Restore Your Core Hypertonic Pelvic Floor Stretches: Techniques for Easing Discomfort

Hypertonic Pelvic Floor Stretches: Techniques for Easing Discomfort

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Hypertonic Pelvic Floor Stretches: Techniques for Easing Discomfort

By Lauren Ohayon 02/27/2024

4 Min Read

This article provides a detailed guide on effective stretching techniques specifically designed for easing the discomfort associated with a hypertonic pelvic floor. You’ll have a deeper understanding of how pelvic floor muscles get tight in the first place. And you’ll learn practical, easy-to-follow advice for improving your pelvic health.

What is a hypertonic pelvic floor?

Hypertonic pelvic floor is the name given to the medical condition of having pelvic floor muscles that do not relax fully to their proper resting tension. You may also have heard the terms “nonrelaxing pelvic floor muscles” or “tight pelvic floor muscles.” The function of the organs in the pelvis can also be affected by pelvic floor tension. The combination of muscles, connective tissues, and ligaments that make up the pelvic floor has several essential purposes:

  • Supports the organs in the pelvis
  • Supports sexual function
  • Helps maintain continence
  • Supports bowel and bladder function
  • Part of the core system, and 
  • Aids in respiration

There are many causes of a hypertonic pelvic floor. Some of them are:

  • Chronic stress 
  • Trauma, including trauma during childbirth
  • Medical conditions that cause inflammation of the tissues
  • Scar tissue in the abdomen or pelvic floor
  • Lifestyle choices, such as excessive exercise
  • and movement patterns and habits

Some symptoms of the hypertonic pelvic floor include:

  • Stress incontinence (leaking urine), especially under higher load, such as sneezing, jumping, or running 
  • Urge incontinence, feeling like you won’t make it to the toilet in time 
  • Pain during and/or after intercourse
  • Constipation or difficulty feeling a bowel movement is complete
  • Low back pain
  • Generalized pelvic pain, often felt in the hips, buttocks, and deep in the abdomen

Does this mean that you’re doomed to have tight pelvic floor muscles forever if you’ve had any of the above conditions? Not at all! Muscles respond to the input they receive, and learning stretches that help your pelvic floor muscles move in a variety of ways can help relieve the pain and discomfort of hypertonic pelvic floor muscles.

pelvic floor stretches

The Science Behind Stretching and Pelvic Health

When you think about stretching, you might think of a hamstring stretch or a quad stretch. And moves like that can be useful as part of your overall exercise plan. However, pelvic floor stretching focuses even more on promoting a sense of relaxation and reducing the sensation of tightness or tension in the pelvic floor muscles. Since a hypertonic pelvic floor can often be stress-related, your stretching program should feel like a stress reliever, not another thing on your to-do list.  

There are important differences to note between normal pelvic floor muscles and hypertonic pelvic floor muscles. Normal pelvic floor muscles are neither overly tense nor excessively relaxed. They are flexible and responsive: They have the ability to contract and relax in response to things like coughing, sneezing, laughing, or physical exertion. If your pelvic floor muscles have a normal amount of tension, you do not usually experience pelvic pain or discomfort during daily activities.

On the other hand, hypertonic pelvic floor muscles get in the way of all of the above. Thankfully, you can train your pelvic floor muscles to respond more reflexively. While you may have heard about strengthening exercises like Kegels, learning to let the muscles relax before strengthening them is even more important in cases of hypertonic pelvic floor. That’s where pelvic floor stretches come in: with this kind of exercise, you’re giving your body and your pelvic floor permission to relax. From this relaxed place, responding to various loads becomes much easier. 

Another analogy might be helpful here: Think about how much easier it is to respond to a difficult situation when you’re well-rested and feeling calm. Your pelvic floor is the same way. 

Building your Stretching Practice

As always, before beginning a new exercise routine, consult with your healthcare practitioner, especially If you have conditions that preclude certain types of movement. If you have hEDS, for example, you may benefit from working 1-1 with a practitioner who can help you keep your joints safe while bringing more range of motion into the muscles.

Preparing for Stretching Exercises

Before you stretch, make sure your body feels ready to move. One of the benefits of stretching is the increased blood flow to the area being stretched, so it helps to already have your blood circulating more actively. Go for a short walk, if you’ve been sitting still (yes, pacing around your house counts!). Take your time as you move into and out of these stretches.

In order to get the most benefit from your stretches, your body needs to feel safe and comfortable. Whether that means rolling out a yoga mat in front of your TV or creating a special corner for your exercises, having a space that feels calm and relatively free of distractions will make it easier to drop into your body. It’s worth taking the time to set the stage for relaxation.

Some people find that using mindful breathing techniques makes their stretching more effective–being mindful of your breath helps your nervous system stay regulated and receptive to the sensations of stretching. In Restore Your Core®, we practice a three-dimensional breathing technique that is optimal for easing tension in the pelvic floor.

In order to understand why you want to focus on a 3D breath, it can be helpful to imagine a balloon with one hand on top and the other on the bottom. If you press down from the top, you can feel a gentle pressure on the bottom. This coordinated movement of the diaphragm and pelvic floor helps manage intra-abdominal pressure–the pressure within the abdominal cavity. 

The three-dimensional breathing technique involves gentle movement throughout the entire torso, starting with gentle rib expansion. During inhalation, the diaphragm contracts concentrically, lowering the pressure in the chest cavity, which pulls air into the lungs and prompts rib movement. Simultaneously, this diaphragmatic action causes the contents of the abdomen to move downward, ideally reaching the pelvic floor (and a hypertonic pelvic floor can inhibit this movement). Exhalation reverses this process: the diaphragm eccentrically contracts, increasing thoracic pressure, which pushes air out of the lungs. This triggers coordinated movement in the ribs, abdomen, and pelvic floor.

Here’s one way to practice the three-dimensional breathing technique. You may want to perform this for 3-4 breaths before and after your stretching routine, so you can see the difference a less-tense pelvic floor can make in your breathing.

  • Lie on the floor, or sit in a comfortable position with your weight on your sit bones
  • Place your hands around your ribs on each side and calmly explore your breath:
    • On the inhale, your ribs rise a bit upwards
    • The ribs also widen a bit outwards
    • And at the very end of the breath, notice how your belly rises a bit
  • If your default is no rib movement, and only your belly moves, see whether you can switch patterns. It might take time and feel difficult at first, but practicing regularly in a relaxed position will help your body learn the new pattern

Here are some other kinds of breath work you might want to build into your routine:

1. Paced Breathing:

  • Sit comfortably in a quiet, relaxed environment
  • Inhale slowly through your nose for a count of 4 seconds
  • Hold your breath for a count of 4 seconds
  • Exhale slowly and completely through your mouth for a count of 4 seconds
  • Repeat this cycle of breathing for several minutes, maintaining a steady rhythm

2. 4-7-8 Breathing Technique:

  • Find a comfortable sitting or lying position
  • Inhale quietly through your nose for a count of 4 seconds
  • Hold your breath for a count of 7 seconds
  • Exhale through your mouth, making a whooshing sound, for a count of 8 seconds
  • Repeat this cycle of breathing 3-4 times, allowing yourself to relax with each breath

3. Visualization Breathing:

  • Sit or lie down comfortably in a quiet space
  • Close your eyes if you like
  • Imagine a calming scene or scenario in your mind, such as a peaceful beach, a serene forest, or a tranquil garden
  • As you inhale, visualize yourself breathing in positive energy, peace, or relaxation from your surroundings
  • As you exhale, imagine releasing any tension, stress, or negativity from your body and mind
  • Continue to breathe deeply and visualize this calming scene for several minutes, allowing yourself to feel more relaxed and centered with each breath.

Stretches for Hypertonic Pelvic Floor

Here are some specific stretches for the hypertonic pelvic floor. As always, listen to what your body has to say–this kind of stretching is not about pushing hard; it’s about allowing yourself to connect with your body and move mindfully. Allow yourself to relax in each position for several breaths. Move slowly to come out of each stretch.

1. Child’s Pose (Balasana)

  • Begin by coming onto all fours with the tops of your feet on the mat
  • Keep your palms down on the mat in front of you with your arms straight
  • Shift your pelvis back toward your heels, allowing the knees to widen if needed
  • Keep big toes close together
  • Rest here comfortably for several breaths

Modifications to make the pose more comfortable or accessible:

  • Move your hands closer to your body
  • Tuck your toes under, if the tops of the feet are sensitive
  • Use a bolster or block under your forehead
  • Use a block or bolster under your pelvis
  • Place a rolled-up towel behind the knees

2. Deep Squat (Malasana).

You may wish to choose one of the variations below if you have pelvic organ prolapse symptoms, knee pain, or other mobility restrictions that make it difficult to sit in a low squat.

  • Begin by standing with your feet a little wider than pelvis-width
  • Lower your body toward the floor by bending your knees
  • Bring your palms together in front of your chest, with your elbows touching your shins
  • Try to keep your spine relatively neutral as you relax into the squat
  • Slowly come up by pressing down with your feet 

Modifications and variations:

  • If downward pressure isn’t an issue, but hip/knee/ankle mobility is: Use a door handle or sturdy piece of furniture to help you support your weight as you lower down and come back up. Only lower down as far as your joints will let you go
  • Chair squat: Instead of sitting down toward the floor, sit onto a chair with legs comfortably wide apart. Press your feet into the ground to come up; repeat several times
  • Supported squat: Follow the same instructions as for Malasana, but let your stibones land on a block, stack of blocks, or bolster
  • Supine Malasana: Lie on your back and draw your knees toward your chest, as if squatting in the air

3. Butterfly Stretch (Baddha Konasana)

  • Sit on your mat or up on a blanket or bolster–prop yourself up high enough that you can sit comfortably on your sit bones with your spine neutral
  • Place the soles of your feet together
  • Let your knees gently move toward the floor

Adjustments and modifications:

  • Support your knees with blocks or blankets or bolsters
  • Slide your feet farther away from the body, or bring them closer to your body
  • Do not strain to press your knees onto the floor
  • Pressing your hands into your inner thighs and resisting the press for a few moments, then releasing that resistance can help your knees relax toward the floor

4. Happy Baby Pose (Ananda Balasana)

  • Begin by lying down on your back with your knees bent
  • Bring your knees in toward your chest
  • Hold onto your lower legs, ankles, or feet to help your body relax into this position
  • Bring some attention to your pelvic floor, and observe how it feels as you inhale and exhale

5. Forward Fold (Paschimottanasana)

  • Sit on the floor with your legs extended straight in front of you
  • Dorsiflex your feet, so that your toes point toward the ceiling
  • Inhale and feel your ribcage gently expand
  • Exhale and hinge forward from your hips
  • Reach your hands towards your feet–it is absolutely ok to reach toward your knees or shins instead. Hold onto your legs wherever they land
  • Relax your neck and shoulders. Allow your spine to round, but don’t force it
  • Rest here for a few breaths

Variations and modifications: 

  • You can also use a yoga strap around the soles of your feet
  • Play with the position of your spine in the stretch: if rounding doesn’t feel good, what does feel good?
  • Allow your legs to widen to accommodate your belly, or practice a standing variation by pressing your hands into a wall at and walking back until your legs are straight. In this variation, keep your spine neutral and move from the hip
pelvic floor stretches

Incorporating Stretches into Your Daily Routine:

Stretching only once every few weeks will not give you the results you want. What matters most is making your stretching routine doable and consistent. Five minutes in the morning and/or evening is better than not at all. Look at your calendar and your day-to-day routine: where can you fit in a little bit of stretching? If nothing comes to mind, just put down your phone right now and change the position you’re in. If you can do that, you can add a few minutes of stretches for tight pelvic floor muscles into your day.

It can be helpful to find an accountability partner to stretch with you, or who you can check in with when you’ve done your stretches. Attending a regular class with a focus on hypertonic pelvic floor exercises, or a program to push “play” on, like Restore Your Core®, makes it even easier–some people find that the aspect of community (join the free RYC® community here) makes taking care of themselves much more doable.

Managing a hypertonic pelvic floor is a long-term project. And you can do it.

Bringing your pelvic floor muscles into a more balanced, functional state requires attention to your overall wellness. And having more functional pelvic floor muscles helps you feel better overall. Health-promoting habits like hydration, nutrition, and getting adequate rest all help reinforce the benefits of exercises for your pelvic floor: Hydration and nutrition both play a role in keeping your bowels moving smoothly and preventing constipation. 

You need to be well-nourished and hydrated in order for your muscles to move well. Rest (not just sleep, but taking a break from stressors) is essential for the healing and repair of your body. Avoid prolonged sitting or standing, which can contribute to muscle tension and pelvic floor dysfunction. Take breaks to stretch and move throughout the day.

You may find that working with a professional trained in pelvic floor dysfunction is helpful as you learn what your particular body needs. Consider what your starting point is and what your goals are when you look for someone to work with: If you’re primarily working with physical symptoms, a physical or occupational therapist or movement teacher may be your first stop. Is some of your discomfort based on emotions that come up when you start to connect with your pelvic floor? You may need to begin your journey with a mental health professional. 

Of course, if your symptoms are acute, please go see your doctor first.

Every time you show up and do pelvic floor stretches for yourself, you’re doing more than just a few exercises. You’re reinforcing that your body is your home, and you get to be cared for. That feeling ripples out into your whole life. Be patient and consistent, and you can do this.

FAQ

1. How often should I perform these stretches?

It’s a good idea to perform pelvic floor stretches regularly, ideally daily or several times per week, to experience optimal benefits. However, listen to your body and adjust the frequency based on your comfort level and any guidance provided by your healthcare provider or physical therapist.

2. Are there any risks associated with these stretches?

Pelvic floor stretches are generally safe. However, if done improperly or excessively, there is a risk of overstretching or aggravating pelvic floor symptoms. It’s important to start slowly, use proper technique, and consult with a healthcare professional if you have any concerns or underlying medical conditions, such as hEDS or spondylolisthesis.

3. How quickly can I expect to see results?

Short answer: it depends. The timeline for seeing results from pelvic floor stretches can vary depending on factors such as the severity of pelvic floor dysfunction, consistency of stretching routine, and overall health status. Some people may notice improvements in symptoms within a few weeks of starting a stretching program, while others may require several months of consistent practice to see significant changes. Patience and consistency are key.

4. What should I do if I experience pain while stretching?

If you experience pain while performing pelvic floor stretches, it’s important to stop immediately and assess the cause. Pain during stretching may indicate that you are pushing your body too far or using an incorrect technique. Modify the stretch to make it more comfortable, reduce the intensity, or seek guidance from a physical therapist or healthcare provider to ensure you’re performing the stretches correctly and safely.

5. Can these stretches help with sexual dysfunction related to the hypertonic pelvic floor?

Yes, pelvic floor stretches can be beneficial for addressing sexual dysfunction associated with hypertonic pelvic floor muscles. By releasing tension and improving muscle flexibility, pelvic floor stretches may help reduce pain or discomfort during intercourse, enhance pelvic floor muscle control, and improve overall sexual function. However, individual results may vary, and it’s important to consult with a healthcare provider for personalized recommendations tailored to your specific needs and concerns.