The Pelvic Floor: Why Weakness Isn’t Always The Issue

Do you experience bladder leakage when you cough, sneeze, laugh or jump? Or are you constantly rushing to the toilet? I bet you assume that you must have a weak pelvic floor or a “small bladder”. Did you know that all of these symptoms can actually be a result of the pelvic floor muscles being too tight and that your pelvic floor may not actually be weak?

For many people, tight pelvic floor muscles can lead to discomfort, pain, bowel or bladder issues and altered sexual function. In this blog, we will discuss how pelvic floor tightness can result in dysfunction and pain, what causes tightness, and ways to alleviate it

The role of pelvic floor muscles:

The pelvic floor is a group of muscles located in the pelvis that supports the pelvic organs, including the bladder, uterus and rectum. Despite its importance, the pelvic floor is often overlooked and not given the attention it deserves. However, maintaining a healthy pelvic floor is crucial for overall bodily function and wellness.

The pelvic floor plays a vital role in supporting the pelvic organs and maintaining bladder and bowel control. A strong pelvic floor can aid in preventing pelvic organ prolapse and it helps with sexual function, including orgasm. The pelvic floor also modulates intra-abdominal pressure and provides stability to the pelvis, back and hips.

Pelvic floor muscles are meant to move and expand freely. They need to be able to contract AND relax for optimal function, movement and coordination. Despite popular belief, many pelvic floor issues are a result of tight muscles not necessarily weakness. Issues can arise if the pelvic floor muscles are too tight, too weak or there is poor neuromuscular control and timing. 

Symptoms of a tight pelvic floor:

Often the symptoms of a tight pelvic floor can be confused for symptoms of a weak pelvic floor. There are a few symptoms of a tight pelvic floor that may surprise you.

• Painful intercourse

• Urinary leakage with coughing, sneezing or jumping

• Frequent or urgent urination

• Pain in the low back, pelvis, abdomen, hip or coccyx

• Chronic constipation

• Rectal pain

• Incomplete bowel or bladder emptying 

• Painful periods

• Abdominal bloating and pelvic congestion

• Pain inserting a tampon or undergoing pelvic examinations (ie, pap smear)

Causes of pelvic floor tightness:

There are various reasons and factors that contribute to pelvic floor tightness, including:

• Pregnancy and Childbirth

• Chronic constipation and straining

• Stress or nervous system dysregulation 

• Chronic coughing

• Scoliosis

• Prolonged sitting

• Falls to the tailbone

• Pelvic surgery and scar tissue

• Poor breathing patterns (eg. asthma, stress, anxiety, sucking your stomach in)
  

There is often an overlooked connection that exists between the back, hips, abdomen and pelvic floor muscles. If you are someone who experiences unresolved pain in these areas and feel like you’ve tried everything but have never checked your pelvic floor, this could be the missing link to why your pain is not resolving.

Conditions that can cause tight pelvic floor muscles:

• Pelvic pain conditions: such as endometriosis, adenomyosis, interstitial cystitis, pudendal neuralgia and vulvodynia

• Labral tears of the hip

• Irritable bowel syndrome

• Poor posture or scoliosis

• Pelvic congestion syndrome

• Pelvic organ prolapse

• Urinary incontinence

• Constipation

• Sexual trauma

• Pelvic surgery: such as a laparoscopy, hysterectomy or caesarean section

It is important to note that tight pelvic floor muscles can be a contributing factor to these conditions, as well as a result of them. In either case, seeking medical evaluation and treatment is important for managing tight pelvic floor muscles and related symptoms.

What can you do to help these issues?

If this sounds like you and you feel like you're not getting answers from the medical system, consider your pelvic floor to be the potential missing piece of the puzzle.

By understanding what causes pelvic floor tightness and ways to alleviate it, you can take steps to improve your quality of life. 

If you experience pelvic floor problems, such as incontinence, pelvic pain or discomfort during sex, it’s crucial to seek help. With the appropriate treatment, management plan and rehab program you can improve these symptoms.

If you’re not sure of your pelvic floor function - please reach out to me or book yourself in to see your local women’s’ health osteopath or physiotherapist.

Keep any eye out for more blog post about some great management techniques in the near future!

Article written by Dr Emma Berry (Osteopath)

Image by Susan Buth Photography