Pelvic Floor Dysfunction(Disorder – Hypertonic)

Pelvic floor dysfunction(disorder) refers to a wide range of issues that occur when muscles of the pelvic floor are weak, tight, or there is an impairment of the sacroiliac joint, lower back, coccyx, or hip joints. Tissues surrounding the pelvic organs may have increased or decreased sensitivity or irritation resulting in pelvic pain. Many times, the underlying cause of pelvic pain is difficult to determine.[1]

Pelvic floor dysfunction may include – urinary incontinence, fecal incontinence, pelvic organ prolapse, sensory and emptying abnormalities of the lower urinary tract, defecatory dysfunction, sexual dysfunction and several chronic pain syndromes, including vulvodynia. 

Pelvic Floor Dysfunction can be caused by:

HYPOTONICITY (Weak pelvic floor muscles):   contributing to stress incontinence, urge incontinence and pelvic organ prolapse.  Incontinence is NOT a normal part of aging.

HYPERTONICITY (Tight pelvic floor muscles):  contributing to Urinary and Fecal Urgency, Urge Incontinence, Chronic Pelvic Pain, Dyspareunia, Vaginismus, Vulvodynia, Pudendal Neuralgia, Interstitial Cystitis and Chronic Prostatits.

NOTE: Kegels are NOT always indicated for pelvic floor problems.  Sometimes they do more harm than good, and often they are NOT performed correctly.

Many people with pelvic pain have pelvic floor dysfunction, but specifically hypertonic muscles, or muscles that are too tight.  When these muscles have too much tension (hypertonic) they will often cause pelvic pain or urgency and frequency of the bladder and bowels.  When they are low-tone (hypotonic) they will contribute to stress incontinence and organ prolapse.  You can also have a combination of muscles that are too tense and too relaxed.

Hypertonic muscles can cause the following symptoms:

Bladder Problems: Urinary frequency, urgency, hesitancy, stopping and starting of the urine stream, painful urination, or incomplete emptying

Bowel Problems: Constipation, straining, pain with bowel movements.The straining associated with constipation can then cause increased pelvic floor muscle pain – additional problems may develop such as rectal prolapse, hemorrhoids and anal fissures.

Pain: Unexplained pain in your low back, pelvic region, hips, genital area, or rectum

Sexual Pain: Pain during or after intercourse, orgasm, or sexual stimulation

Muscle Pain: Uncoordinated muscle contractions causing the pelvic floor muscles to spasm. The supportive function of the pelvic floor muscles may also be compromised, increasing the vulnerability to other pelvic floor problems such as vaginal prolapse