Pelvic Floor Muscles: Weak or Tight?

Incontinence is a concern that many of us associate with pelvic floor weakness, often leading to the prescription of Kegel exercises. However, a significant number of cases involving incontinence can be attributed to tight (hypertonic) pelvic floor muscles rather than a weakness (hypotonic.) To make matters more complex, the symptoms can even look the same - incontinence, pain with intercourse, and pelvic floor dysfunction including prolapse can be symptoms of both weak and overly tight pelvic floor muscles. Below we will shed some light on the intricate connections between emotions, stress, muscle imbalances and various lifestyle factors that contribute to pelvic floor issues, and what you can do about it.

The Jaw, Stress, Pelvic Floor Connection

Emotions play a silent yet powerful role in pelvic floor health. Research shows that when we experience anger, frustration, or stress, our pelvic floor muscles are often engaged unconsciously. The clenching of the jaw during such emotional states is a parallels this connection. To read more on the jaw, stress and pelvic floor connection, check out THIS blog post.

The Multifaceted Causes of Pelvic Floor Dysfunction

Not only are some of the symptoms of weak and overly tight pelvic floor muscles similar, but the cause may be, as well. From breathing patterns and posture, to outer hip muscle tension (or compensation,) all the way down to your foot and ankle mobility, there are a number of different reasons for pelvic floor dysfunction. If you regularly wear tight clothing (check on THIS blog post for more info on tight clothing) even that could negatively impact your pelvic floor.

Anything that we do to an extreme can contribute, as well, whether you are on your feet all day long or if you are regularly sitting in dysfunctional positions, excessive coughing and sneezing when you are sick or experiencing allergies can wreak havoc on your pelvic floor health in the short and long term.

Everything from constipation to the angle of your foot and choice of shoes can affect your pelvis and cause overly tight (or weak) muscles throughout the entire pelvic floor, or on one side or the other. Lastly, physical or emotional trauma, whether sexual or pregnancy/birth trauma, can have a big impact on the amount of tension through the pelvic floor.

What to Do?

If you have the option, pelvic floor physical therapy is a great place to start! However, if this is not an option and you have overly tight pelvic floor muscles the first thing to do is to learn to relax the pelvic floor muscles. The best way to do this is with your breath. Just begin to take nice, big, deep breaths. As you start to relax see if you can get the inhale to expand all around your ribs, through your lower abs and back, all the way to the pelvic floor. While you are taking these breaths and feeling the movement through your torso, try to make sure that your shoulders are not cinching up to your ears. You will have far greater access to bringing the breath down into your body (all the way to the pelvic floor) if you keep your shoulders down and as relaxed as possible.

Crocodile breath photo credit functionalmovement.com

For some this practice can take a little bit to get down, but keep trying, it will work with patience and consistency. You can also try the breathing (big, deep breaths) in different positions - try it while sitting on a stability ball to feel the pelvic floor feedback, in child’s pose, a yoga/deep squat, or laying on the ground on your stomach with your hands under your forehead (see Crocodile Breath photo above.) Find a position that works for you and then continue to get the breathing in every day. At the beginning, it is best if you can do it first thing in the morning or at night after the kiddos have gone to bed, giving you time to focus on the body movements. Then start to integrate it into your habits and workouts. Before you know it you will be using this type of breathing more often than not and have the tremendous feeling of having control of your body!

Conclusion

In our journey to understand pelvic floor dysfunction it is crucial to question preconceived notions and embrace a holistic perspective. Pelvic floor weakness is definitely a possibility when it comes to incontinence or any other pelvic floor dysfunction but don’t count out the fact that the muscles may actually be overly tight. By doing Kegels to remedy the situation you may end up making it worse if you are starting from a place of overly tight muscles. The beauty of starting with the breath is that overly tight and weak muscles will benefit. Then, after you are able to fully relax the pelvic floor at will, you can start to safely work on strengthening the muscles properly.

By recognizing the emotional and physical connections, as well as the multitude of factors contributing to pelvic floor issues, we can take charge of our well-being. This blog post serves as a guide, encouraging you to look beyond the leak, explore the complexities of pelvic floor health, and adopt a comprehensive approach to reclaim control over their bodies.