Hypertonic Pelvic Floor vs Hypotonic Pelvic Floor

By Shannon Strauch, PTA, STMT-1 on 12/28/2023

Hypertonic Pelvic Floor

Also known as pelvic floor muscle dysfunction or pelvic floor hypertonicity, refers to a condition where the muscles of the pelvic floor are overly tight or tense. The pelvic floor is a group of muscles that forms a sling or hammock at the bottom of the pelvis, supporting the pelvic organs, including the bladder, uterus (or prostate in men), and rectum. When the pelvic floor muscles are too tight, it can lead to a range of symptoms and issues, including:

1. Pelvic Pain:

   Hypertonic pelvic floor muscles can cause chronic pelvic pain, discomfort, or a feeling of pressure in the pelvic region.

2. Painful Intercourse:

   The increased tension in the pelvic floor muscles can lead to pain or discomfort during sexual intercourse.

3. Urinary Urgency and Frequency:

   Hypertonic pelvic floor may contribute to urinary symptoms such as a frequent urge to urinate or difficulty fully emptying the bladder.

4. Bowel Issues:

   Tension in the pelvic floor muscles can affect bowel function, leading to constipation or pain during bowel movements.

5. Dyspareunia:

   This term refers to pain experienced during sexual intercourse and can be associated with hypertonic pelvic floor muscles.

Several factors may contribute to hypertonic pelvic floor, including stress, anxiety, trauma, chronic holding of tension in the pelvic area, or previous pelvic surgeries. Pelvic floor physical therapy is a common and effective approach to address hypertonicity. It involves targeted exercises and techniques to release and relax the tense muscles, improve flexibility, and restore normal function.

Hypotonic Pelvic Floor

Also known as pelvic floor muscle weakness, is a condition where the muscles of the pelvic floor are overly relaxed or have reduced tone. The pelvic floor is a group of muscles that forms a sling or hammock at the bottom of the pelvis, supporting the pelvic organs, including the bladder, uterus (or prostate in men), and rectum. When the pelvic floor muscles are weak or lack proper tone, it can lead to a variety of symptoms and issues, including:

1. Urinary Incontinence:

   Weak pelvic floor muscles may contribute to stress urinary incontinence, where there is leakage of urine during activities such as coughing, sneezing, or exercising.

2. Fecal Incontinence:

   Insufficient muscle tone in the pelvic floor can result in difficulty controlling bowel movements, leading to accidental leakage of stool or uncontrolled gas.

3. Pelvic Organ Prolapse:

   Weakness in the pelvic floor muscles can contribute to the descent of pelvic organs, such as the bladder, uterus, or rectum, into the vaginal canal.

4. Decreased Sexual Sensation:

   Reduced pelvic floor muscle tone may affect sexual function and sensation.

5. Pelvic Heaviness or Discomfort:

   A feeling of pelvic pressure or heaviness may be present when the pelvic floor muscles lack proper support.

Hypotonic pelvic floor can be caused by various factors, including pregnancy and childbirth, aging, hormonal changes, chronic constipation, and a sedentary lifestyle. Pelvic floor physical therapy is often recommended for individuals with hypotonic pelvic floor muscles. This therapy focuses on strengthening and toning the pelvic floor muscles through targeted exercises, biofeedback, and other techniques.

Understanding whether the pelvic floor is hypertonic or hypotonic is crucial for developing an appropriate treatment plan. Pelvic floor physical therapy is often recommended to address these issues, and it involves exercises and techniques to either relax or strengthen the pelvic floor muscles, depending on the underlying problem.

If you are experiencing symptoms related to your pelvic floor, it's important to consult with a healthcare professional or a pelvic floor physical therapist who can assess your condition and provide tailored advice and treatment.

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