Do you feel a little leak of urine as you step off that curb unexpectedly? Do you notice a few drips as you run or feel that little dribble when you sneeze? What about when you squat and deadlift heavy weight?? All of these scenarios are very common in women who have had a baby or babies, however here is the good news: THEY DO NOT HAVE TO BE YOUR NORMAL! There is help and there are treatments and exercises that can give you your life, exercise routine, etc. back and even better, LEAK-FREE! Today, we are going to talk about pelvic floor tightness or ‘increased tone’ in the pelvic floor muscles and why kegels are not the answer in this case! Often times, us women talk about ‘doing our kegels’ or ‘I had a baby, I probably should do some kegels.’ Or maybe your healthcare provider prescribed kegels for you to do and yet, you notice your symptoms aren’t improving or maybe they even seem worse since you started doing kegels! Well, my friend, kegels may not be the answer for your symptoms! Let’s start with a quick, broad overview of what the pelvic floor muscles are and what they are supposed to do when functioning properly. The pelvic floor muscles sit at the base of the pelvis and you can think of them like a ‘sling’ or ‘hammock’ at the bottom of the pelvis surrounding the openings. There are superficial pelvic floor muscles and deep pelvic floor muscles. If you think of doing a proper kegel, there is a squeeze portion (superficial muscles) and a lift portion (deep muscles). Just as important, there should also be a full relaxation of the muscles after the squeeze and lift, where all the tension releases. The pelvic floor muscles have an important role in continence (urinary and fecal), breathing, support of the spine and pelvis, and postural stability. They also function to support your internal organs. A properly functioning pelvic floor is able to contract when we need it to in order to prevent leaking (ex: sneezing, coughing, running, lifting) and relax when we need it to (ex: breathing, at rest, to birth a baby). So, how do you know if your pelvic floor is tight??? Some common symptoms that may be indicative of a tight pelvic floor (aka increased tone) include:
Why is my pelvic floor tight??? Pelvic floor tightness can occur for various reasons -- just like we often carry tension in our neck/shoulders when we experience stress, the pelvic floor muscles are also a common place women carry tension. When these muscles are constantly tensed, then if you try to do kegels and contract these muscles more, they will have difficulty fully lengthening. For a muscle to function properly, it must be able to fully lengthen and fully contract. Or else it will not be very effective! Let’s look at your biceps muscle for an example. If you flex your biceps (bend your elbow) and hold it there for an hour or two, when you go to straighten your elbow it will be pretty difficult and will feel ‘tight’ and ‘stiff.’ You likely wouldn’t be able to contract it very well after that, it would feel very weak. The same thing happens with the pelvic floor when those muscles get tight and have increased tone. The muscles aren’t able to lengthen fully and thus, aren’t able to contract very well making them weak. This can lead to leaking urine when coughing, sneezing, jumping, running, etc. The pelvic floor muscles can also become tight as a compensation for weakness in other areas, such as glute weakness, adductor weakness, or abdominal weakness. Thus, it is very important to be assessed by a physical therapist if you are having pelvic floor dysfunction because a physical therapist will look at areas of muscle imbalances + a lot more to ensure we are not just treating your symptoms but getting to the root cause! Adding a lot of kegels to an already tight and tense pelvic floor may make your symptoms worse! So, if you’ve tried kegels and your symptoms have not changed or have worsened, I suggest you hold off on doing the kegels and see a pelvic floor or postpartum physical therapist! What can I do if my pelvic floor muscles are tight??? First, see a pelvic floor physical therapist or a physical therapist trained in working with prenatal/postpartum women. You don’t have to have had a baby to have pelvic floor dysfunction! It is very common in men and women! Here are a couple things to try:
Check out these videos on my YouTube page for more on diaphragmatic breathing & pelvic floor relaxation! You can reach me directly via email at [email protected] with questions or for scheduling purposes! I’d love to help you :) Leave me a comment below with questions or share your personal experience!
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AuthorKaitlin Hartley, PT, DPT Archives
January 2020
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