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Pelvic Floor Muscle Over-activity what it means, and what to do about it.

Let’s break down what Pelvic Floor Muscle over activity might look like. This can be a confusing issue and depending on what type of doctor you see, the answer might be different. If you have pelvic floor muscle over activity, you might experience symptoms such as:

  • Low back pain
  • bladder retention
  • pain with sex
  • constipation
  • UTI “like” symtpoms
  • tailbone pain
  • hip pain
  • bladder urgency
  • abdominal pain

If you go see a doctor for these concerns, you might be told you have pelvic floor dysfunction, pelvic floor tension myalgia, bladder pain, overactive bladder, dyspareunia, vaginismus, sciatica, coccydynia, pelvic floor dyssynergia; to name a few. If this sounds confusing, it probably is! It is hard to navigate, especially given the amount of time your doctor probably did not get to spend with you, explaining what is going on. If this sounds like what you are struggling with, this blog is for you!

The group of muscles in the pelvic floor have several very important functions. They are responsible for bowel and bladder function; back, hip and pelvic joint stability; sexual function; blood flow through the pelvis; and supporting pelvic organs. Just like any muscle in the body, these too can become too tight, or over active. This happens for many reasons, too many to discuss in one blog. However, pregnancy/delivery, surgery, injury, stress or illness can set them off. Similar to tension headache, the pelvic muscles are not able to relax or lengthen properly, causing a laundry list of symptoms that can occur.

The first thing to do is see a pelvic floor physical therapist. This sounds like something you would not like to do, but it is really not that scary! At your first visit, your therapist will take a thorough medical history, talk about lifestyle factors and mental health to understand more about what your symptoms are, and what helps or aggravates them. Then they will do a full musculoskeletal exam to screen your spine, pelvis, hips and lower extremities to get a baseline of your strength and flexibility. This also allows you provider to rule in or out any joint pathology or if further imaging is needed.

The examination of the pelvic floor muscles is a vaginal or rectal exam (for men). Don’t stop reading now… The pelvic muscle exam is what really gives you a confirmation of whether or not those muscles are over active or weak, or both! It is just one finger vaginally (or rectally) to assess each muscle in the group and determine how well you coordinate the muscle group as a whole. This part of the exam takes less than a few minutes but can give you a wealth of information.

Your therapist should design a home program for you, specific to your needs.. For example, there may be some weakness in your hip musculature in addition to over active pelvic floor. In this case we want to balance relaxation and elongation training of the pelvic floor with strengthening and stability work in the hips. This should always be geared toward your individual findings and needs.

At Foundational Concepts, our therapists spend a full hour with you, to get to the bottom of your issues and address the cause, not just the symptoms. If you are experiencing any of the issues discussed in this blog, you should seek the help of a pelvic floor PT. In most states (we are in KS and MO) there is direct access to PT, meaning you don’t need to see a doctor first. You can see a PT, and they are often the best person to help you find the right doctor to see. Some people might need a urologist, while others may just need to follow with their primary care physician.

We offer a free 15 minute phone consultation with one of our pelvic floor specialists. Click HERE to get answers to any questions you may have and ensure you are in the right place to get well.

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