A tense pelvic floor can occur when the muscles of the pelvic floor have difficulty fully relaxing or letting go. The following signs and symptoms may indicate it is time to work on relaxing your pelvic floor!
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Constipation and pain when passing stools or having a feeling of incomplete emptying of bowels. ·
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Low back, pelvic, hip or buttocks pain
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Painful sex
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Urinary or bowel urge incontinence (leaking on the way to the bathroom)
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Incomplete emptying of the bladder, slow flow of urine or stopping/starting of urine stream
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Hesitancy or delayed start of urine stream
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Urinary or bowel urgency frequency- feeling like you need to go to the bathroom all the time, and only voiding small amounts
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Painful urination
It is very important to be able to fully and consciously relax your pelvic floor muscles as well as be able to contract them. If the muscles of your pelvic floor are already stiff and tense, it is very difficult to contract them effectively and build strength. A tense pelvic floor ix a weak pelvic floor! In order for the muscles of your pelvic floor to be able to function properly and be pain free, you must first learn how to relax them. Relaxing your pelvic floor is often called down-training of the muscles and referred to as a reverse kegel. Physiotherapists from Pelvic Floor Health Solutions likens the feeling of releasing your pelvic floor to the moment of relief you feel when you have reached the bathroom; when you urinate or have a bowel movement.
One way to release your pelvic floor is through visualization and deep diaphragmatic breathing. Begin by visualizing the hammock of muscles that make up your pelvic floor, descending, widening and releasing while you inhale. When you breathe in deep your diaphragm flattens and lower, and the muscles of the pelvic floor open, lengthen and stretch. When you exhale, your pelvic floor recoils like a piston and your diaphragm rises to push the air out. This is sometimes referred to as your pelvic floor rhythm, pelvic floor breath, core breath etc. and if you can find this rhythm of breath and PFM release and contract, reverse kegels with be much easier to perform.
To do a reverse kegel, start by lying on your back with your knees resting open on pillows. Gently contract the muscles of your pelvic floor on your exhale to feel what tightening the muscles feels like. Then relax, and allow that tension to release completely as you take a big breath in. Feel the difference between tension and relaxation. Next, without moving your pelvis or your spine, visualize that the muscles between the pubic bone and tailbone lengthening away from one another by gently moving your pubic bone towards the ceiling and gently move your tailbone towards the surface you are lying on. Imagine that the pelvic floor muscles are getting longer as this happens creating more space in your pelvic floor. Do this at the same time that you take a deep breath in. Be patient. This takes some time to feel the letting go or lengthening of these muscles. This can be practiced in sitting and standing as well. Eventually, once you have mastered the art of relaxing your pelvic floor muscles, you can begin with gentle pelvic floor strengthening exercises. Don’t forget to check in with your pelvic floor throughout the day, and let go of any tension that you discover.