Told You Have a Hypertonic Pelvic Floor, Now What?
So your doctor says you have a hypertonic pelvic floor…
You may be thinking – “What does that really mean?”, “What am I supposed to do about it?”, or “What else has this been impacting that I may not know about?”
Well let’s talk about it.
First of all, let’s pause and take a breath—literally. That tightness in your pelvic floor? It’s a little like your muscles are holding onto tension they don’t need, like clenching your jaw when you’re stressed. But instead of your jaw, it’s happening in the group of muscles at the base of your pelvis.
What Is a Hypertonic Pelvic Floor?
Essentially, it just means the muscles of your pelvic floor are tight. Your pelvic floor is a hammock of muscles that supports your bladder, bowels, and (if applicable) uterus. When these muscles are too tight or overactive, they’re essentially working overtime, even when they should be relaxed. Think of it as a muscle that’s stuck in a constant state of flexing— not comfortable!
Common Symptoms
A hypertonic pelvic floor can show up in a lot of different ways, including:
Pain with activity: During sex, when peeing, when pooping, or even just sitting.
Pain despite activity: In the genitals, groin, anus, low back, hips.
Trouble Peeing: Difficulty starting a pee stream or feeling like you didn’t empty your bladder fully.
Urgent or Frequent Need to Pee: If your urge to pee is really strong, you feel like you need to run to get there, or you just feel the urge really frequently.
Leaking: Urine or even stool
Constipation: Yep, those tight muscles can make it harder to poop.
Difficulty with Sex: Trouble with arousal, erections, or orgasm; pain with insertion
Pressure or heaviness: In the pelvic region.
If any of these sound familiar, you’re not alone—and you’re not stuck like this forever.
Common Causes
Hypertonic pelvic floors don’t happen out of nowhere. Some common culprits include:
Chronic stress and anxiety: Ever notice how tension creeps into your shoulders or jaw? The same thing can happen to your pelvic floor.
Injury: Think childbirth, surgery, even a bad fall
Trauma: Sexual, physical, verbal, etc.
Shame: Around genitals, sex, peeing, pooping, sexuality
Posture and movement habits: How you sit, stand, and move can affect these muscles.
Overdoing Kegels: Yes, let’s just avoid those until speaking with a trained specialist.
The presence of one of the symptoms above does not automatically mean you have a hypertonic pelvic floor, please consult with a medical provider for a proper diagnosis.
How to Relieve It
The good news? There are plenty of ways to help relieve this.
Everyone’s situation is unique, and it’s often valuable to have a team. Sometimes someone just learns to deep breathe or change a habit and all is well, others may need ongoing therapy.
A great place to start —
Pelvic Floor Therapy: A pelvic floor therapist can use an array of techniques to help guide you to a relaxed pelvic floor and relieve your symptoms.
Depending on your needs and the therapist’s training and approach, this can be body work, adapting habits, trigger point release, nervous system regulation, breath training, stretches, training in pelvic tools and more.
A pelvic floor therapist can also help you create a team that would best suit your needs.
Overall
A hypertonic pelvic floor isn’t your forever normal, and it’s not your fault. With a bit of awareness and the right approach, you can teach those muscles to relax and get back to feeling good in your body. Remember, it’s okay to ask for help, whether that’s from a therapist, a coach, or even a supportive community. Your pelvic floor deserves some love—and so do you!
Remember: this post is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here. 