Overactive Pelvic Floor

Georgie Palmer (Physiotherapist – Burnie)

People may have come across the concept of a weak pelvic floor – images spring to mind of women crossing their legs when they sneeze, or rushing to get to the loo – but an overactive pelvic floor can seem like a bit of a mystery.

But first, what is a “normal” pelvic floor? Your pelvic floor is a group of muscles that sits in the base of your pelvis like a hammock. It has two main functions, to support your internal organs (bladder/bowel/uterus if you are female) and to elicit some sort of control over your bladder and bowel actions by voluntarily tightening and closing off the urethra and anus. In females it also has a sexual function, of sensation and tensing during orgasm.

A normal pelvic floor can contract when required and then relax fully. We know a little about a pelvic floor that is poor at contracting – this is our weak pelvic floor, and can lead to leakage of wee or poo. At the other end of the spectrum, an overactive pelvic floor has muscles that cannot relax and this can lead to difficulty using your bladder or bowel properly, and painful sexual intercourse.

Symptoms of an overactive floor can include pain (and painful sex), cramping, aching and heaviness, difficulty doing a wee, or not completely emptying your bladder, having to rush to get to the toilet, having to go to the toilet very frequently, pain when you wee, difficulty doing a poo, and constipation.

An overactive pelvic floor can have a multitude of causes:

  • Too much load on the pelvic floor – for example repetitive lifting of heavy weights/core exercises as seen in gymnasts and elite athletes or doing too many pelvic floor exercises.
  • Inflammation – from vaginal infection/abscess, or any trauma including falls, sexual abuse, vaginal delivery of baby, episiotomy, surgical scarring.
  • Emotions – guarding when stressed/anxious with or without realizing you are doing so.

So how can physio help?

If you suspect you have an overactive pelvic floor, or identify with some of the symptoms mentioned above, physiotherapy may be able to help.

Physio for pelvic pain or suspected pelvic floor will usually involve an assessment of lower back/hips/pelvic joints, breathing patterns as well as the pelvic floor itself.

Depending on the findings of the assessment there are a range of treatment options, and we will be guided by what you feel comfortable with. Some examples of different treatment options include

  • Pain education
  • Pelvic floor muscle awareness/relaxation strategies
  • Breathing exercises
  • Graded exposure
  • Relaxation strategies
  • Advice regarding/return to comfortable sexual activity

The aim of physiotherapy for the pelvic floor is to help you help yourself, an active rather than a passive treatment. So expect some homework to do!!

If you would like some help with your pelvic floor, call our Burnie clinic to make an appointment to see Georgie on 64314586.