Hypertonia: Why relaxation is KEY:
Most people are familiar with pelvic floor muscle weakness (hypotonia), but fewer are aware that the opposite issue—excessive tension in the pelvic floor (hypertonia)—can be just as problematic. In fact, many women today are unknowingly dealing with an overactive pelvic floor, leading to a variety of discomforts and dysfunctions.
What is a Hypertonic Pelvic Floor?
A hypertonic pelvic floor occurs when the muscles are excessively tight and unable to relax properly. Ideally, pelvic floor muscles should have a dynamic range, contracting when needed and relaxing fully at other times. However, when these muscles are chronically contracted, they lose their ability to function correctly, leading to symptoms such as:
- Pelvic pain or a heavy, dragging sensation
- Pain with intercourse (dyspareunia) or vaginismus (involuntary muscle tightening)
- Difficulty with bowel movements, straining, or incomplete emptying
- Urinary urgency or hesitancy
- Low back pain and hip pain due to muscle tension referral patterns
Causes of Pelvic Floor Hypertonia
There isn’t a single cause of pelvic floor hypertonicity; rather, a combination of lifestyle, habitual patterns, and physiological factors contribute to this condition. Some common causes include:
1. Overuse of Core and Pelvic Floor Muscles
Women who frequently engage in core-intensive workouts, such as excessive Kegel exercises, Pilates, gymnastics, or weightlifting, may unknowingly hold tension in their pelvic floor muscles. While these activities have benefits, a lack of relaxation and release work can result in excessive pelvic muscle activation, leading to dysfunction.
2. Habitual ‘Holding’ Patterns
Many people develop a subconscious habit of holding in their stomachs or clenching their pelvic muscles throughout the day. Additionally, those who frequently delay urination or bowel movements (due to a dislike of public toilets, busy schedules, etc) train their pelvic floor to stay in a tightened state, which can eventually cause chronic tension.
3. Chronic Health Conditions & Trauma
Women with conditions such as endometriosis, vulvodynia, irritable bowel syndrome (IBS), or interstitial cystitis often experience chronic pelvic pain. This pain can lead to a protective tightening of the pelvic muscles, exacerbating the problem.
Additionally, birth trauma—including episiotomies, severe perineal tearing (such as 4th-degree tears), and forceps-assisted deliveries—can result in scar tissue and adhesions in the pelvic floor. These restrictions can create compensatory tension patterns, causing discomfort in the surrounding muscles, including the hips and lower back.
Why Kegels Aren’t Always the Answer
One of the most common misconceptions about pelvic floor dysfunction is that all women need to strengthen their pelvic muscles. However, if hypertonia is present, doing more Kegel exercises (which focus on contraction) can actually make symptoms worse. Imagine trying to strengthen a muscle that is already clenched—it has no room to contract further! Instead, the focus should be on down-training, which involves releasing and lengthening the pelvic muscles.
Natural Treatment Approaches: The Power of Yoga and Breathwork
Ancient yoga-based therapies provide some of the most effective tools for releasing chronic pelvic floor tension. As a yoga teacher specializing in nervous system recalibration, I’ve seen incredible results in women who incorporate targeted stretches, breathwork, and visualisation techniques into their routine. These practices help to:
- Encourage full relaxation and release of overactive pelvic floor muscles
- Regulate the nervous system, shifting from a constant ‘fight or flight’ state to a more balanced, relaxed state
- Improve circulation and reduce pain by increasing blood flow to the pelvic area
- Restore functional movement by lengthening the muscles before strengthening them in a safe, supportive way
Seeking Professional Support
While yoga and breathwork are powerful tools, it’s important to recognize when additional support is needed. Pelvic floor physiotherapists can assess individual tension patterns and use techniques such as massage, myofascial release, and scar tissue mobilization to help restore function. I often refer my clients to these specialists when deeper intervention is required.
Listen to Your Body
If you’re experiencing any signs of pelvic floor hypertonia, know that you are not alone. These issues are incredibly common, yet they are often overlooked or misunderstood. By learning to release, restore, and rebalance your pelvic muscles—rather than simply strengthening them—you can cultivate a healthier, more functional pelvic floor and overall well-being.
If this resonates with you and you’d like to explore pelvic floor relaxation techniques, check out my guided breath work and yoga based sessions inside The Chill Out Space within womenswellbeing.me online health hub.