What does it mean to have an overactive pelvic floor?
Have you heard of the term Overactive Pelvic Floor Muscles but aren’t quite sure what it means? For many women, the pelvic floor is a part of the body we rarely think about, until something goes wrong. Like any other muscle in our body, your pelvic floor needs to be able to contract and relax. When your pelvic floor muscles are ‘overactive’ it means that they may have trouble lengthening or relaxing, this can sometimes lead to discomfort, pain, and even issues with bladder, bowel, and sexual function.
Why Does the Pelvic Floor Become Overactive?
Overactivity in the pelvic floor can be due to different reasons. For some people in may be a response to pain, trauma, stress, or anxiety. For others is may be linked to some of the habits, movements or exercises we do. A pelvic floor that is ‘holding on’ is often a sub conscious response. Some of the common reasons the pelvic floor muscles may be overactive are discussed below.
Pain
One of the most common reasons for pelvic floor overactivity is pain. When your body senses discomfort in or around the pelvic area, the muscles may tighten reflexively to protect you. Even after the pain has resolved, these muscles can stay in a heightened state of tension.
Some examples include:
Childbirth injuries: Tearing or episiotomy, especially if healing was delayed or particularly painful.
Chronic pain in the pelvis, hips, or lower back: These can cause the pelvic floor to remain tense over time.
Recurrent UTIs or thrush: These infections can sensitize the area and lead to protective tension in the muscles.
Painful conditions like haemorrhoids or fissures: These issues can cause the pelvic floor to tighten and stay that way.
Stress and Emotional Factors
Stress does not just affect your mind; it can show up in your body too. The tone and tension in our pelvic floor can be linked to the tension in other parts of our body. For example, is you are holding tension in your shoulders or jaw, then your pelvic floor may also be tense. As part of treating pelvic floor over activity it can often involve reflecting on past experiences and our day to day live to see if there are any obvious triggers. Involving other health professionals such as a psychologist or counsellor may be appropriate if you are needing to address triggers that may be related to past trauma or stress and anxiety.
Habitual Tension from Exercise or Activities
Certain activities and exercises, while great for fitness, can unintentionally teach your pelvic floor to stay “on” all the time. These include:
Ballet and gymnastics, which often require high levels of core engagement.
Pilates, particularly when exercises are focused on constant core activation.
Horse riding, where maintaining posture can keep the pelvic muscles in a state of tension.
While these activities are beneficial for strength and control, they sometimes create habits of holding the pelvic floor too tight, which can lead to problems if not balanced with relaxation techniques. This doesn’t mean that you can’t do these activities, however it may be important to ensure that your are aware of the increased tension and can focus on breathing, stretching and relaxation after the activity.
What Are the Signs of an Overactive Pelvic Floor?
Not sure if your pelvic floor is overactive? Here are some signs to watch out for:
Pain or discomfort in the pelvis, lower back, or hips.
Difficulty starting or completing bladder or bowel movements.
Feeling like you cannot empty your bladder completely.
Pain during or after sex.
A general sense of tightness or tension in the pelvic area.
If these symptoms resonate with you, it is important to know that support is available, and there is plenty that can be done to help.
How Do You Treat an Overactive Pelvic Floor?
The best way to find out if your pelvic floor is overactive is to consult with a Pelvic Health Physiotherapist. They can perform a thorough subjective and objective assessment to identify what is going on and tailor a treatment plan to suit your individual needs. Some of the strategies that your physiotherapist may discuss with you are listed below.
Relaxation Techniques
Learning to relax your pelvic floor is key. We use techniques like diaphragmatic breathing and guided relaxation to help release tension and retrain your muscles to let go.
Exercise Modifications
If you love activities like Pilates, you do not have to stop, but you might need to make some adjustments. Do not be afraid to talk to your instructor and ask for some modifications to ensure you are strengthening your core in a way that supports pelvic health without exacerbating overactivity.
Addressing Pain and Sensitivity
Hands-on physiotherapy can reduce tension in the pelvic floor. We might use gentle internal release work, stretches, or tools like TENS, dilators, or a pelvic wand to desensitize the area and help it feel safe to relax again.
Holistic Support
Sometimes pelvic floor overactivity is linked to deeper emotional or psychological factors, such as past trauma or stress. In these cases, working with a multidisciplinary team such as a GP, physiotherapist and psychologist or counsellor can be beneficial. Together, we can address the physical, emotional, and medical aspects of your care.
An overactive pelvic floor is a common issue, but it is one that can be effectively treated with the right approach. Whether you are experiencing pain, discomfort, or just want to learn more about your pelvic health, there is help out there.
