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What is the Pelvic Floor?

The floor of your pelvis is made up of muscles, connective tissue and fascia (non-contractile tissue that coats all muscles, tendons & organs). It is described as a sling of tissue as it looks a little like a hammock that runs from the pubic bone in the front of the pelvis to the tailbone at the back.

The function of the pelvic floor is to support the internal organs and helps us to control passage or retention of urine and fecal matter as well as sexual function. There are 3 openings in the pelvic floor in women – urethra, vagina & anus.


They are the same as any other muscle or connective tissue in the body. They can be damaged and can be rehabilitated. They can be weak or strong. And like all muscles in the body they have a tone. Tone is the amount of muscle tension at rest. Normal tone should be high enough to resist gravity in standing/sitting/lying or during movement while low enough to still allow a full range of movement.

Many people are now aware that the pelvic floor needs to be strong and functioning well and are increasingly aware of the pelvic floor contraction exercises or kegel exercises to help strengthen the pelvic floor.


What is an Overactive Pelvic Floor? 

But what happens when the pelvic floor muscles, like any other muscles, spasm and or contract and become weak? When the muscles in the pelvic floor are overworking all the time it is described as an overactive or a hypertonic pelvic floor where the resting tone of the muscles is too high.

What Causes The Pelvic Floor To Become Overactive? 

There can be a great many number of reasons that cause the PF to become overactive. It can be one issue alone or several contributing factors such as:

  • Stress and anxiety – this can cause all muscles to tense up
  • Overactive bladder – a condition that causes you to go to the toilet frequently
  • Overactive abs/core – as the pelvic floor works together with the abdominals, if your abdominals are overactive the chances are the PF will be too
  • Poor sustained postures – sitting or standing in a poor posture for a long time can create tension in the PF as it can be in a shortened position. Remember to keep moving and changing positions!
  • Overdoing PF exercises without the relax component – an important part of a good pelvic floor contraction should be the release and relax part.
  • Sexual assault or abuse – when dealing with assault or abuse it is always recommended to seek a combined approach of trauma counsellors and psychologists as well as pelvic floor practitioners
  • Chronic low back and or pelvic pain – these conditions can be associated with abdominal dysfunction and the pelvic floor makes up the floor of the abdomen
  • Endometriosis, vulvodynia and vaginismus – pain conditions that can contribute or be solely attributable to a high tone pelvic floor
  • Pelvic surgeries – scarring as well as insufficient rehab can contribute to this

What Are The Symptoms Or Signs Of An Overactive Pelvic Floor? 

There can be a number of different signs and symptoms but some of the more common ones include:

  • Difficulty emptying bladder and or bowel
  • Interrupted urine flow
  • Constipation
  • Pain with bowel movements before or after
  • Pain during penetrative intercourse
  • Pelvic floor spasms
  • Pain inserting a tampon or during a gynecological examination

What Can Be Done To Treat It?

The first focus of treating an overactive pelvic floor needs to be to relax and ease off the overworking muscles. This is unfortunately more difficult than activating a muscle. A great deal must be done to address the nervous system, as it is contributing to the muscle being told to be permanently “switched on”. Visualization plays a key role in this. There are several cues which can be used: Imagine a flower bud opening up or water rippling outwards in a pond or a jelly fish floating relaxing and opening out.

If you see a pelvic floor physiotherapist they may help with some manual therapy techniques which can be done internally as well as externally. As well as using different tools to show you what is happening for example real time ultrasound.

There are things you can try immediately to try and help resolve some of the symptoms:

  • Belly Breathing/diaphragmatic breathing 
  • Learn to relax your abdomen rather than constantly sucking it in 
  • Stretches such as butterfly stretch as well as happy baby
  • Strengthening of other muscles appropriately such as gluteal muscles (if required)

Once the muscles of the pelvic floor are able to relax properly, they are then able to move through a full range of movement. Once this is achieved then we start the strengthening component of the treatment process. This is an important part as the tight overactive pelvic floor is also weak.

Like with all muscles it is so important to treat and train what the specific issue is for the individual presenting with them. There is no one size fits all, it is best to be checked and assessed properly.

Contact Us Now If Based in Singapore or London – or Find A Physio in Your Area if you have any concerns about your pelvic floor.