Are you looking for ways to relieve your pelvic floor muscle tension now and for good?
These expert Pelvic Floor Physiotherapy exercises and techniques will help you get immediate relief and know how to overcome pelvic floor tension long term.
Read on now to learn:
- Treatment techniques that relieve pelvic floor muscle tension
- Exercises and 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?
Treatment Techniques that Relieve Pelvic Floor Muscle Tension
1. Lying Down
Take the load off your pelvic floor by avoiding prolonged standing or sitting where possible.
Lying down with a pillow under your knees or lying on your side with a pillow between your legs will relieve the weight of your abdomen off your pelvic floor muscles. When you are upright, your pelvic floor is under load.
Unloading your pelvic floor muscles can give you immediate pain relief especially when combined with a warm pack.
2. Using a Warm Pack
Immediate relief can often be achieved by placing a warm pack outside your briefs over your pelvic floor.
Use mild heat only – some women find that the warm pack can be held in position with an additional pair of briefs placed over the top of a small warm pack or using a towel to keep the warm pack in position. The warm pack can be used for 15 to 20 minutes at a time. Apply the pack when lying down with a pillow under your knees.
Pelvic floor muscle relaxation methods are outlined next and these can provide immediate relief when combined with a warm pack.
3. Practicing Pelvic Floor Relaxation
Daily practice of pelvic floor relaxation is an important for teaching tight and painful pelvic floor muscles to relax.
Pelvic floor relaxation exercises can provide immediate relief from pain and spasm.
Dr Patricia Neumann, specialist Pelvic Floor Physiotherapist has produced an innovative Pelvic Floor Relaxation CD to relieve pelvic floor muscle tension at home.
Down Training Relaxation Technique
This pelvic floor muscle relaxation method known as Down Training1 teaches the pelvic floor muscles to relax and release.
- 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.
4. Using Vaginal Dilators
Vaginal dilator therapy is often used in the clinic and by women at home to treat pelvic floor muscle tension.
Vaginal dilators (shown right) are used inside the vagina to improve the comfort with the feeling of vaginal penetration and to train pelvic floor relaxation with penetration.
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 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.
Vaginal dilators should be used with the best lubricant ingredients for pelvic floor health and safety.
Vaginal dilators can be purchased online from professional pelvic health stores see www.kegels.com.au
5. Managing your Bowels
Avoid straining to use your bowels and aim for the correct stool consistency – constipation and straining will exacerbate pelvic floor muscle tension and associated pain.
Use the correct bowel emptying technique to avoid straining and achieve a comfortable bowel movement.
Keep your stool soft and well formed so that it is easy to pass. Choose stool softener foods if your stool is too firm and causes you discomfort and straining.
6. Correcting your Sitting Posture and Support
- Minimize prolonged sitting by taking frequent rest breaks where you stand and walk around
- 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.
- 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.
7. Manual Physiotherapy 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 usually highly trained and skilled in manual therapy techniques for the pelvic floor. Treatment techniques are usually progressed gradually over time and may include:
- Desensitising painful areas to touch (using physical touch or vaginal dilators)
- Pelvic floor stretches using digital resistance against these muscles
- Massage techniques
- 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 (Sacroliliac joints), tailbone problems and low back problems.
- Progressive strengthening of the pelvic floor muscles only when appropriate.
8. Complimentary Therapies
Pelvic floor physiotherapy rehabilitation may be just one component of addressing pelvic floor muscle tension.
Other health practitioners may also be involved in managing overactive pelvic floor muscles including counsellors and/or couple therapy depending upon the woman’s associated problems.
Exercises and Activities to Avoid with Pelvic Floor Muscle Tension
Exercises that load the pelvic floor increase pelvic floor muscle tension and exacerbate pelvic pain.
These exercises and activities can increase pelvic floor muscle tension:
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.
INSIDE OUT – PELVIC FLOOR SAFE EXERCISES
with Pelvic Floor Physiotherapist
Learn how to exercise and avoid exercises that overload the pelvic floor causing pelvic floor problems.
Inside Out book and DVD is a complete exercise solution for women seeking to exercise safely and protect their pelvic floor.
1Shelly 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.