
Injury: Think childbirth, surgery, even a bad fall. Scar tissue can contribute to this or compensation for other muscles not functioning properly
Trauma: Sexual, physical, verbal, emotional, medical and more
Shame: Around genitals, sex, peeing, pooping, sexuality, and more
Posture and movement habits: How you sit, stand, and move can affect these muscles (I say this NOT to increase fear with movement, just that we want to look at the whole system and what can contribute)
Overdoing kegels: Yes, often these are poorly prescribed by providers not properly trained in pelvic rehab.
The presence of one of the symptoms above does not automatically mean you have a hypertonic pelvic floor, please consult with a medical provider for a proper assessment.
How to Relieve Hypertonic Pelvic Floor Muscles
I have good news - There are plenty of ways to help relieve this!
Everyone’s situation is unique, and it’s often valuable to have a team for holistic care. Sometimes someone just learns to deep breathe or change a habit and all is well, others may need ongoing therapy or thorough assessment.
Pelvic floor therapy is a such a supportive space to get help. You can get a thorough look a your WHOLE body as one functioning system. A pelvic floor therapist can use an array of techniques to help guide you to what is needed for relief the symptoms that brought you to this article to begin with.
Depending on your needs and the therapist’s training and approach, this support can look like body work, habit adaptation, movement techniques for lengthening, mobility, and strengthening, trigger point release, nervous system regulation, breath training, mental health support, brain response re-processing, training in pelvic tools and more.
A pelvic floor therapist can also help you build upon your team with additional support that would best suit your needs.
Overall
A hypertonic pelvic floor doesn’t have to be your forever baseline pelvic muscle state. It’s also not your fault it’s happening, it’s not all in your head, and even if “everything is normal” at the doctors, there is absolutely support to help you feel better. Another important note to make, is that when we mention the impact of anxiety and stress on the pelvic floor, we want to clarify that this doesn’t mean “oh it’s just anxiety”, and if you “just relax” your symptoms will go away. It is much more nuanced than that, and again, so much can be contributing to pelvic health. That’s why we look at your body holistically, and address anxiety with an individualized approach.
With the right approach, you can teach the body to get back to feeling good again. Remember, it’s okay to ask for help, whether that’s from a therapist, a coach, or even a supportive community member. Your pelvic floor deserves some love and focused attention.
Anxious Pelvis offers trauma-informed pelvic floor occupational therapy, virtual coaching, & education for pelvic pain, vaginismus, painful sex, bladder and bowel dysfunction, pregnancy, postpartum, perimenopause, and gender-affirming care.
Denver Clinic: 3801 E Florida Ave, Suite 915, Denver, CO 80210
Virtual care through our coaching & education services available worldwide.
By Anxious Pelvis | Pelvic Floor Occupational Therapy in Denver, CO & Virtual Coaching Worldwide
Remember: this post is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here. 