Why is my Pelvic Floor Tight?! The Effect of Stress on the Pelvic Floor

Many of my patients have increased muscular tension that is either causing or contributing to their symptoms (tight muscles tend to be painful!). So during our sessions, I’m often working with my patients to help them release this tension. This can involve treatments such as:

• Massage, cupping, dry needling, or other hands-on treatment

• Targeted relaxation exercises such as deep breathing

• Stretches such as child’s pose and happy baby 

• As well as working on strengthening individual weaknesses as those could be contributing to increased tension elsewhere in the body. (Muscles will often tense up if surrounding muscles are weak. A frequent example I use is core weakness and lower back pain - these two conditions often coincide because if the core is not doing its part to support your posture, you can end up overusing the lower back, which leads to pain.)

I hear a lot of my patients express frustration that they tense up their pelvic floor seemingly automatically. They say things like “If I could only relax!” or “I don’t know why it’s so hard for me to just let go.” So today, I want to share a fascinating study which showed that we are actually programmed to tense our muscles (specifically the pelvic floor muscles) in response to stress!

In this study, researchers took two groups of women, one suffering from the painful condition of vaginismus (in which pelvic floor muscles are in a constant state of spasm) and another who did not have any pelvic floor dysfunction (otherwise known as a control group). They then hooked these women up to EMG, showed them four different film excerpts, one classified as neutral and the others as threatening, sexually-threatening, and erotic, and then measured their reflexive pelvic floor activity in response to each excerpt. 

What they found was that women naturally tightened their pelvic floor muscles in response to any threatening film clip (whether sexually-threatening or generally-threatening). That may not be surprising in itself, but the fascinating part of the experiment was that this happened in both groups. Which means that even if you do not have any pelvic floor symptoms or dysfunction, pelvic floors are likely just wired to respond to a threat! Interestingly enough, the trapezius muscle also showed the same reflexive tightening response as the pelvic floor so the researchers concluded that muscle guarding in these muscles was part of a general defensive response - which makes total sense, right? I think we’ve all been in a situation where we’ve felt angry or anxious or threatened, and have naturally tensed our neck and shoulders!

So what does this mean for people who are experiencing pelvic floor symptoms or for people who have been told that they have a too tight (in medical terms, a hypertonic) pelvic floor? I see two main takeaways here:

1. First, realize that everyone tightens their pelvic floor in response to stress. So if you feel stressed about carrying stress in your pelvis, you now know that it is a completely natural reaction to stress. So try to give yourself some grace!

2. Secondly, as we now know that the pelvic floor responds to stress,  if you are dealing with pelvic floor symptoms, I’d recommend trying to bring more awareness to the where you are holding stress within your body and then implement strategies to reduce that tension. Which actually looks very similar to the videos I linked above! For example:

   1. Perform the child’s pose and happy baby stretches from above daily (you can do them as a cooldown from your workout, during TV commercial breaks, to wind down for bed…there are lots of  little opportunities to work in some stretches!)

   2. Practice deep breathing (again, from above) with an emphasis on the pelvic floor relaxing as you breathe in. Some cues I’ve seen people respond well to are:

      1. Imagine your pelvic floor melting like butter

      2. Imagine your pelvic floor opening like a flower

      3. Imagine your sit bones spreading apart 

   3. If you feel yourself getting stressed throughout your day, stop and take 3 deep breaths. Take a quick body scan and notice if you are clenching your pelvic floor or your buttcheeks…and if you are, let them go!

All of these techniques should help you begin to train your pelvic floor out of its “fight or flight” mode. 

However, if you feel like your pelvic floor is causing you problems that you cannot overcome alone, that’s what we’re here for! Pelvic Floor PT is truly the gold standard for assessing and resolving pelvic floor dysfunction so if you need help (and you’re local to Durham, NC), feel free to contact us for a complimentary 15-minute phone consultation. We’d love to help!