Understanding Your Pelvic Floor: Tight, Weak or a Combination of Both
If you are someone who has ever struggled with pelvic floor symptoms, than it’s likely that you’ve encountered the whole tight versus weak conversation. And while, yes, it is possible to just have a tight pelvic floor or just have a weak pelvic floor, it’s actually more common to have a combination of both, especially after postpartum healing has occurred. In this blog post, we are going to cover what a tight pelvic floor is and symptoms to be aware of, what a weak pelvic floor means and what symptoms may be associated with that, and finally, what it means when you have a combination of both, how to handle that and what exercises you can do while working on both issues at the same time.
What do you mean by TIGHT pelvic floor?
Every muscle has an optimal “length-tension” relationship. Meaning they were designed to be a certain length with a certain amount of tension associated with it for optimal performance. Sometimes, either because of lifestyle, habits, injury or other, a muscle can start to either become to long (weak) or too tense (tight), and when that happens, you may start to notice some signs and symptoms of that change.
So, let’s talk first about a tight pelvic floor.
This is also known as pelvic floor hypertonicity or pelvic floor muscle tension and it occurs when the muscles in the pelvic floor are excessively contracted or tense over a period of time. This condition can lead to various issues, including pelvic pain, difficulty with urination or bowel movements, pain during sexual intercourse, and even lower back pain.
let’s dive a little deeper into understanding a TIGHT pelvic floor…
If the muscles are in a state of chronic tension, then that also means they are in a state of constant shortening (or half shortened). So if you go to “contract” the pelvic floor, you don’t have much more to tighten since they are already tight! An example of this would be when you bend over to pick up something heavy and you try to contract your pelvic floor to keep from yourself from peeing. Because your pelvic floor is already tightened, it struggles to pull up and tighten further to keep from leaking, therefore causing incontinence to occur.
And another thing to consider, when your muscles are in a constant state of overly tight, that can actually lead to weakness (although tight) because you they are not able to move from relaxed to tight through a full range of motion in order to strengthen. They are just stuck in one place, not moving, making it very difficult to strengthen!
If a tight pelvic floor is something you think you may be struggling with, then the biggest take away for you will be to learn how to regain FULL range of motion of your pelvic floor. This means learning how to relax it, allowing it to drop down to it’s fully lengthened position so that you can then contract them when you are strengthening them or when you need to during your daily life (psst, this is where diaphragmatic breathing comes into play!).
What is a WEAK pelvic floor?
There are times when your pelvic floor may not be tight and is just plain weak. Really understanding the state of your pelvic floor would require an internal examination from a pelvic floor physical therapist to assess the muscles and determine the diagnosis, but let’s dive into a weak pelvic floor, assuming that tightness isn’t playing a role as well.
A weak pelvic floor just means that the actual muscles of your pelvic floor are, well, WEAK. They aren’t very strong, or at least not strong enough to be able to perform optimally and do the things they were designed to do, like hold some of your organs in place and keep you from peeing or pooping yourself, for example.
If your pelvic floor truly is just weak with no other issues at play, then obviously the main focus would be to learn how to strengthen the pelvic floor muscles correctly, still coordinating that activity with your breath, and then learning how to contract them when you need them to in your daily life!
I wanted to mention here too that sometimes, it may seem like your pelvic floor is weak because of the symptoms you’re having, but actually, what may be happening is that they just aren’t very coordinated. That might sound silly, like how much coordination does your pelvic floor really need, but actually, coordination is a huge piece of contracting and relaxing when and where you need them to! In the same way that your pelvic floor may be too tight or too weak, it can also be uncoordinated and require training and cues to gain coordination so that it does what you want it to do.
Tight Vs. Weak - Signs and Symptoms
Let’s get into it! What signs and symptoms might you experience with a tight pelvic floor? A weak pelvic floor? Are some of them the same? Or are they vastly different?
Let’s take a look!
Tight Pelvic floor Symptoms:
Pain with sex
Pain with insertion (like a tampon)
Incontinence
Jaw pain
Type A personality
High stress
Inability to fully empty bladder
Spraying while peeing
Taking several moments to begin flow of urine
Constipation or skinny poops
SI back pain
Tailbone pain
Hip pain
Weak Pelvic floor symptoms:
Incontinence
Inability to engage lower core
Rib gripping (upper abs constantly flexed)
Low back pain
Hip pain
Decreased sensation during sex
Clenching of surrounding muscles (butt, abdomen, hip/inner thighs)
Inability to feel a Kegel contraction
Now, notice that the bolded symptoms above are found in both a weak and a tight pelvic floor, which is why it’s often confusing or difficult to know if you have one or the other, or both!
What to Do for a Tight or Weak Pelvic Floor:
If you have an idea of what it is you may be struggling with, whether you think you may have a tight pelvic floor or a weak pelvic floor (and not a combination of both), then let’s break down what things you may want to focus on to help!
steps to help fix a tight pelvic floor
Pelvic Floor Relaxation Exercises: Learning to relax the pelvic floor muscles is a key component of managing pelvic floor tightness. All three things below can help release tension in the pelvic floor muscles:
Deep breathing exercises
Diaphragmatic breathing
Targeted pelvic floor relaxation exercises like:
Happy baby
Pigeon pose
Child's pose
Deep squat
Upward child's pose
Deep diaphragmatic breathing on your back, all 4's, side, or belly
2. Pelvic floor stretches: Gentle stretching exercises for the pelvic floor can be beneficial. These stretches should be performed under the guidance of a pelvic floor physical therapist to ensure they are done correctly and safely.
3. Mindfulness and stress management: Chronic stress and anxiety can contribute to pelvic floor tension. Engaging in mindfulness practices, meditation, or other stress-reducing techniques can help relax the pelvic floor.
4. Biofeedback therapy: Biofeedback is a technique that helps you become aware of and gain control over certain physiological functions, such as muscle tension. It can be helpful in training the pelvic floor muscles to relax properly. This can be done with your local pelvic floor PT if they have a biofeedback machine!
5. Posture improvement: Poor posture can contribute to pelvic floor tension. Focusing on maintaining good posture throughout the day can help alleviate strain on the pelvic floor. Placing a towel under your sacrum when sitting is a great idea to keep you from slouching and clenching your pelvic floor.
6. Pelvic floor massage: Some individuals find relief from pelvic floor tension through external or internal pelvic floor massages. A dilator is something you may use at home for helping with painful intercourse although I do recommend being shown how to use this properly from a pelvic floor physical therapist.
Remember, it can take TIME for things to work out and for your pelvic floor to let go of tension. It took time to get to the state of tension that it’s currently at and it will take time to get out of it and return to a resting state. If you’re looking for more on this topic, make sure to click the button below to download my FREE guide to reducing pelvic floor tension.
steps to help fix a Weak pelvic floor
Pelvic Floor Strengthening Exercises: This doesn’t just mean do your Kegels, in fact, there are MANY other exercises that actually demonstrate more pelvic floor muscle recruitment than a Kegel does. And also you still want to start off with full range of motion by utilizing your breath first with:
Deep breathing exercises
Diaphragmatic breathing
Targeted pelvic floor strengthening exercises
2. Increase Awareness Throughout the Day: Be aware of times where you need to be engaging your pelvic floor during daily activities that would require it.
3. Posture Improvement: In the same way that poor posture can lead to a tight pelvic floor, it can also lead to a weak pelvic floor!
4. Biofeedback Therapy: This can be helpful especially if coordinating and figuring out how to engage your pelvic floor is a struggle for you or you aren’t feeling it very well.
3 Exercises to Try When You Have a Tight AND Weak Pelvic Floor:
Alright, now let’s chat for a minute about what the heck to do when you think you may have both a tight AND weak pelvic floor. Do we relax? Do we strengthen? And how do we do both if we need to be doing both?? What comes first?
I can already hear the questions rattling off in your brain, so let me help you out a little bit and let’s go over three exercises that you can do when you have BOTH a tight and a weak pelvic floor and you’re looking to heal both at the same time:
Full Diaphragmatic breath for pelvic floor range of motion
Again, if you think you have are struggling with a tight pelvic floor (even if it is also weak), the first step is always to find your FULL range of motion first. This means going back to the basics of diaphragmatic breathing, learning how to fully relax your pelvic floor on the inhale and then contracting on the exhale. The goal here is to ensure that your pelvic floor is restored in a way that allows it to fully relax and then fully contract through its full range of motion.
Knee squat
You want to focus on deep inhales releasing your pelvic floor when you squat back to your heels. On the exhale, you want to then switch and focus on engaging pelvic floor and core on the way up from the squat. This again allows the relaxation piece on the way down followed the a full contraction of the pelvic floor while pushing up against gravity (usually the hardest part for your pelvic floor to handle).
Tripod rock back to hip flexor stretch forward
Looking for more guidance with pelvic floor tightness, weakness or both??
My Mind Body Core Program covers EVERYTHING you need to know when it comes to a weak or tight pelvic floor or if you have both going on! You will be guided step-by-step for how to heal and restore your pelvic floor to FULL range of motion as well as regain the strength component as well.
Make sure to click the button below to check out my MBC Postpartum Program and also take a look at my tight pelvic floor mini program as well if you’re looking for a way to easily get started.