The pelvic floor is a complex and crucial but often under addressed component of Women’s Health. While many women are aware of the function of the pelvic floor in maintaining continence of both bowel and bladder, it is less understood the complexity of appropriate functioning of the pelvic floor in sexual function, prolapse, abdominal pain, constipation and the ability for the pelvic floor to be both weak and overactive.
The pelvic floor comprises of two layers, a deep and superficial layer. The superficial layer has a greater role in closure or the external sphincters, while the deep layer plays a greater role in supporting the pelvic organs, including the bladder and uterus, together providing core stability, urinary and bowel control. Like any muscle group, the pelvic floor can become problematic if it’s not functioning optimally. A weak or damaged pelvic floor is better understood, but did you realise that your pelvic floor can also be overactive, a presentation where the pelvic floor remains in a tightened and contracted position and not appropriately relaxing to allow accurate continence control and relaxation.
What Is an Overactive Pelvic Floor?
An overactive pelvic floor occurs when the muscles in this region are excessively tight or tense. An overactive pelvic floor is marked by muscle hyperactivity and results in the muscles being unable to appropriately relax to allow the pelvic floor to rise and fall as required with emptying of the bladder or bowel or with sexual function. This condition can result in a variety of symptoms, many of which can be confusing or distressing. Interestingly, an overactive pelvic floor is often also a weak pelvic floor. Think of a muscle only being trained in one specific position without moving through its full range of motion.
Symptoms of an Overactive Pelvic Floor
People with an overactive pelvic floor might experience:
- Pelvic Pain: Persistent discomfort or pain in the pelvic region is common. This can be a dull ache or sharp pain and may be exacerbated by activities like sitting, exercising, or sexual activity.
- Urinary Issues: Frequent, urgent, or painful urination can occur. Some individuals might experience difficulty maintaining a flow of urination or feelings of incomplete emptying.
- Bowel Problems: Constipation, painful bowel movements, or a feeling of incomplete evacuation are frequent complaints.
- Sexual Dysfunction: Painful intercourse or difficulty achieving orgasm can be common symptoms of an overactive pelvic floor.
- Muscle Spasms: The pelvic floor muscles may spasm or cramp, causing sudden and uncomfortable sensations throughout the pelvis.
Causes and Risk Factors
Several factors can contribute to an overactive pelvic floor:
- Stress and Anxiety: High levels of stress or anxiety can lead to muscle tension throughout the body, including in the pelvic floor.
- Pelvic Trauma: Injuries from childbirth, surgery, or accidents can lead to muscle imbalances or dysfunction.
- Poor Posture: Prolonged poor posture can strain the pelvic floor muscles, contributing to tightness and discomfort.
- Chronic Constipation: Straining during bowel movements can lead to overactivity in the pelvic floor muscles.
- Inactivity: A sedentary lifestyle can contribute to muscle imbalances and exacerbate pelvic floor issues.
Diagnosis and Treatment
Diagnosing an overactive pelvic floor usually involves a comprehensive assessment by a healthcare professional. This includes obtaining a detailed history, where appropriate, physical examination, and possibly imaging with real time ultrasound imaging.
Treatment typically focuses on relieving muscle tension and addressing the underlying causes. Strategies may include:
- Pelvic Floor Therapy: A physiotherapist specializing in pelvic health can teach techniques to relax and properly engaging and relaxing the pelvic floor muscles. This might involve exercises, manual therapy, and relaxation techniques.
- Behavioral Modifications: Stress management techniques such as mindfulness, relaxation exercises or breathing can help reduce overall muscle tension.
- Biofeedback: This technique helps individuals become more aware of their pelvic floor muscle activity and learn to control it more effectively.
- Medication: In rare cases, medications to manage pain or reduce muscle spasms may be recommended.
- Lifestyle Changes: Improving posture, increasing physical activity, and addressing constipation through diet and hydration can also contribute to better pelvic floor health.
Conclusion
An overactive pelvic floor can be a complex and challenging condition, but understanding its symptoms and causes is the first step toward effective management. With the right treatment and lifestyle adjustments, it is possible to alleviate symptoms and improve quality of life. If you suspect you have an overactive pelvic floor, consider reaching out to our trained women’s health physio for a tailored approach to your care. By addressing this issue head-on, you can achieve better pelvic health and overall well-being.
Zoe Lorenzo
Specialist Women’s Health Phyio
zoe@moveforlifephysio.com.au
