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Overactive Pelvic Floor: Hypertonicity and How to Find Relief

Overactive Pelvic Floor: Hypertonicity and How to Find Relief

The pelvic floor is a crucial network of muscles, ligaments, and tissues that support the bladder, uterus (in women), prostate (in men), and rectum. An overactive or hypertonic pelvic floor refers to a condition where these muscles are excessively tight and unable to relax. This can lead to discomfort and sometimes debilitating symptoms.

Understanding the causes, recognising the symptoms, and exploring the available treatments can help manage this condition effectively.


Causes of Hypertonic Pelvic Floor

Whilst there is often no single factor that causes the development of a hypertonic pelvic floor, several factors can contribute to it:

  1. Chronic Pelvic Pain: Conditions such as endometriosis, interstitial cystitis, and chronic prostatitis can lead to muscle tension as a protective response to pain.
  2. Trauma or Injury: Physical trauma, childbirth, or surgery can cause scarring and muscle tightness.
  3. Stress and Anxiety: Psychological stress can manifest physically, leading to muscle tension, including in the pelvic floor.
  4. Poor Posture: Prolonged periods of poor posture can affect the alignment of the pelvis and contribute to muscle imbalance.
  5. Overuse: Excessive exercise or activities that put strain on the pelvic floor, such as heavy lifting, can lead to hypertonicity. 


Symptoms of Hypertonic Pelvic Floor

Having an overactive pelvic floor can severely impact your quality of life and psychological wellbeing.

The symptoms of a hypertonic pelvic floor can often include:

  1. Pelvic Pain: Persistent pain in the pelvic region, lower back, or hips.
  2. Urinary Issues: Frequent urination, urgency, painful urination, or incomplete emptying of the bladder.
  3. Bowel Problems: Constipation, pain during bowel movements, or difficulty in passing stools.
  4. Sexual Dysfunction: Pain during intercourse (dyspareunia) for women, erectile dysfunction for men, or general discomfort during sexual activity.
  5. Muscle Spasms: Involuntary muscle contractions or spasms in the pelvic region that may make it difficult or impossible to insert internal period care products such as tampons or menstrual discs and cause gynaecological exams and pap smears to be painful.
  6. Ischemia: A condition caused by the build-up of blood in the arteries due to the constant contraction of the pelvic floor muscles and an inability to relax them.


Treatments for Hypertonic Pelvic Floor

A multi-faceted approach is often the most effective treatment for a hypertonic pelvic floor. :

  1. Relaxation Techniques: Practicing pelvic floor relaxation techniques such as diaphragmatic breathing and yin yoga can assist in relaxing the pelvic floor muscles.
  2. Pelvic Floor Physical Therapy: Specialised physical therapists can teach exercises to relax and lengthen the pelvic floor muscles. Techniques such as biofeedback, manual therapy, and trigger point release are commonly used.
  3. Medications: Muscle relaxants, pain relievers, and medications to manage underlying conditions like interstitial cystitis can be prescribed.
  4. Psychological Support: Cognitive-behavioural therapy (CBT) and other forms of counselling can help manage stress and anxiety contributing to muscle tension.
  5. Lifestyle Modifications: Improving posture, managing physical activities to avoid overuse, and incorporating relaxation techniques such as yoga or mindfulness can be beneficial.
  6. Alternative Therapies: Acupuncture and massage therapy have shown positive effects for some individuals in reducing muscle tension and pain.

If you experience symptoms of a hypertonic pelvic floor, consulting with a healthcare professional specialising in pelvic health is crucial for an accurate diagnosis and effective treatment plan.




  1. National Health Service (NHS). (2021). Pelvic floor exercises for women. Retrieved from NHS
  2. British Society of Urogynaecology. (2020). Understanding Pelvic Floor Dysfunction. Retrieved from BSUG
  3. Mayo Clinic. (2021). Chronic pelvic pain in women. Retrieved from Mayo Clinic
  4. International Society for the Study of Women’s Sexual Health (ISSWSH). (2020). Hypertonic Pelvic Floor Muscles. Retrieved from ISSWSH


Disclaimer: This blog is for informational purposes only and is not a substitute for professional medical advice. Always consult with a qualified healthcare provider for accurate diagnosis and appropriate treatment.