The Pelvic Floor: Why Weakness Isn’t Always The Issue

Do you experience bladder leakage when you cough, sneeze, laugh or jump? Or are you constantly rushing to the toilet? It’s common to assume these issues stem from a weak pelvic floor or a “small bladder.” However, the culprit might actually be tight pelvic floor muscles rather than weakness.

For many people, tight pelvic floor muscles can lead to discomfort, pain, bowel or bladder issues and altered sexual function. In this blog, we will discuss how pelvic floor tightness can result in dysfunction and pain, what causes tightness, and ways to alleviate it.

The pelvic floor is a group of muscles located in the pelvis that supports the pelvic organs, including the bladder, uterus and rectum. Despite its importance, the pelvic floor is often overlooked and not given the attention it deserves. Maintaining a healthy pelvic floor is crucial for overall bodily function and wellness.

The pelvic floor plays a vital role in supporting the pelvic organs and maintaining bladder and bowel control. A strong pelvic floor can aid in preventing pelvic organ prolapse and it helps with sexual function, including orgasm. The pelvic floor also modulates intra-abdominal pressure and provides stability to the pelvis, back and hips.

Pelvic floor muscles are meant to move and expand freely. They need to be able to contract AND relax for optimal function, movement and coordination. Despite popular belief, many pelvic floor issues are a result of tight muscles not necessarily weakness. Issues can arise if the pelvic floor muscles are too tight, too weak or there is poor neuromuscular control and timing.

Often the symptoms of a tight pelvic floor can be confused with symptoms of a weak pelvic floor.

There are a few symptoms of a tight pelvic floor that may surprise you:

• Painful intercourse
• Urinary leakage with coughing, sneezing or jumping
• Frequent or urgent urination
• Pain in the low back, pelvis, abdomen, hip or coccyx
• Chronic constipation
• Rectal pain
• Incomplete bowel or bladder emptying
• Painful periods
• Abdominal bloating and pelvic congestion
• Pain inserting a tampon or undergoing pelvic examinations (i.e, pap smear)

There are various reasons and factors that contribute to pelvic floor tightness, including:

• Pregnancy and Childbirth
• Chronic constipation and straining
• Stress or nervous system dysregulation
• Chronic coughing
• Scoliosis
• Prolonged sitting
• Falls onto the tailbone
• Pelvic surgery and scar tissue
• Poor breathing patterns (e.g. asthma, stress, anxiety, sucking your stomach in)

There is often an overlooked connection that exists between the back, hips, abdomen and pelvic floor muscles. If you are someone who experiences unresolved pain in these areas and feel like you’ve tried everything but have never checked your pelvic floor, this could be the missing link to why your pain is not resolving.

• Pelvic pain conditions: such as endometriosis, adenomyosis, interstitial cystitis, pudendal
  neuralgia and vulvodynia
• Labral tears of the hip
• Irritable bowel syndrome
• Poor posture or scoliosis
• Pelvic congestion syndrome
• Pelvic organ prolapse
• Urinary incontinence
• Constipation
• Sexual trauma
• Pelvic surgery: such as a laparoscopy, hysterectomy or caesarean section

It is important to note that tight pelvic floor muscles can be a contributing factor to these conditions, as well as a result of them. In either case, seeking medical evaluation and treatment is important for managing tight pelvic floor muscles and related symptoms.

If this sounds like you and you feel like you’re not getting answers from the medical system, consider your pelvic floor to be the potential missing piece of the puzzle.

By understanding what causes pelvic floor tightness and ways to alleviate it, you can take steps to improve your quality of life.

If you experience pelvic floor problems, such as incontinence, pelvic pain or discomfort during sex, it’s crucial to seek help. With the appropriate treatment, management plan and rehab program you can improve these symptoms.

If you want more information about how your pelvic floor may be functioning and how to improve your symptoms, please reach out to Emma or book yourself in to see your local women’s health osteopath or physiotherapist.