When you have a tight muscle, the signs are usually obvious — pain, soreness or cramping (think: a charley horse in your calf or a knot in your neck).
The same type of tension can happen in your pelvic floor muscles (they consist of skeletal muscle just like your biceps or quads), except the symptoms are often different. Which means you could be experiencing a cluster of issues in your body and not even realize they're tied to tightness in your pelvis.
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That's why we spoke with Marcy Crouch, DPT, pelvic floor physical therapist and creator of The DT Method birth prep and recovery courses, who explains the many ways pelvic floor tension may manifest in your body, plus how to test yourself for — and relieve — tightness.
Symptoms of Tight Pelvic Floor Muscles
Tension in this area of your body doesn't always show up the same way as tightness in your other muscles. Here's what happens when you have a tight pelvic floor:
1. Pain During Penetration or Intercourse
If you're wondering what pelvic floor tightness feels like, the answer is that you might not feel the tense muscles most of the time, but they'll often make themselves known during any kind of penetration.
"During vaginal penetration, the pelvic floor muscles must lengthen and release to allow something (a penis, finger, tampon, etc.) to go into the vaginal canal," Crouch says.
But if those muscles are chronically tight or in an active spasm, you may experience pain when something is pushed inside the vagina, she explains.
Discomfort can occur when you have sex, insert a tampon or visit your doctor for an internal gynecological exam.
2. Difficulty Urinating
If your pelvic muscles are performing optimally, you probably won't think much about your bladder function. But a tense pelvic floor could produce problems with peeing.
Here's why: "When the bladder is filling, the pelvic floor muscles turn on and contract to keep us dry and support the bladder, and when it's time to urinate, the muscles release so urine can flow out of the bladder and urethra," Crouch says.
But if your pelvic floor is hypertonic (i.e., chronically tight, shortened or contracted), your muscles may have difficulty relaxing and lengthening when they should, which can make it tough to start urinating and to completely empty your bladder, Crouch explains. This may also make you feel a constant urge to urinate, she adds.
3. Leaking Urine
On the other hand, tense pelvic floor muscles can also cause your bladder to leak.
"Often we think that leaking urine is associated with muscles that are too weak, and this is certainly the case, but leaking can also be due to a hypertonic pelvic floor," Crouch says.
That's because when the muscles are constantly contracted, they can't move through their entire range of motion to close the urethra and keep us continent, she explains.
A tense pelvic floor may be the culprit behind chronic constipation.
"The anal sphincter and the pelvic floor, specifically the puborectalis muscle, have to lengthen and release so stool can pass through the rectum and out the anal opening," Crouch says.
But when the pelvic floor muscles are too tight, or if they can't lengthen, the anus can't open, making bowel movements very difficult, she says.
5. Lower Back Pain
Believe it or not, the root of your lower back pain may be your hypertonic pelvic floor. Research shows that tightness in these muscles can create tension in the low back as well as into the hips and pelvic girdle, Crouch says.
"There's also evidence to link weak pelvic floor muscles with low back pain due to core stability problems," she adds.
How to Test Your Pelvic Floor for Tightness
If you're experiencing any of the telltale signs of a tight pelvic floor, you can also try these two tests to assess the level of tension in your muscles.
1. Try to Perform a Kegel
Contract your pelvic floor muscles (think about stopping the flow of urine) and then relax them. If your muscles remain contracted and can't release fully afterward, you're likely dealing with a tight pelvic floor, Crouch says.
For people with tight or hypertonic pelvic floor muscles, Kegels should only be performed as a diagnostic tool and are not recommended regularly (more on this later), Crouch says.
2. Do a Self-Internal Vaginal Assessment
Insert a clean finger into the vaginal canal and attempt a Kegel contraction. "If you feel a large amount of squeezing around your finger, with pain or soreness and no releasing, those muscles may be tight," Crouch says.
How to Relieve a Tight Pelvic Floor
So, what can you do to release tension in the pelvic floor? Here, Crouch offers a few suggestions:
1. See a Pelvic Floor Physical Therapist
This is the best bet for people with hypertonic pelvic floor problems, Crouch says. Pelvic floor specialists can help you pinpoint your pelvic issue and develop a specialized treatment plan.
If you can't make it to physical therapy in person, some providers like Crouch also offer virtual sessions. Check out PelvicRehab.com or the Academy of Pelvic Health Physical Therapy to locate a pelvic health therapist near you.
2. Avoid Kegels
"We wouldn't be lifting weights all day on a muscle that's in spasm, so it's the same for the pelvic floor," Crouch says.
In other words, if your muscles are already contracted, you don't need to contract them further with Kegels.
3. Do Pelvic Floor-Lengthening Stretches
Stretching tight pelvic floor muscles isn't as intuitive as stretching tight quads or calves, but it is possible, and it can help with symptoms.
Stretches meant to lengthen and relax the pelvic floor are sometimes referred to as reverse Kegels. Happy baby pose and the deep squat stretch are two of Crouch's favorites. Both moves help open and release your hips and pelvis. Integrate diaphragmatic breaths for an even deeper stretch.
- Lie on your back. Bend your knees and bring them toward your belly.
- Grip the outsides of your feet and gently pull them down toward your armpits.
- Try to keep your ankles directly above the knees, so your shins are perpendicular to the floor.
- You want to feel a mild, comfortable stretching sensation into the hip region.
- Hold this stretch for a minute.
Deep Squat Stretch
- Start seated with your legs straight out in front of you.
- Bend both legs, so that your calves come close to the back of your thighs and your feet are planted on the ground.
- Lean forward and raise your butt to come into a deep squat on your feet, pointing your toes slightly outward. If your heels rise up, you can place a rolled blanket or mat beneath them.
- Place your elbows on the insides of your knees and press your palms together in prayer.
- Hold this position for a minute.
If you need extra support in your deep squat, you can place one or two yoga blocks beneath your butt for stability.
Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.