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What Is A Hypertonic Pelvic Floor?
Struggling with pelvic pain or unexplained constipation, and unsure what’s going on? We’re sure you’ve heard of a weak pelvic floor, particularly in the context of pregnancy, postpartum recovery, and leaking when you cough or sneeze. But what happens when the pelvic floor isn't weak at all? What if the problem is the complete opposite?
A hypertonic pelvic floor is more common than most people realise. In fact, in a survey conducted by the Royal College of Obstetricians & Gynaecologists (RCOG), it was found that over 60% of UK women have at least one symptom of poor pelvic health.
In this blog, we’re breaking down everything you need to know, sharing what a hypertonic pelvic floor actually is, what causes it, the symptoms to look out for, and most importantly, how to start finding some relief.
Hypertonic Pelvic Floor Explained
Let’s start by breaking down the name first to help gain a better understanding. “Hypertonic” means excessive tone or tension. When we apply that to the pelvic floor, we're talking about a group of muscles that are stuck contracted, kind of like they have lost the ability to fully let go and relax.
The pelvic floor is a hammock-like group of muscles that stretches across the base of the pelvis. It supports your bladder, bowel, and reproductive organs, working alongside your diaphragm, deep abdominals, and back muscles with every breath you take.
It’s supposed to contract when it needs to, in order to stop leaking, and then release. When the pelvic floor is healthy and fully functional, it’s able to do both.
What Causes A Hypertonic Pelvic Floor?
It’s not often that it’s a case of one thing going wrong. It usually develops over time, from a combination of physical, habits, lifestyle factors, psychological factors, and sometimes underlying health conditions. This is why it’s important to see a healthcare professional if you experience symptoms. Some of the most common factors include:
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Stress & anxiety: When your body is in a state of stress, your fight-or-flight responses kick in, and this can cause shortening of the pelvic muscles, which, over time, can lead to them remaining in this state.
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Holding in urine or stools: Regularly holding in urine or stools can train the pelvic floor muscles to stay in this permanently gripped position.
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Prolonged sitting & poor posture: Things like desk-based work and poor posture can create tension in the pelvic area.
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Pregnancy & childbirth: Carrying a baby is physically demanding on the body, and hormonal changes and labour can all impact your pelvic floor. Some people might develop a hypertonic pelvic floor during pregnancy as the body prepares to support a growing child.
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Over-exercising the core: If you train heavily, or do a lot of weightlifting, CrossFit, or high-intensity core work, it can unintentionally keep the pelvic floor in that state of constant activation that we’ve mentioned before with other causes.
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Underlying health conditions: Conditions such as endometriosis, interstitial cystitis, irritable bowel syndrome (IBS), and pudendal neuralgia can all be associated with hypertonic pelvic floor dysfunction.
What Does It Feel Like? Symptoms To Look Out For
Symptoms can be varied, which makes it difficult to determine the exact cause. Often, pelvic pain is the most common complaint, usually shown as a persistent ache, pressure, or throbbing in the lower abdomen and the surrounding area. Usually, symptoms can be categorised into these broad categories:
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Bladder-related: urgency, frequent urination, difficulty starting the urine stream, a sensation that the bladder never fully empties, and pain during or after urination.
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Bowel- related: constipation, straining, a sense of not being completely empty, and pain when passing stools or wind.
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Sexual: pain during or after intercourse.
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General pelvic: pelvic pressure or heaviness, lower back pain, hip pain, coccyx pain, and intensified menstrual cramping.
How To Relax A Hypertonic Pelvic Floor
The good news is that a hypertonic pelvic floor can be treated! Although it should be said that it can take time. Often, a specialist physiotherapy session can be a great start.
They’ll understand the full history of your symptoms, assess the muscles both internally and externally, identify any trigger points or areas of restriction, and then build a treatment plan that works for you.
Professionally guided treatments can include manual therapy and myofascial release to work on the tight tissues, trigger point therapy to address pain patterns, biofeedback, and neuromuscular re-education to help the muscles relearn a healthy cycle of contraction and release.
As well as these treatments, you could benefit from the following at home to support recovery:
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Diaphragmatic breathing: Slow, deep breaths to encourage the pelvic floor to drop and release.
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Gentle stretching: Poses like child’s pose, happy baby, and a deep squat can help to release tension in the pelvic floor. These are all stretches recommended by the NHS.
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Warm baths: Simple and effective. It helps your muscles relax and can give you temporary relief from symptoms.
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Mindfulness and stress management: As stress can trigger a hypertonic pelvic floor, calming the nervous symptoms with things such as meditation and yoga can all support reducing your body’s pelvic floor tension.
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Regular movement: Low-impact exercise, such as walking or swimming, can also help relieve tension, and they support healthy muscle function.
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Reducing prolonged sitting: Movement breaks, being aware of your posture, and making ergonomic adjustments when you’re working can make a big difference in reducing any habitual pelvic floor gripping.
Can A Hypertonic Pelvic Floor Cause Bladder Leaks?
Yes, a hypertonic pelvic floor can lead to frequent bladder leaks.
Because the pelvic floor muscles are constantly tense, they become fatigued and can lose the ability to respond properly when they need to. A cough, sneeze, or sudden urge to go to the toilet can all result in leaks.
If you’re experiencing leaks, incontinence products can provide confidence while you work through any treatment.
The likes of incontinence pads sit discreetly inside your normal underwear and are ideal for lighter leaks, while incontinence pants provide a more secure, all-in-one option for heavier leaks.
When To Seek Help
Recognising any of these symptoms from this article? Whether it’s pelvic pain, needing to get to the toilet fast, discomfort during sex, or even unexplained lower back pain, it’s worth getting assessed sooner rather than later.
It’ll also give you that peace of mind. We want you to get back to feeling your 100% self again, and early intervention can help you get there faster.
You can speak to your GP, who might be able to refer you to a pelvic floor physiotherapist on the NHS. When you do seek help, there’s nothing to feel embarrassed about.
As we highlighted at the start of this article, it’s extremely common and pelvic health professionals work with these conditions every single day, and they are equipped to help you as best they can!
Find The Right Support For You
Living with bladder leaks? Even if temporarily, as a symptom of a hypertonic pelvic floor, we can help. No matter what stage of your treatment plan you’re at, having the right incontinence products can make a world of difference.
They can support you with discreet and comfortable options that fit easily into your routine.
If you're managing leaks while working on your pelvic floor health, we've got you covered. Shop our full range of incontinence pads and pants, designed to keep you both comfortable and confident every step of the way.
