Hi friends! Have you struggled with pelvic pain, constipation, difficulty emptying the bladder, pain with sex, or tailbone pain? While these are not the only symptoms you my have, they are common if you have pelvic floor muscles that are too tight! Here are 9 tips to help deal with tight pelvic floor muscles.
#1 Identify the Cause
This is a huge step in treating pelvic floor muscles that are too tight. Knowing what the cause is can help us treat the real reason as opposed to simply masking symptoms. This may require you to see several healthcare providers over multiple disciplines. Here are some of the most common providers when dealing with pelvic pain: gynecologists, gastroenterologists, urologists or urogynecologists, and of course pelvic floor physical therapists and occupational therapists.
#2 Pelvic Floor Physical Therapy
Pelvic floor physical therapy is a great place to start to address any issues with the pelvic floor muscles. Most states in the US have direct access, which means you can see a PT without needing a referral from a physician. And the great news—pelvic PT is covered by most insurances!
A pelvic PT can help in so many ways! One of the biggest ways a PT can help is through education. The PT can explain to you the anatomy of your body and the way it functions. Understanding this, can be a big step towards managing your pain. They also help you to recognize habits you may have and help you to create new, healthy ones. They can provide relaxation training and biofeedback (down training) to help relax tight pelvic floor muscles. They can also use manual therapy techniques, such as massage and trigger point release, to help relax the pelvic floor and surrounding muscles.
#3 Healthy Bowels
Keeping bowel movements regular and avoiding straining will help prevent any extra strain or stress on the pelvic floor muscles. If you’re struggling with constipation or diarrhea this can place extra strain on the pelvic flour muscles. Ideally, your poop will have the consistency of a squishy banana since this makes it the easiest to pass without placing any extra strain or work on the muscles.
Talk with your healthcare provider on how to optimize your bowel movements. Remember that water and fiber, or even laxative use, aren’t always the only answers to constipation. Make sure your healthcare providers are truly listening to you and your symptoms and getting to the root cause of any problems.
#4 Keep a Healthy Bladder
Not only do we need our bowels to be healthy, but we need a healthy bladder, too! Make sure you are getting enough water, limiting bladder irritants, and peeing every two to five hours during the daytime. If you are struggling with urinary incontinence, going pee a lot, or strong urges to pee this may be contributing to tight pelvic floor muscles or these may be symptoms of the muscles being too tight.
#5 Nervous System “Quieting”
When we are stressed, our sympathetic nervous system is stimulated. The sympathetic nervous system is responsible for our “fight or flight” survival instinct and gets us ready to get ourselves out of harm’s way. Even though we aren’t in harm, our bodies aren’t smart enough to differentiate between the stress of the holidays and the stress of something threatening our safety (like a lion chasing us).
#6 Diaphragmatic breathing
The diaphragm is a large muscle and it sits just under the ribcage and spans from the chest bone in the front to the spine in the back. When using our diaphragm to breath, it moves downward as we inhale and upward as we exhale. As the diaphragm comes down, it can help to gently stretch the pelvic floor muscles with downward pressure (without bulging/pushing!).
This is a great breathing technique to use when dealing with pelvic floor issues. Using diaphragm breathing can help improve the effectiveness of pelvic floor stretches/exercises. On the other hand, chest breathing can lead to tightness in the ribs, spine, and muscles of the trunk contributing to pelvic pain.
Watch the video below to learn how to perform diaphragm breathing.
#7 Pelvic Floor Muscle Training
Pelvic floor muscle training incorporates more than just Kegels. Just like other muscles in our bodies, there is more than one way to strengthen these muscles. Think about your butt (gluteal muscles)—there are several ways to make these muscles stronger: squats, bridges, donkey kicks, etc. Same with the pelvic floor! Kegels aren’t the one and only way, and they aren’t the solution to all pelvic floor problems. In fact, with some pelvic floor problems like pelvic pain, doing Kegels can make symptoms worse.
Since the pelvic floor is part of the core, that exponentially expands our options for training it! The pelvic floor muscles must also work together with other muscles in our bodies. This means that working on the strength and flexibility of other muscles can help our pelvic floor muscles! Pelvic floor muscle training might include coordination training, training WITH other muscles, and flexibility training.
Check out our YouTube channel for FREE exercise videos on how to train your pelvic floor muscles. As a Pelvic Flicks subscriber you can get access to live weekly workouts.
#8 Stretching
Stretching the pelvic floor muscles is an important part of pelvic health that is often overlooked (sometimes we get too focused on strengthening the pelvic floor muscles). Imagine what that does to these muscles overtime! What if you were constantly squeezing your hand into a fist? Overtime, would your hand get stiff, contracted, and not work as well? Absolutely! The same is true for the pelvic floor muscles. Here are some great stretches to try. One minute is a good target for holding stretches, but you can hold it for less/more time. Do what is comfortable for you. While you hold them take slow, deep breaths. This will help to calm your nervous system and allow you to stretch deeper. As you exhale, try to go just a little bit deeper into each stretch. Keep in mind, that you should never stretch so far that it is painful.
#9 Perineal Massage
Perineal massage is a technique that helps the pelvic floor muscles to lengthen and relax during penetrative intercourse. A promising research study looked at women who suffered from dyspareunia and chronic pelvic pain. Each participant had perineal massage performed and showed less pain up to 24 weeks after treatment (Moirera de Silva, 2017). For the treatment, women had massage performed for 5 minutes, one time per week, for a total of four weeks (Moirera de Silva, 2017). That’s 4 treatments, or 20 minutes of total time, for less pain! Wouldn’t 20 minutes of your time be worth it to have less pain with sex, allowing you to enjoy that time with your partner?
If you are struggling, there is help out there! To find a pelvic floor physical or occupational therapist near you ask your providers or visit www.mypfm.com/find-a-pt.
To learn more about your pelvic floor muscles, check out these great resources:
Watch our Pelvic Pain and Your Pelvic Floor YouTube playlist
Subscribe to access our video courses on demand at Pelvic Flicks
Learn more about your pelvic floor on our Instagram
Visit our Amazon store for our favorite pelvic health products
Sign up for our email newsletter
For providers, check out myPFM Academy to learn more so you can better help your clients. With two membership options, you have access to courses, a growing library of patient handouts, hundreds of custom sharable images and infographics, and multilingual resources. At myPFM Academy you’ll find courses like:
What Do We Really Know About PFM Tone? with Beth Shelly, PT, DPT, WCS, BCB-PMD
Does the Inability to Relax Pelvic Floor Muscles Cause Pelvic Pain? With Dr. Susie Gronski DPT, Sexuality Counselor, and Educator Certified Pelvic Rehabilitation Practioner
Understanding and Treating Pelvic Pain with Dr. Lauren Trosch, PT, DPT, OCS
Orthopedic Pelvic Assessment and Treatment for the Pelvic Pain Population with Dr. Kelli Wilson, PT, DPT, OCS, FAAOMPT
Written by Emily Reul, PT, DPT
References
Moira de Silva AP et al. Perineal massage improves dyspareunia caused by tenderness of the pelvic floor muscles. Rev Bras Ginecol Obstet. 2017;39(1):26-30.