Do you suspect you have an overactive pelvic floor? An overactive pelvic floor is when the muscles contract more than necessary. This results in excessive pelvic floor muscle tension. Pelvic floor overactivity is like ‘tight shoulders.’ Causes of an overactive pelvic floor include:
- Stress
- Pelvic trauma
- Injury
- Surgery or infection
- Untreated bowel or bladder issues
- Hypermobility
Symptoms of an overactive pelvic floor include:
- Painful sex or vaginismus
- Painful bowel movements
- Tailbone pain
- Bladder or bowel leaking
Exercise can contribute to an overactive pelvic floor. It is common in cases of high intensity exercise without mobility and relaxation. Mobility and relaxation provide balance. This can be exacerbating if the person also has a fast paced or stressful lifestyle.
In some cases, you may need to refrain from high intensity exercise. This will allow time for the pelvic floor to normalize, as guided by a physical therapist. Many people can continue to exercise if they have awareness of overactivity. They must also use strategies to balance the impact from their exercise.
Exercises to avoid with an overactive pelvic floor
Some exercises with an overactive pelvic floor can cause further strain and aggravate existing muscle tension. Exercises to avoid with a tight pelvic floor include:
- High-intensity running or jumping
- Weightlifting using heavy weights or resistance bands
- Any exercise involving external or internal rotation of the hips and spine
- Sit-ups, crunches, planks, or abdominal work involving a curl-up position
- Bicycle exercises when lying on your back
- Any exercise that creates pressure on the pelvic floor, such as squats, lunges, and bridges
When working with a tight pelvic floor, it is recommended to limit the amount of time spent on these activities. Take frequent breaks in between sets or exercises as needed.
How breath work helps an overactive pelvic floor
Breath work can reduce the nervous system’s stress response. It can also mobilize the pelvic floor. Use diaphragmatic breathing:
- In a warm-up before exercise
- In a cool-down after exercise
- During times of stress and anxiety
- As a daily exercise for pelvic floor mobility
To perform:
- Place your hands on the upper belly
- Slowly inhale, sending air to your hands
- Slowly exhale – the belly should flatten as the air leaves
- Continue, building up to a 6-second inhale/6-second exhale. Make sure you’re getting belly movement as you breathe.
- Perform for at least 10 breaths
Avoid breath holding
There’s a difference between proper bracing and improper strain. It is generally recommended to avoid breath-holding. Instead, continue breathing throughout exercise, exhaling on the hardest part of an exercise. This breath pattern encourages contraction of the pelvic floor. Don’t make breath-holding a habit. In exercise, breath-holding increases tension for support during heavy exertion. Use it sparingly, and only if you use proper technique.
Include mobility programming
Is your workout of choice low impact with full body movement (like yoga, tai chi, etc.)? Then you can use your workout to your advantage to address an overactive pelvic floor. Do you like to do burpees, powerlifting, dance, or other high impact activities? Then a complimentary mobility program is a must. Higher intensity workouts increase muscle demand and elevate cortisol levels (a stress hormone). This is normal, but if you already have an overactive pelvic floor, this can prevent it from improving.
Rather than stopping your workouts, first try a mobility program. Plan a cool-down after each workout, and incorporate stretching throughout each day. Here are some examples:
- Thread the Needle
- Cat Cow
- Child’s Pose
- Shin Box
- Figure 4 Stretch (Pigeon Pose)
- Prone Press-up (Cobra or Upward Dog Pose)
- Downward Dog
Strengthen the booty
Weak or tight hips contribute to dysfunctional pelvic floor muscle activity. It’s worth strengthening the hips to address this factor. If you are a person who sits a lot, has knee or back pain or has poor posture, this may be especially valuable for you. Some overactive pelvic floor exercises to strengthen the hips include:
- Clamshells
- Hip thrusts
- Bridges
- Lateral leg raises
- Squats
- Lunges
- Side planks
Evaluate stress
Sometimes it’s the other stuff in life that affects tension in the body. Dealing with sources of stress can help to relieve muscle overactivity. Improved pelvic floor function (continence) and reduced pain mean muscle tension is improving.
Get medical care for overactive pelvic floor issues
Exercise can help or hinder pelvic floor symptoms. But if the source has never been found, medical care might be the right next step. See a qualified physician or physical therapist. They can help treat sources of muscle dysfunction or pain. It may make a great difference in the ability to restart or continue your exercise of choice.
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