Why Are My Pelvic Floor Muscles Tight?
In the last blog post we talked about how pelvic floor muscle tension is one of the reasons why someone can have pain with penetration. Usually when people learn pelvic floor muscle tension is the cause of their pain, “why is my pelvic floor so tight” is the next question asked.
And it’s a great question! Sometimes muscle tension doesn’t have one single cause but rather is a perfect storm of a number of factors. Sometimes it’s more obvious than that. The cause or your pelvic floor tension is very much dependent on and unique to you.
Here are a few reasons people have pelvic floor muscle tension
Scar tissue (from birth or from a surgery)
Underlying conditions such as endometriosis, interstitial cystitis (IC), lichen sclerosus, or other chronic pain conditions
Stress
Orthopedic injuries
We’ll break down these four causes below.
Scar tissue
Scar tissue can result from tearing during delivery and may or may not cause pain afterwards. While grade III and IV tears are more likely to be associated with pain, grade I and II can cause pain as well. No matter the size of your tear, if your in pain, manual therapy, scar massage and relaxing the muscle surrounding the scar can help reduce sensitivity and pain around your scar.
Underlying conditions such as endometriosis, interstitial cystitis (IC), lichen sclerosus, or other chronic pain conditions
Conditions such as endometriosis, IC, lichen sclerosus or other chronic pain conditions tend to cause the pelvic floor muscles (and the muscles surrounding them) to tighten because the muscles are trying to guard and protect the area. This guarding can further contribute to the pain you’re already experiencing. Now remember, this is a natural and protective response from your body. But too much protection can contribute to more pain, so in this case we want to teach the muscles that they are safe, they do not need to stay constantly clenched, and retrain your body to let go.
Stress
Similarly to underlying conditions such as endometriosis, interstitial cystitis, lichens sclerosus and other chronic pain conditions, stress can cause you to unknowingly clench muscles. We’ve all been there, right? Imagine driving through stop and go traffic and suddenly realizing your jaw is clenched. Chronic jaw clenching can contribute to chronic headaches. Other people when stressed clench their pelvic floors and abdominal muscles. Clenching in your pelvic and abdominal region can cause pelvic pain or pain with sexual activity (amongst other things). Just like when muscles are clenched due to underlying conditions, teaching your body to let go of that constant clenching can help reduce associated pain.
Orthopedic Injuries
Orthopedic injuries to the hips, foot, knee or back also affect the pelvic floor muscles. We’ve all heard the phrase “everything’s connected” regarding the body, but this sentiment can seem abstract until we actually look and see these connections. If the foot can no longer move how it’s supposed to, this is gonna make the knee and then the hip compensate by moving differently than they typically would. This compensation causes changes to the tissue in the foot, knee, hip and thus can stretch or shorten the pelvic floor muscles, causing pain and other pelvic floor symptoms. Treating underlying ankle, knee and hip injuries is part of pelvic floor PT because anything that impacts the way you move impacts your pelvic floor.
There isn’t always a clear answer as to why someone has pelvic floor tension and this is often because it can be a mix of the issues listed above. This is why a full body assessment is important in determining the “why” when someone has pelvic floor muscle tension or dysfunction.
So, what’s the takeaway?
Everyone is different. Everyone’s muscle tension and pain has different causes.
An evaluation by a pelvic floor physical therapist can help you achieve a better understanding of why you hold tension where you do, and what you can do to address that tension to help you feel better. Contact us to learn more about working with us locally in Austin or virtually from anywhere!
By Dr. Jessica Chastka, PT, DPT, WCS
Jessica (she/her) earned her Bachelor’s in Exercise Science from the University of Louisiana at Monroe, while playing softball. She received a Doctorate in Physical Therapy from University of Texas Medical Branch in Galveston in August 2015. In 2019 she became Board Certified in Women’s Health, through the American Board of Physical Therapy Specialists.
For the last five years she has been working as a pelvic floor physical therapist, treating people who have pelvic pain, leakage, urgency, frequency and constipation. This includes the pregnant and postpartum population as well as people with chronic pain. She is passionate about making her patients feel heard and seen, validating those who feel that their problems are not worth mentioning because everyone has them or because embarrassed to talk about them.