What is Hypertonic Pelvic Floor Dysfunction?

I guess I should start off by describing what it is that has been a pain in my tush (literally!!) these last few years. Hypertonia or "too tight" muscles can occur anywhere in the body. The opposite can occur too, where the muscles lack tone and are weak and can be hypotonic. When the pelvic floor becomes overly tight and has the inability to relax, the muscles are overworked and the lack of relaxation can eventually lead to decreased blood flow throughout the muscle(s) and subsequently a lack of oxygen to the affected areas, causing a build up of lactic acid, irritating all those nerves that intertwine between the various muscles. Despite there often being a delay in diagnosis and treatment, pelvic floor disorders are quite common among women (Bharucha, Faubion, Shuster, 2012).

A too tight pelvic floor can present with a variety of symptoms, some of which include pain (hips, hamstrings, lower back, perineal region), nerve pain, urinary issues (burning, itching, frequency difficulty emptying, leakage), bowel issues (constipation, bloating, IBS, abdominal pain), as well as sexual difficulties (pain with initial and deep penetration, groin pain during or after orgasm). Many of these feelings can leave a person hopeless, but there is, without a doubt, the ability to heal with the right people helping you (Bharucha, Faubion, Shuster, 2012).
Many people, both men and women, find relief from pelvic pain and dysfunction by finding a multitude of people to consult with. Some of these can include an orthopedic physical therapist, pelvic floor physical therapist, physiatrist, acupuncturist, massage therapist, and uro-gynecologist.

Oftentimes, many people have no idea what the cause of the dysfunction is and often can be from a combination of things. I think much of my pain started after lots of weight lifting where I was constantly engaging my pelvic floor and not allowing adequate relaxation in between engagement of the muscle(s). In addition, I was biking multiple times a week- being in a flexed sitting position for up to 60 minutes at one time. Also, many people carry their stress in their pelvic region, just like somebody else would in their shoulders or jaw. I watch a scary movie or get ticked off at a fellow driver on the road and I would find myself clenching my bottom. Add all of that together with a job that has me sitting in hard, non-fitted chairs/stools for long periods of time as well as holding my bowel or bladder for extended lengths of time until I was finished with a case in the operating room. I call it a perfect storm! I had NO idea all the poor behaviors I had developed were causing so much harm. And I had no idea that so much of what I was experiencing was abnormal....it had become a "normal" thing for me. After nearly 2 years of Xrays, MRIs, physical therapy, medical massage therapy, acupuncture, botox injections into my piriformis muscles, I finally found an answer to my debilitating, all-consuming pain. My pelvic floor PT, Nina, has been my lifesaver, literally. I thought about my pain every day, all day. Many days I'd smile and act normal and I would be experiencing 10/10 searing, burning, aching, heavy pain. She has allowed me to live in less pain; to find enjoyment in activities I never thought I could enjoy again. We have a lot of work yet to do, but I can't help but feel like there is positivity behind the long, perfect storm that I've been consumed by for so many years.

And you can feel better too. YOU have to be your advocate. It will take time and unfortunately, finding the right people to help may take time as well. But I am committed to offering support in whatever way I can. Pelvic floor dysfunction is often described as the invisible problem because the pelvic floor is not easily seen and thought of, which is the reason diagnosing and treating are often delayed for long periods of time. As Amy Stein has written in her book Heal Pelvic Pain, there are two essential truths to always bear in mind. Firstly, know that you are never alone, despite having feelings of helplessness and loneliness. Second, there is help and hope for an end to your pain and despair (Stein, 2009).
Stay positive. "You have been criticizing yourself for years and it hasn't worked. Try approving of yourself and see what happens." -Louise Hay
See you next time!

Faubion, Shuster, Bharucha. (2012, February 1). Recognition and Management of Nonrelaxing Pelvic Floor Dysfunction. Retrieved April 14, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3498251/
Stein. (2009). Heal Pelvic Pain. New York, United States: The McGraw Hill Companies.