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Untangling the Knots: Signs You Might Have Pelvic Floor Tightness

In the world of health and wellness, the pelvic floor remains an enigmatic entity for many. Some may question, "Isn't a tight pelvic floor a sign of strength and control?" Others wonder if their muscles are just too weak. The truth is, this crucial group of muscles and tissues often operates in the shadows of our awareness, causing problems without ever taking center stage in our health concerns. In this blog, we embark on a journey to shed light on the elusive topic of pelvic floor tightness—what it is, how it manifests, and why it deserves our attention. Join us as we unravel the intricacies of this often-overlooked aspect of our physical health and learn to recognize the signs that your pelvic floor might be trying to send you a vital message.


How Do I Know if I Have Pelvic Floor Tightness?


The symptoms experienced by individuals with a hypertonic or overactive pelvic floor can vary significantly, contingent upon the degree of tension within the pelvic floor, the duration of these symptoms, and the adaptations the muscles have undergone in response to this tension.


A Range of Discomforts:

  • Bladder leakage: Involuntary loss of urine.

  • Tailbone pain: Often linked to a history of falling on the buttocks.

  • Straining or the sensation of incomplete bladder and/or bowel emptying: Difficulty voiding or moving bowels.

  • Pain during intercourse: Either during or after sexual activity.

  • Perception of a barrier during intercourse: Described as feeling like a partner is "hitting a wall."

  • Pelvic pain during tampon insertion or pelvic exams: Particularly during routine wellness visits.

  • Evidence of tearing or bleeding during intercourse or bowel movements: Indicative of pelvic floor issues.

  • Constipation: Difficulty in passing stools.

  • Abdominal discomfort or pain: Often exacerbated by abdominal pressure or constipation.

  • Limited mobility in the back or hips: Typically due to persistent tension or chronic pain in these areas.

Contributors to Pelvic Floor Tightness:

  • Musculoskeletal trauma or injury: Events like car accidents, falls, pregnancy, or surgical procedures, especially in the lower back or lower body, can lead to inadequate muscle healing. This can prompt the pelvic floor muscles to tighten in an attempt to compensate for their diminished strength.

  • Stress: Both physical and emotional stress can manifest as tension in the pelvic floor. Individuals with tension in their shoulders, neck, or jaw are more likely to exhibit tension in their pelvic floor as well.

  • Behavioral habits: Oftentimes developed in response to stress, individuals may delay responding to the urge to use the bathroom for prolonged periods. Those with demanding or high-stress lifestyles may frequently engage in kegel exercises (pelvic floor contractions) to prevent the relaxation of their pelvic floor for extended periods. Over time, this habit of maintaining constant tension in the pelvic floor can lead to a lack of relaxation when needed most during toileting or intimate moments.

  • Medical history: Conditions such as IBS, ovarian cysts, interstitial cystitis, overactive bladder, uterine/bladder/rectal prolapse, UTIs, menopause, vaginal/pelvic infections, kidney infections, endometriosis, and sciatica can all contribute to pelvic floor tension and various pelvic floor disorders. These medical histories may exacerbate existing tension or create new issues within the pelvic floor.

Doctor of Physical Therapy explaining pelvic floor tightness
"You're journey to improved pelvic health begins here."

Treatment and Hope:


Treatment for pelvic floor dysfunction and tension often requires a collaborative, multidisciplinary approach tailored to the underlying cause of dysfunction and the patient's unique medical history. It is crucial to address both the physical and emotional aspects of pelvic floor muscle control. Seeking guidance from your healthcare provider can be invaluable on your path to improved well-being.


Pelvic floor therapy, a conservative treatment modality, revolves around understanding your specific concerns and medical background. With this knowledge, a skilled physical therapist crafts an individualized treatment plan designed to alleviate your pelvic-related issues.


Research from 2022 underscores the effectiveness of pelvic floor therapy, highlighting its role in instigating lasting changes through treatment, targeted exercises, and lifestyle adjustments that promote ongoing symptom management. In the words of Sayner et al. in a 2022 publication in PTJ (Physical Therapy Journal), "Pelvic floor muscle training (PFMT) is an effective first-line treatment and preventative strategy for pelvic disorders such as bladder or bowel dysfunction, pelvic surgery, pelvic organ prolapse, or pelvic pain."


After a comprehensive evaluation, your pelvic floor therapist will create a personalized treatment strategy based on your symptoms and objectives. This may involve addressing dysfunctions externally and/or internally within the pelvic region. Exercises will target enhancing the mobility, strength, and coordination of your pelvic floor during everyday activities like lifting, exercising, or performing physically demanding tasks in your life. Whether you've been grappling with pelvic floor dysfunction for over a decade or have just recently encountered these issues, remember that the pelvic floor, like any other muscle group, has the potential for improvement with consistent effort and guidance from both the patient and therapist.


If you have questions about how we can assist you or are interested in scheduling an initial consultation, please reach out to us at (817) 393-7020. Your journey to improved pelvic health begins here.





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