Heard a tight pelvic floor isn’t quiiiiite a good thing and wanna learn more? You’re in the right place! Gone are the days of praising a “tight vagina” (thankfully!) as we now know the pelvic floor – the sling of muscles that sit in the bottom of your pelvis and regulate bowel, bladder, and sexual function – needs mobility for adequate strength, coordination, and control.
I liken it to a fist…your hand should be able to make a fist, but it shouldn’t be stuck in a fist. A hand constantly clenched in a fist is painful, weak, and dysfunctional, and a tight pelvic floor is no different. So pelvic pain, back & hip pain, period cramps, constipation, pelvic organ prolapse, even bladder leakage, urgency, and frequency (!!!) can all be caused by pelvic floor muscle tension, and getting to the bottom of how and why you have that tension to begin with is the best first step to seeing improvement in symptoms.
As a pelvic rehab therapist, I teach patients how to ~relax~ their pelvic floor more often than not, because muscle tension “down there” is becoming the regular for women of all ages, shapes, lifestyles, and backgrounds. Once you see the reasons behind it, this trend will make farrrrrrr more sense, but let’s remember that “common” and “normal” are two very different words and I’m on a personal mission to keep this phenomenon from turning into the new standard.
So let’s get to it, shall we? The following list is meant to be an eye-opening guide to help you determine (1) if you have a tight pelvic floor, and (2) where you can begin focusing your efforts to decrease that muscle tension. Do not, I repeat…DO NOT let this become a source of overwhelm. If two or more points resonate with you, you’re not alone. Set yourself up for success and pick the one that’s easiest or most convenient to address first (a path of least resistance kinda thing), then go from there.
Taking it one step further, at the end I’m sharing my tried and true strategies for fixing pelvic floor muscle tightness ~and~ the bowel, bladder, and sexual symptoms that come along with it. No posting and ghosting here, friend…I’ve got you! There’s hope and healing on the other side of this one, so settle on in, take a sip of your nearest beve’, and prepare for a few light bulb moments ahead.
Causes of a tight pelvic floor
If you didn’t already, you now know a tight pelvic floor isn’t something you should be striving for. While the bowel, bladder, and sexual pain, weakness, and dysfunction that result from pelvic floor muscle tension can be frustrating, depressing, and even debilitating, take comfort in knowing you’re not alone, the cause could be something you had no awareness or control over, and my favorite part…it’s TOTALLY fixable.
As you read through this list, take mental or literal note of the points that resonate with you. While I can’t necessarily assess you in the clinic setting, I can almost guarantee that if you relate to a few of the following ~and~ have pelvic floor issues, you likely have a tight pelvic floor. If so, take a deep breath, stop doing kegels immediately (yes…even if you have bladder concerns), and make sure you read to the end for *exactly* what to do next.
1. STRESS & ANXIETY
Yeah…we’re divin’ right in, because over 60% of the adult population considers themselves stressed or anxious, and with those feelings often comes muscle tension. While most would vouch for an aching jaw or tight shoulders, the pelvic floor has the same response; it’s just not always as obvious as our awareness of “down there” is limited. I ~always~ ask my patients if their pelvic floor issues started around a time of stress, worry, or fear, and more often than not, there’s an *ahem* not-so-coincidental correlation.
RELATED POST: 3 [Shocking] Ways Your Pelvic Floor Responds to Stress
RELATED POST: Mantras, Meditation, & 14 Other Kiiiiiiinda Crunchy Practices for Stress Relief
2. POOR POSTURE
Every time I talk about posture I get a visceral reaction to memories of my mom encouraging me to stand up straight and pull my shoulders back. Buttttttt…she was right (surprise, surprise), and now I know posture effects so much more than how I look. Posture – specifically pelvic posture – plays a HUGE role in pelvic floor tightness. A posterior pelvic tilt (glutes and abs clenched and tail tucked) promotes muscle tension by creating a “shorter” pelvic floor. This posturing is common in when sitting in cars, desk chairs, and on the couch to name a few. Mindfulness and a bit of body awareness are all you need to correct this, making it one of my favorite places to start.
3. BACK & HIP PAIN
This is one of those “chicken and the egg” situations, because chronic back and hip pain can cause pelvic floor muscle tension, but a tight pelvic floor can also create back and hip pain. At the end of the day, it really doesn’t matter who’s at fault, but rather that all issues are resolved, am I right!? A symptom timeline can help determine the difference, with the guilty culprit often being the issue that started first. Core and glute strengthening can be helpful when trying to decrease back and hip pain, and everything you need for the pelvic floor is below.
4. IUDs
My opinion on intrauterine devices (IUD) aside, we can all agree that placing a quarter-sized foreign object in tissue as tender as the cervix might cause some problems. Beyond the pelvic floor’s “simple” response of tensing up in the presence of an IUD, hormone imbalance and a higher risk of developing pelvic infections can both contribute to a tight pelvic floor. If your bowel, bladder, or sexual symptoms started around the same time you had an IUD placed or changed, this could be an area worth investigating more.
5. HORMONAL CONTRACEPTIVES
Kinda like IUDs, other hormonal contraceptives like birth control pills and arm implants can affect the pelvic floor. While there’s no structural component creating muscle imbalance, hormonal contraceptives alter estrogen and progesterone levels in the body which can cause inflammation, altered blood flow to the pelvis, diseases such as PCOS, endometriosis, and fibroids, and changes in mood – all of which can ultimately result in a tight pelvic floor. If your bowel, bladder, or sexual symptoms started around the same time you started or changed your birth control, this could be a factor worth considering.
6. ENDOMETRIOSIS, PCOS, & FIBROIDS
If I had a dollar for every time a woman came into my clinic with pelvic floor tightness along with endometriosis, polycystic ovarian syndrome (PCOS) and/or fibroids, I’d be quite wealthy. And as someone who has endo and PCOS as well as a generally tight pelvic floor, I can personally attest to this common correlation. These diseases structurally place increased pressure and tension on the pelvic floor and its surrounding organs, fascia, and ligaments, so it’s no surprise the muscle respond by tightening. At this point there is no known “cure” for any of the above, but prioritizing gut health and hormone balance has helped me significantly.
RELATED POST: My Favorite Resources for Easy & Actionable Endometriosis Information
7. PROLONGED SITTING
Between binge-worthy Netflix series, a growing number of desk jobs, and an increased frequency of travel, people nowadays spend more time sitting than ever before. Sitting for extended periods causes hip and back tightness and poor blood flow to the pelvis…add in the whole poor posture “thing” from above and you’ve created the perfect storm for a tight pelvic floor. While sitting is inevitable, taking stretch or stand breaks at least every thirty minutes (and being mindful of your posture in between) can significantly decrease the affects of prolonged sitting on the pelvic floor muscles.
8. YOUR SHOE CHOICES
I love a cute pointed flat and comfy set of slides as much as the next gal, but because the feet and pelvic floor are directly connected in the brain, any shoes that create foot pain or pressure in the wrong places can contribute to a tight pelvic floor. The common culprits are heels, pointed or narrow shoes, and shoes without back support like flip-flops. Not willing to give these up? Me neither! Simply do a shoe audit and try to minimize the time on your feet in anything that falls in this category.
RELATED POST: These Shoe Types May Be Sabotaging Your Pelvic Health
9. SHALLOW BREATHING
The diaphragm (muscle that controls breathing) and pelvic floor are directly connected, so if one is tight, the other is likely to follow suit. Chronic stress, tight clothing, a habit of “sucking it in”, and poor posture can all cause a shallow breath that only fills the chest rather than the abdomen and pelvic floor as well. If you notice it feels hard to take a deep breath, only feel your chest move when you breath, or you get winded quickly, this may be an issue for you.
10. TIGHT CLOTHING
I don’t know about you, but my social medial is littered with “shape wear”, “bodycon” items, and waist trainers. Add in the fact that a smaller pant size is considered “winning” by society’s standards, and all of the above have women buttoning, strapping, and cinching up to give the appearance of a slimmer waist. But if your abdomen is sucked in, you can’t breathe properly (see #9 just above) and there’s increased compression around the pelvis, both of which cause more pressure and tightness in the pelvic floor.
11. C-SECTION & ABDOMINAL SCARRING
There’s absolutely nothing wrong with having a C-section, and you have my 10000000000% support for however you birthed your babe(s) into the world. But C-sections (and other abdominal surgeries for that matter) create adhesions in the abdominal wall, and because the core muscles directly intertwine with the pelvic floor, this can create pulling, tension, and tightness in the pelvic floor muscles. No matter how long since your surgery, it’s never too late to get this tissue moving – massage, cupping, and castor oil packs can all be helpful.
12. PERINEAL SCARRING
Just like abdominal scars, perineal scarring, most often from tearing with childbirth, can also cause tissue adhesion and secondary pulling on the pelvic floor muscles. I experienced this first hand as I had a severe third (almost fourth) degree tear with Sloan and the bowel & bladder issues plus pain with sex that came along with it. Also like abdominal scars, no matter how long it’s been, it’s never too late to get this tissue moving, and the blog posts below include the step-by-step instructions to make that happen.
RELATED POST: [Everything] You Need to Know About Vaginal Dilators
13. A HISTORY OF ABUSE
Trauma or abuse in any form and at any age can lead to pelvic floor muscle tightness. As women, we carry a lot of emotions in the pelvis, and if you’ve experienced physical, mental, or emotional abuse, the pelvic floor will “close off” as a defense mechanism. Pelvic floor relaxation in conjunction with talking to a mental health specialist is a helpful route to take in these situations. There’s also so many great books to help with this and my absolute favorite is “Transforming Trauma: The Path to Hope and Healing” by Dr. James Gordon.
14. CHRONIC PAIN
Pain that’s been present for a significant amount of time is bound to effect other areas of the body. And because muscles respond to pain by tensing up, surprise, surprise!!!…the pelvic floor typically follows suit. A tight pelvic floor often tags along or results from pain caused by fibromyalgia, diabetes, cancer, and arthritis, and the vicious pain-tension cycle can ensue. Getting these chronic diseases and their symptoms under control as best as possible is key as you work simultaneously to decrease pelvic floor muscle tension.
15. BLADDER LEAKAGE, URGENCY, & FREQUENCY
*Sigh*…another game of “who done it”, because we’ve already admitted a tight pelvic floor can cause bladder issues, but yes…bladder issues can also cause a tight pelvic floor. Fear of leakage, trying to hold it in, and doing 834910386382 kegels a day to make it all stop unfortunately puts you on the fast track to pelvic floor muscle tension. So relax (I know…easier said than done), hit pause on the kegels (trust me here), and scroll a bit further to find my number one resource for this conundrum.
RELATED POST: 5 Reasons Kegels Aren’t Working for You
16. VULVA SKIN IRRITATION
“Vulva” is the name we give to the female genitalia (or the outside of the vagina you can see) and includes the labia majora, labia minora, clitoris, hood of the clitoris, and vaginal opening. If the vulva is irritated from waxing or shaving, chemicals in your laundry, soap use when cleaning, toxic menstrual care products, low quality lube, or even wiping too hard, the muscles under that tissue can tense up in response. I’ve ~literally~ had people simply change how they treat their vulva, and their pelvic floor tightness *magically* goes away. There is a right way to clean and care for your vulva, and it’s all HERE!
RELATED POST: The 411 on Pubic Hair & Your Ultimate Guide to Care for “Down There”
RELATED POST: Lube 101: An All Natural (Yet Totally Realistic Guide) to What You’re Using Down There
17. YEAST & BACTERIAL INFECTIONS
We’ve likely all experienced that dreaded itch or burning or smell or smell that signals an infection somewhere in the urinary tract (UTI) or vaginal canal. Depending on how often you get them or how bad your symptoms are, the bladder issues, discomfort, and frustration that come with infections can be enough to trigger the start of pelvic floor muscle tightness. Getting to the bottom of these infections (especially if you get them regularly) is key to keeping the pelvic floor happy and healthy.
RELATED POST: 7 Unexpected Causes of a UTI & My Favorite All-Natural Ways to Prevent & Treat Them
18. CHILDHOOD PELVIC HEALTH ISSUES
Constipation, bed wetting, a not-so-pleasant potty training experience, regular UTIs…even though you might not remember these issues, your pelvic floor does and this can manifest as tight pelvic floor muscles in adulthood. You could talk to a parent or caregiver to see if this is in your history, but while learning more may shed light on what you’re currently experience, we unfortunately can’t go back and change it. What you can do is intentionally move forward, so keep reading, friend.
19. WEAK HIP MUSCLES
Besides the pelvic floor, the glute and hip muscles are equally responsible for supporting the structure and contents of the pelvis. If said hip muscles are weak, the pelvic floor will work overtime to compensate for lack of hip strength, and…you guessed it…pelvic floor tightness is the likely result. Performing a handful of specific hip strengthening exercises two to three times a week (you can find my favorites here) is enough to boost those booty gains and give your pelvic floor a well-deserved break.
Now what to do about it
When I tell women they have a tight pelvic floor, the most frequent follow-up question is “why?”. And rightfully so! Then I often name a few common reasons from the list above based on their medical history and clinical presentation. But once we know (or can at least speculate) the “why”, the next best question we should be asking is what to do about it, and I’m so glad you asked *wink wink*!
Within each of the points above I’ve shared tips, tricks, guides, and other relevant blog posts jam-packed with more information for addressing that specific concern. But if you’re a “go all in”, “no time to waste”, “give me the good stuff” kinda gal, then this is where you’ll want to go next to learn exactly what to do for a tight pelvic floor –
MY MOST POPULAR BLOG POST EVER
Like I said, pelvic floor muscle tension is pretty dang common, so it’s no surprise that my blog post revealing my daily pelvic floor relaxation routine is my most clicked on post EVERY. SINGLE. MONTH. In it you’ll find a handful of exercises that take less than 15 minutes a day as well as my most downloaded guide on how to relax the pelvic floor.
THE BEST RESOURCE IF YOU HAVE BLADDER ISSUES TOO
A tight pelvic floor + bladder leakage, urgency, frequency, and nighttime urinating is ridiculously common, but also extremely frustrating. Because kegels (for the bladder) can make a tight pelvic floor worse, but pelvic floor relaxing (for the pelvic floor) will make bladder issues worse…right!? This confusion is why I created The Bladder Blueprint, a step-by-step, 8-week online course that walks you through what to do and ~exactly~ when & how to do it for healing in (D) ALL OF THE ABOVE.
Inside The Bladder Blueprint you’ll find guidance on pelvic floor relaxing (check!), kegels (check!), along with bladder habits, bathroom tips, and easy strategies to make sure your results last a lifetime (check!, check!, check!). If you have five minutes a day and the desire to finallyyyyyyyyy fix these problems for good, TBB was created for Y-O-U and I can’t wait to see you inside.
PERSONALIZED ONE-ON-ONE SUPPORT
All this information can be a bit overwhelming, and while that’s not my intent, sometimes good ol’ analysis paralysis sneaks in and stops the best of us dead in our tracks, even if the motivation and desire for healing are there #guilty. Working one-on-one with a pelvic rehab therapist is thee best way to nix confusion and get results quickly when it comes to a tight pelvic floor and all the symptoms that come along with it. Schedule an appointment (and start seeing positive change in your pelvic health) today! I’ve helped hundreds and hundreds of women do the same, and there’s no reason you can’t too.
Ok, I’ve been wanting to write this post for a looooooong time, but my fear of missing or overlooking something kept me from doing so. That being said, I’ve already updated this once and am still likely missing a cause (or two) of pelvic floor tightness! But I’m confident this list is a great place to start questioning if you have muscle tension, where it’s stemming from, and what to do about it.
Over 95% of the women that come into my clinic have pelvic floor muscle tightness due to one or more of the reasons above. If you’re still not totally convinced a tight pelvic floor describes you, I recommend erring on the side of caution and taking one of the steps above to address your issues through pelvic floor relaxing. As I mentioned in the beginngi, a happy, healthy, strong, coordinated, and controlled pelvic floor is one that can move, so get that relaxin’ going…knowing I’m here to help you every step of the way.
– Amanda
Disclaimer: The content provided here does not constitute medical advice, nor is it a substitute for personalized healthcare. I’m a doctor, but I’m not your doctor. If you have concerns about a medical condition, diagnosis, or treatment, you should consult with a licensed healthcare professional.
Disclosure: Some of the links above are affiliate links, meaning, at no additional cost to you, I will earn a commission if you click through and make a purchase. No pressure, but I have a feeling you’re gonna like what I’ve taken the time to put my recommendation behind.
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amanda.m.hurlburt
You’re so welcome! Happy to hear this resonated with you 🙂
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