How do I Calm My Pelvic Floor?

Life in the complex world of today

Life today is complex. I really don’t need to mention more than that, as I am sure many of you resonate with that statement. As a pelvic floor physical therapist working in Manhattan, NY I see all different types of cases, but the one thing that has been pretty common as of recent is persistent pelvic floor tightness. This can result in pain, urinary dysfunction, poor biomechanics, constipation, and the list goes on and on – but two main questions always arise. Why is this happening and how can I fix it?

Why do we get Pelvic Floor tightness?

This is actually a pretty complicated question, as the body will do everything it can to keep us in a state of equilibrium and so tightness can come from a variety of sources. From a mechanical perspective, the pelvic floor is at the crossroads of many functional movements and is integral to core strength and stability. From an emotional perspective I tend to see patients who are stressed, have higher levels of anxiety, and might be nervous to receive treatment as those who tend to have a holding pattern in their pelvic floor.

Lastly, there is a medical reason for pelvic floor tightness such as IBS, endometriosis, use of new birth control, or bacterial/viral infection to name a few.  This list is not nearly extensive enough to describe the types of patients who come in for pelvic floor treatments, but it gives us a general picture of what can cause chronic pelvic floor tightness.

How do we treat it? 7 strategies to calm “holding patterns” in a tight pelvic floor.

Again, this is a complicated question as the best treatments will be directed towards the source. There are a few things that can be done for all patients that can help reduce pelvic floor tightness which are described below.

1. Breathing: I am sure many pelvic floor therapists can go into great detail and express extensively why this helps. The simplest of answers is that it helps restore normal breathing patterns while inducing a stretch into the pelvic floor. How we perform this is laying supine with one hand on your chest and the other on your belly. Practice breathing deep into your belly and pelvic floor while reducing breath into the chest. Breathe in for 4 seconds, hold for 4 seconds, and release for 4 seconds – repeat as necessary.
2. Stretches: This helps us reduce tension on the pelvic floor from the surrounding tissues. One of my favorites for the pelvic floor is “happy baby” which focuses on the adductors and pelvic floor. Lay on your back with your legs close to your chest and the bottom of your legs perpendicular to the floor. Pull from your feet, down into the floor and breathe deep into the pelvic floor.
3. Low core work: This helps us re-activate our stability and reduce tension into the pelvic floor and the back. Start by laying on your back and focus on pulling your core inwards as if you were fitting into a tight pair of jeans. Hold for 10 seconds, and repeat at least 10 times. Progress to sitting and standing positions
4. Contract/relax: This is a neuro input to help the pelvic floor relax – I find it works nicely with the pelvic floor drop. Kegel as if you were lifting a blueberry to your belly button and relax. With repetitions the pelvic floor may release from the holding pattern.
5. Pelvic floor drop: This is a fine-tuned movement from #4. Start by kegeling, hold the kegel and imagine a “crane game”. When you reach where you would normally drop the toy (or candy!), quickly release your pelvic floor. You may work breath into this movement.
6. Down training (biofeedback): If you have a biofeedback device laying around, you can use it to help you understand when you are holding your pelvic floor versus when you are relaxed.
7. Meditation: Always a great option to calm the body and mind. Try progressive relaxation (PRE) to help relax the body from head to toe. Practice daily!

Before starting any pelvic floor program, please consult with a pelvic floor physical therapist to see what strategies are the best for you! Feel free to visit me here at the Center for Spine Care and Mobility in the Flatiron District for a personalized evaluation and program. If you have any questions, please reach out to me at ayoung@spinecareny.com.