______________________________________________________________________________
Getting to Know the Pelvic Floor
The pelvic floor muscles sit like a hammock between your pubic bone and tailbone playing a key role in supporting your pelvic organs. These work to:
Maintain bladder & Bowel control
Help support organs
Co-ordinate with abdominal and back muscles to support the pelvis
Provide sexual functions
The Challenge of Overactive Pelvic Floor Muscles
Pelvic floor overactivity is characterised by an increase in the tension of the muscles that surround our pelvic organs. Tight pelvic floor muscles create many bothersome symptoms, and some can mimic the symptoms of weak pelvic floor muscles.
This can be determined via a pelvic floor assessment conducted by your pelvic health physiotherapist. This could entail either an internal pelvic floor examination (a gloved finger inserted into the vagina or rectum) or through use of an ultrasound sensor externally (over the perineum/labia, or over the tummy). During an internal pelvic floor examination, your physiotherapist can determine how much tension there in in the pelvic floor muscles. Either examination show the muscle’s ability to contract and to relax. This aids the physiotherapist in grading the quality of the movements.
You can find out more about pelvic floor assessment here.
Because people with pelvic floor overactivity already have increased tension in their pelvic floor, treatment aimed at adding more tension to the area - such as doing "Kegels" or lots of pelvic floor contractions - may not work or may actually make the symptoms worse.
Symptoms of Overactive Pelvic Floor Muscles
Now symptoms can vary and be different amongst every individual so let’s have a look at some of the effects an overactive pelvic floor may have on one:
Urinary leakage during strain such as coughing or sneezing or during activity such as running or simply standing up
Incomplete emptying of the bladder when urinating
Urinating frequently
Increased urgency whilst the bladder fills
Painful bowel movements
Incomplete or difficult emptying of the bowels
Pain:
During intercourse
During and/or after orgasm / ejaculation
During periods
Low back pain
Pelvic pain
Abdominal pain
Some of these signs above might be starting to sound like symptoms experienced by someone with a weak pelvic floor and you might have already started pelvic floor exercises to strengthen the muscles.
However, it may be determined that you may be experiencing overactivity in this area. In such cases, your physiotherapist will help you manage this by prescribing a treatment plan tailored more towards encouraging relaxation for the pelvic muscles.
Tip from Your Physiotherapist May Involve
Muscle stretches for both lower back and pelvic muscles to aid in promoting movement of the internal and external muscles that are linked to the pelvis
Ensuring complete relaxation of the pelvic floor muscles before completing each repetition of a pelvic floor muscle exercise
Relaxation and deep breathing techniques
This can involve mindfulness or yoga
Manual therapy to release tension in external and internal pelvic muscles
This may include massage to back and hips, and/or internal pressure to release tension in the muscles
Home treatment can involve the use of pelvic wands to improve pelvic floor flexibility and reduce pelvic pain in between appointments
Pelvic Wand
What’s Next?
Considering the similarities between symptoms of a weak pelvic floor and overactive pelvic floor muscles we believe it's important to seek help to determine what the issue is. By assessing your pelvic floor, we can help you determine which treatment plan is right for you. Your physiotherapist will tailor a program towards your goals and personal needs.
If this sounds like symptoms you experience, you can contact us or book online to get started on your journey to improving your pelvic health.
References:
Aw, H. C., Ranasinghe, W., Tan, P. H. M., & O'Connell, H. E. (2017). Overactive pelvic floor muscles (OPFM): improving diagnostic accuracy with clinical examination and functional studies. Translational andrology and urology, 6(Suppl 2), S64–S67. https://doi.org/10.21037/tau.2017.05.41
Worman, R. S., Stafford, R. E., Cowley, D., Prudencio, C. B., & Hodges, P. W. (2023). Evidence for increased tone or overactivity of pelvic floor muscles in pelvic health conditions: a systematic review. American journal of obstetrics and gynecology, 228(6), 657–674.e91.
Comments