There is a lot of focus on underactive pelvic floor muscles due to the impact that it has on activities of daily living and the social implications for both men and women. However having an overactive pelvic floor can be associated with similar issues. An overactive pelvic floor can cause chronic pelvic pain, low back pain, hip/thigh pain and pain during urination, bowel movements and/or intercourse. It can also lead to problems with bladder function in the long term. An overactive pelvic floor can be caused by performing a lot of abdominal exercises due to the load placed on the core and pelvic floor, sports that require rigid body positions or high level athletes. The most important thing to do with an overactive pelvic floor is to firstly get it assessed by a women’s health physio to ensure there is no other concerns, and then you must learn how to relax the pelvic floor muscles. This can be achieved through progressive relaxation, specific pelvic floor relaxation, deep breathing or gentle stretches.
Heba Shaheed (2016), highlighted that for those with an overactive pelvic floor they should focus more on:
- The recruitment of their diaphragm, trying to encourage deeper and wider breaths in
- Visualising the dropping or relaxation of their pelvic floor muscles as they inhale. Imagery such as visualising the way a pebble drops into a pond and the ripples it makes outwards can help people to learn to let go of these muscles
- The relaxation of their pelvic floor even within exhale
- The Pilates or exercise movement happening with the exhale but without actively contracting or lifting through their pelvic floor muscles
- Activating their transversus abdominis muscle by gently drawing in their lower abdomen towards their spine, as they exhale.
Although the main focus will be to learn how to relax the pelvic floor muscles, they still have a purpose to support the pelvic organs. As a result you should still be conscious of engaging the pelvic floor muscles during exercise, but remember to relax as well. What goes up, must come down.
Below are a few helpful links to practice relaxing your pelvic floor as well as some examples of stretches.
http://www.fixprogram.com/blog/post/2016/12/01/The-over-active-pelvic-floor (Heba Shaheed, 2016)