Get immediate relief from pelvic floor muscle tension with these expert Pelvic Floor Physiotherapy exercises and techniques for pelvic floor muscle tension.
Read on now to relieve and overcome pelvic floor muscle tension with:
- 5 ways to relieve pelvic floor muscle tension
- Activities to avoid with pelvic floor spasm
- What is pelvic floor muscle tension?
- What causes pelvic floor muscle tension or pelvic floor muscle spasm?
- What problems can result from overactive pelvic floor muscles?
5 Ways to Relieve Pelvic Floor Muscle Tension
1. Pelvic Floor Relaxation ‘Down Training’ Methods
The following pelvic floor muscle relaxation or ‘Down Training’ steps (Shelly 2002) encourage pelvic floor relaxation when performed regularly.
- Relax–lie down with a pillow under the knees for 20-30 minutes daily to relax the pelvic floor muscles. Sometimes a warm pack placed over the pubic area or lower abdomen can assist pelvic floor relaxation.
- Employ diaphragmatic breathing – this means breathing into your diaphragm. Slow diaphragmatic breathing (like yoga breathing) is very important for relaxing the pelvic floor muscles.
- Visualise your pelvic floor muscles relaxing and a warmth in the pelvic floor region
- Gentle perineal bulging – this is very gentle bulging of the pelvic floor and should be taught by a pelvic floor physiotherapist. Bearing down too strongly can actually increase spasm so this must be done gently.
- Relaxed environment is important e.g. soft music, surrounding warmth.
- Total body relaxation – relax the muscles of the whole body, this may involve progressive relaxation of the different muscles from the face and neck through to the feet.
- Employ body scanning for any areas of increased muscle tension and aim for complete physical relaxation.
Pelvic Floor Relaxation CD by Dr Patricia Neumann, specialist Women’s Health Physiotherapist has produced this outstanding CD to help in the treatment of women with pelvic floor muscle tension. Relaxation CD guides the user through progressive pelvic floor muscle relaxation exercises and is an excellent guide to pelvic floor muscle relaxation. It is specifically for use with pelvic floor retrainer also known as vaginal dilator in the privacy of the home setting.
2. Vaginal Dilators
Vaginal dilator therapy may be introduced for treatment of pelvic floor muscle tension.
Refer to our Pelvic Floor Physiotherapy article on How to Use Vaginal Dilators to learn how to use vaginal dilators at home.
Vaginal dilators (shown) are designed with progressively increasing length and diameter, and are used to help a woman become accustomed to vaginal penetration and to help train pelvic floor muscle relaxation. Vaginal dilators are usually used initially by the woman in the comfort and privacy of her home. When used to manage sexual dysfunction dilator therapy may progress to the partner assisting with dilator use at a later stage when the woman feels ready for this management.
Vaginal dilators are also used by women following radiation therapy and following some forms of pelvic surgery such as hysterectomy where the vaginal tissues have become inelastic and require some gentle stretching for the woman to resume sexual activity with comfort. Sometimes the length of the vagina can become shortened during hysterectomy surgery and in these cases vaginal dilators can assist with gentle elongation of the vaginal tissues.
3. Correct Sitting
- Try to minimise prolonged sitting by taking frequent rest breaks where you stand and walk around
- Avoid sitting on round rubber rings which can increase pressure on the pelvic floor
- A quality pelvic support cushion can help to alleviate pelvic pressure and pain. A pelvic support cushion can reduce pressure on the pelvic flor muscles, reduce associated pelvic pain and increase sitting tolerance.
- Sit with good posture avoiding slumped posture which is known to increase pelvic tension. This means maintaining the curve in your low back when sitting.
4. Manual Therapy Treatment
A trained pelvic floor physiotherapist may use specific methods to promote pelvic floor relaxation and to re-educate the correct activation of these muscles. Pelvic floor physiotherapists are highly trained and skilled in manual therapy techniques for the pelvic floor. These methods are usually progressed gradually over time and may involve:
- Desensitising painful areas to touch (using physical touch or vaginal dilators)
- Pelvic floor stretches using digital resistance against these muscles
- Massage techniques
- Identifying areas of pelvic tension
- Postural re-education
- Biofeedback instruments which tell you about the activity of the pelvic floor muscles
- Treating concurrent conditions which may present along with pelvic floor spasm such as problems with pelvic joints (SIJ joints), tailbone problems and low back problems.
- Progressive strengthening of the pelvic floor muscles only when appropriate.
5. Complimentary Therapies
Pelvic floor rehabilitation may be just one component of addressing pelvic floor muscle tension. Other practitioners may also be involved in managing overactive pelvic floor muscles including counsellors and/or couple therapy depending upon the woman’s associated problems.
Activities and Exercises to Avoid with Pelvic Floor Muscle Tension
- Pelvic floor exercises or kegel exercises
- Intense core abdominal exercises
- Painful intercourse/ painful vaginal penetration
- Prolonged sitting
- Heavy lifting or heavy activity
- High impact exercise e.g. running
What is Pelvic Floor Muscle Tension?
Pelvic floor muscles can become taut with spasm and overactive just like other skeletal muscles in the body. Overactive pelvic floor muscles have increased tension and or an inability to fully relax, a little like having very tight and painful neck muscles that will not relax. When a woman experiences pelvic floor pain, this may actually cause her to involuntarily tighten her pelvic floor muscles even more, and so a cycle of ongoing pelvic pain and increased pelvic floor muscle tension or pelvic floor muscle spasm develops.
Gynaecologists and physical therapists are seeing increasing numbers of women with pelvic pain associated with the inability to relax the pelvic floor muscles. Because of the complexity of pelvic pain, this condition often goes undiagnosed.
What Causes Pelvic Floor Muscle Spasm?
Possible causes include the following:
- Overloading the pelvic floor muscles with too much pelvic floor exercise and insufficient relaxation. Women who regularly perform pelvic floor exercises or kegel exercises need to take the time to relax their pelvic floor muscles too.
- Overloading the pelvic floor with potentially unsafe intense abdominal core exercises
- Pelvic surgery including prolapse surgery and hysterectomy
- Pelvic infection or inflammation
- Recurrent infection such as cystitis
- Pelvic trauma
- Postural problems
- Mental/emotional factors.
It currently remains unclear whether pelvic pain causes pelvic floor muscle spasm, or whether the pelvic floor muscle spasm causes the pain – it’s a bit of a chicken or the egg story. What is known is they are both very much interrelated.
Problems Caused by Overactive Pelvic Floor Muscles
Overactive pelvic floor muscles can cause a range of bladder, bowel and sexual problems in addition to pain, emotional issues and progressive pelvic floor muscle weakness. These problems include:
- Bladder problems; slow urine flow, difficulty commencing urination, inability to completely empty the bladder, interrupted urine flow and even urinary urgency. These can result from the lack of pelvic floor muscle relaxation.
- Bowel problems; constipation, incomplete emptying of the stool, difficulty commencing bowel movement and straining throughout emptying. The straining associated with constipation can then cause increased pelvic floor muscle pain and increased tension. Furthermore additional problems may develop such as rectal prolapse, hemorrhoids and anal fissures.
- Sexual problems associated with intercourse and penetration. Vaginismus is the term used to describe the condition where the pelvic floor muscles spasm involuntarily with the threat of vaginal penetration which can prevent sexual intercourse, insertion of tampons and gynaecological examination. Sexual problems that result from overactive pelvic floor muscles can cause considerable emotional difficulty with stress, anxiety and relationship difficulties.
- Ongoing pain floor pain and discomfort caused by pelvic floor muscle over activity or pelvic floor muscle spasm can be very stressful and anxiety provoking which often makes the condition worse. The physical discomfort associated with pelvic floor muscle tension presents differently in different women; it may present as pain, ache or discomfort in the low abdominal, low back and/or in and around the vagina and anus.
- Pelvic floor muscle weakness results from the pelvic floor muscles contracting too much and tiring out. As a result when they are required to work they are not able to, contributing to problems such as stress incontinence (involuntary leakage of urine with exercise or activity). The supportive function of the pelvic floor muscles may also be compromised, increasing the vulnerability to other pelvic floor problems such as vaginal prolapse.
If you suffer from pelvic floor muscle tension and/or pelvic pain, you can access professional treatment by speaking with your doctor or a qualified Pelvic Floor Physiotherapist in your area accessed via the Continence Foundation of Australia free call phone 1800 33 00 66.
For more reading on therapeutic management of pelvic pain refer to:
Shelly B., Knight, S. et al. (2002) Pelvic Pain, ch 23-27. Therapeutic Management of Incontinence and Pelvic Pain, J. Laycok and J Haslam. London, Springer-Verlag: 156-189.
ABOUT THE AUTHOR, Michelle Kenway
Michelle Kenway is a Pelvic Floor Physiotherapist and author of Inside Out – the Essential Women’s Guide to Pelvic Support. The Inside Out exercise DVD and book show women how to exercise safely and effectively with pelvic floor safe exercises.