Are my Pelvic Floor Muscles too tight??- Overactive Pelvic Floor Muscles

What is Pelvic Floor Muscles Overactivity? 
 As defined by the ICS (international continence society) this is "a situation in which the pelvic floor muscles do not relax, or may even contract when relaxation is functionally needed, for example when emptying the bladder or the bowels." (Refence 1) 

Although it may appear to be a definition with a somewhat obvious simple solution: RELAX ......it is actually a lot more complex than that. Many women are faced with this problem and unfortunately despite ongoing research findings and evidence they are continually told JUST RELAX when these muscles are not cooperating. The aim of this post is to help highlight what it means having an overactive pelvic floor muscle, what can be involved and who may be needed in your care team to help you manage.
An overactive pelvic floor muscles can be a result of

• Trauma -directly and indirectly to the pelvis or pelvic floor - for example accidents result in a fall, or abuse)
• Injury such as from childbirth- assisted deliveries e.g. forceps or vacuum extraction), 
• Surgery in particular abdominal or pelvic surgery that can result in adhesions and scar tissue impacting the organs and muscles 
• Pathology (for example underlying conditions) 
• Chronic pelvic pain 
• Issues with posture
• Use of the pelvic floor muscles incorrectly 
• Psychosocial/emotional issues     

As a result of the above this type of muscles result in 

• Urinary problems such as incontinence and/or voiding issues 
• Bowel issues including emptying properly
• Pelvic pain 
• Trauma 
• penetrative pain 
• Psycho-social and emotional issues
• Postural issues 
• Pathology
• Sexual dysfunction such as pain with intercourse (dyspareunia) 

It becomes clear the management of these muscles is not as simple or a "one size fits all" approach. As shown several factors can be reason or a result in addition to having more than one cause or effect. Therefore treatment requires an individualized, multidisciplinary approach that can  include : 
1) Medical - doctor, specialists  such as urogynecologist, urologists, 
2) Psychologists specialising in pelvic pain 
3) Specialized Pelvic Health Physiotherapists - 
At Inner Active Pelvic Health Physiotherapy our physiotherapists are trained in the management of overactive pelvic floor muscles that can result in pelvic pain and/or bladder and bowels issues. We work closely with other healthcare providers to ensure a holistic approach. Treatment is based on taking a very detailed history of your condition and understanding your story.  An assessment that is suitable and appropriate to your situation can be done of the pelvic area, including the pelvic joints, muscles, movement and posture assessments.  Treatment can include the following: education, manual therapy, use of biofeedback or electrical physiotherapy, use of trainers or graded exposure therapy. 

If you suspect you may have overactive pelvic muscles that may be associated with your condition, reach out and see how our physiotherapists can help. Contact us  HERE 

Author 
Tafy Seade (Pelvic Health Physiotherapist) 
​August 2020
 References 
1) Messelink B, Benson T, Berghmans B, Bø K, Corcos J, Fowler C, Laycock J, Lim PH, van Lunsen R, á Nijeholt GL, Pemberton J, Wang A, Watiert A, Van Kerrebroeck P Standardization of terminology of pelvic floor muscle function and dysfunction: Report from the Pelvic Floor Clinical Assessment Group of the International Continence Society. Neurol Urodyn 2005;24(4) 374-380.