The pelvic floor muscles attached to the front, back and sides of the pelvis and also the base of the spine. They act like a hammock to support the bladder, uterus and bowel. This group of muscles have to be able to contract and release in order to control continence and support pelvis contents, but also allow for urination, bowel movements and vaginal births!
Dysfunctional muscles (weak or tight) of the abdominal wall or muscles surrounding the hips and pelvis can cause the pelvic floor to overcompensate and overwork leading to tightness. Poor posture and poor alignment of the pelvis can also cause the pelvic floor to be placed in a permanently shortened position.
It's a common misconception that a tight, short muscle must be strong, but that's NOT the case. When a muscle, any muscle, is placed in a position where it is permanently shortened, this is going to restrict it's movement. Imagine walking around on your toes all day, fatiguing your calf muscles - then imagine trying to jump up really high. Yes, your calves are going to feel pretty weak aren't they?! Imagine holding your arm bent all the time - I'm pretty sure that your bicep is going to feel pretty fatigued, tight and weak after a while!
This principle also applies to the pelvic floor - hold it up in a shortened position all the time and you can be sure it is going to become very tight and very weak.
Common symptoms of a hypertonic (tight) pelvic floor include:
Sudden urges to urinate (urge incontinence),
A need to urinate often,
Difficulty starting the flow of urine,
A feeling of not being able to empty the bladder,
Can be associated with painful bladder syndrome/interstitial cystitis,
The weakness can also reduce the ability to stop leaks during exercise or whilst laughing, sneezing, coughing etc. (stress incontinence) - it's not only a weak pelvic floor that is to blame for leaks!
Many people believe that when they're experiencing a pelvic floor 'issue', that the thing to do is kegals or in other words, isolated pelvic floor contractions, however this is going to make the dysfunction worse if you have a hypertonic/tight pelvic floor. Plus quite often someone with a hypertonic pelvic floor is unable to feel that they are contracting it anyway (as it is already contracted!).
The initial goal of exercise in the case of a hypertonic pelvic floor is to identify and release tight areas of the body in order to take pressure off the pelvic floor muscles and encourage the them to relax and lengthen. This would need to happen before the pelvic floor muscles and other weak areas can be strengthened.
Ways you can help release your pelvic floor
Regular deep core breathing is an important part of relaxing the tension out of the pelvic floor. Be sure to have a read of my previous article on how to correcting perform core/diaphragmatic breathing.
Good posture is also very important to reduce the stress on the pelvic floor, bladder and other pelvic organs. Ensure you are not tucking your tailbone under, rounding your shoulders forwards or jutting your chin forwards.
Avoid sucking/holding your tummy in as this will also cause your pelvic floor to also suck up all the time. Your core is a system that works together, it's not just a few individual muscles - when your tummy is pulled in, your pelvic floor responds by doing the same. Ultimately, letting go of your tummy will help the pelvic floor release and this will enable them all to function better.
Avoid holding your breath - when you hold your breath, this raises the pressure within your abdomen (intra-abdominal pressure). This puts stress on the abdominal wall and on the pelvic floor to keep the contents of your abdomen and pelvic in! Always breathe and exhale on exertion during lifting whether it's a barbell or a child!
Stress is also associated with a hypertonic pelvic floor - so managing stress is a very important factor in treating this condition.
You can also seek professional treatment from a women's health or pelvic floor specialist physiotherapist if you feel the above is not easing your symptoms or you would like a definitive diagnosis to be able to improve your quality of life. This isn't something to put up with - it is not a normal result of having a baby. Please get in touch so I can give you the contact details of a specialist physiotherapist in your area.
Pelvic Floor and Core Friendly Fitness for Mums