Your pelvic floor is an essential part of your body’s structure. Working as shock absorbers for your body’s core, these muscles require strength, flexibility and coordination to support organs like the bowel, bladder, uterus, vagina, rectum and prostate. You may notice bothersome symptoms when the pelvic floor isn’t functioning properly. 

While talking to a doctor about pelvic floor issues may seem embarrassing, overdoing Kegels probably isn’t the answer. You don’t have to put up with pelvic floor dysfunction no matter your age or gender – there is help and hope if you’re struggling. 

What is hypertonic pelvic floor?

Hypertonic pelvic floor issues occur when the lower pelvis muscles spasm, tighten or remain in a contracted state. When this happens, the pelvic floor muscles can't fully relax, which may cause difficulty controlling certain bodily functions and lead to pain. The condition can vary from person to person, be temporary or constant and affect both women and men. 

"Most people don't realize it, but when healthy, the pelvic floor muscles play an instrumental role in our day-to-day lives," says physical therapist and pelvic health specialist Sam Weber, DPT, PT. "They need strength to prevent loss of bowel/bladder contents, endurance to support pelvic organs and coordination to work with the core to regulate changes in pressure inside your abdomen.”

Your pelvic floor muscles also need flexibility to complete all these functions. Like any muscle group, pelvic floor muscles can become tight and weak if they lack flexibility.  

Hypertonic pelvic floor symptoms can vary, but may include:

• Pain with any type of penetration, including pelvic exams and sexual intimacy.
• Uncomfortable insertion or removal of feminine products.
• Pain in the pelvic area with prolonged sitting, like riding in a car, working a desk job or biking.
• Leaking urine or stool when sneezing, coughing, laughing or running.
• Frequent urge to urinate, painful urination or straining to have a bowel movement.
• Difficulties with sexual function or pain in the testicles, perineum or groin area. 

These symptoms can occur after pelvic surgery or repair, vaginal delivery, chronic stress, abuse or trauma or chronic constipation. 

If you’re struggling with pelvic floor issues, specialized rehabilitation can help. 

Do Kegel exercises help? Can you do too many?

The effectiveness of Kegels depends on the condition of your pelvic floor. While these exercises may benefit both men and women, performing too many ─ or performing them incorrectly ─ may increase muscle tension and pain, or worsen your symptoms. Kegels should never cause pain. 

“A proper Kegel should feel like a squeeze, lift and release without having to hold your breath or strain using extra muscles such as your legs or abs to get the contraction going,” says Weber. “There are a lot of great resources online, but if you are missing one of these steps or your symptoms don’t change with practice, you should consider working with a specially trained pelvic floor therapist.”

Nobody needs to live with the symptoms of a pelvic floor disorder. A pelvic floor therapist can create an individualized treatment plan based on a thorough evaluation to help you achieve your specific goals. 

Are hypertonic pelvic floor and other pelvic floor issues curable?

“These issues are definitely curable,” says Weber. “Generally, restoring the pelvic floor muscles’ flexibility and reducing pain is my first step with patients with hypertonic pelvic floor so the muscles can better do their many jobs.”

Treatment may include: 

• Diaphragmatic breathing and relaxation techniques.
• External and internal manual therapy.
• Stretching surrounding muscle groups.
• Biofeedback to monitor muscle activity and guide relaxation techniques.
• At-home exercises customized to your symptoms. 

“Pelvic floor symptoms are common, so it’s important to know you’re not alone,” says Weber. “There are many ways we can help improve your current symptoms. Pelvic floor specialists are specially trained to work with these symptoms and provide treatment that makes you feel most comfortable.”