Overactive Pelvic Floor Muscles

An overactive pelvic floor occurs when the pelvic floor muscles have difficulty relaxing and remain tense when they should be able to switch off. Many women describe this as having a "tight pelvic floor". Healthcare professionals may also use the term "hypertonic pelvic floor" to describe the same condition. These symptoms can be uncomfortable and frustrating, but with the right assessment and rehabilitation, many women experience a significant improvement in their symptoms.

Overactive Pelvic Floor Muscles

Your pelvic floor muscles are designed to contract and relax. Just like any other muscle in the body, they work best when they can move through their full range of motion.

An overactive pelvic floor occurs when these muscles remain tense or have difficulty relaxing. This increased muscle tension can contribute to a range of symptoms, including:

Pain during or after sexual intercourse
Pain when inserting tampons or undergoing a vaginal examination
Pain when passing urine despite no urinary tract infection (UTI)
Pain when opening your bowels
Difficulty emptying the bladder or bowel completely
Pelvic pain, aching or muscle tension around the pelvis, hips or lower back

Not everyone with these symptoms has an overactive pelvic floor, which is why a thorough assessment is important to understand the underlying cause of your symptoms.

Symptoms such as pain when passing urine, pelvic pain or pain during sex can have several different causes. It is important to seek assessment from an appropriate healthcare professional (GP or gynaecologist) to determine the underlying cause of your symptoms - then come to see a pelvic floor physiotherapist.

Many women worry that their pelvic floor muscles are "too tight" or "too strong". In reality, healthy pelvic floor muscles need to be able to both contract and relax effectively.

If you have pain with urinating (weeing), please ensure this is not a UTI and check in with your GP. Also if you develop severe pain, visible blood in your urine, fever or symptoms of a urinary tract infection, you should seek prompt medical advice.

How can Pelvic Floor Physiotherapy Help ?

Pelvic health physiotherapy aims to identify the factors contributing to your symptoms and develop a personalised treatment plan.

Depending on your assessment, treatment may include:

Education about your symptoms and pelvic floor function assessment
Techniques to help the pelvic floor muscles relax
Breathing and relaxation strategies
Gentle movement and mobility exercises
Manual therapy (myofascial release) where clinically appropriate
Advice on bladder and bowel habits
A gradual return to exercise and everyday activities
A personalised home rehabilitation programme

Treatment is always tailored to your individual symptoms and goals.

Overactive pelvic floor symptoms are assessed and treated as part of my Women's Health Physiotherapy service. During your appointment, we can assess your pelvic floor muscles, lower back and hips to understand what may be contributing to your symptoms and develop a personalised treatment plan.

Book Online

FAQs;

How do I know if my pelvic floor is too tight?

or

How do i know if I have a tight pelvic floor?

Symptoms such as pain during sex, difficulty inserting tampons, pain when passing urine without a urinary tract infection, pain opening your bowels or persistent pelvic pain may be associated with an overactive pelvic floor. However, these symptoms can have several different causes, so a thorough assessment (with your GP, and/or a pelvic health physiotherapist) is important before making a diagnosis.

Can you have a tight pelvic floor even if it's strong?

Yes. A muscle can be both strong and overactive at the same time. Healthy pelvic floor muscles need to be able to contract and relax effectively, rather than simply being "strong."

(I LOVE this question. I think it'll rank well and it's exactly the sort of myth you can gently correct.)

Can an overactive pelvic floor cause pain during sex?

Yes. Increased tension within the pelvic floor muscles can contribute to pain during sex (dyspareunia) for some women. A pelvic health assessment can help identify whether the pelvic floor is contributing to your symptoms.

Why does it hurt when I wee but I don't have a urine infection?

Pain or discomfort when passing urine without a urinary tract infection can have several possible causes, including an overactive pelvic floor. It is important to seek an assessment to determine the underlying cause and ensure appropriate treatment.

Can pelvic health physiotherapy help an overactive pelvic floor?

Yes. Pelvic health physiotherapy can help many women with overactive pelvic floor symptoms by improving pelvic floor relaxation, reducing muscle tension and developing an individual rehabilitation programme based on their symptoms and goals.

Why do I have pain during sex?

Pain during sex can have several different causes, one of which may be an overactive pelvic floor. A pelvic health assessment can help determine whether the pelvic floor is contributing to your symptoms and guide the most appropriate treatment. If this is new it would be best to check in with your GP, then come for a pelvic floor consultation.