Hypertonic (Tight) Pelvic Floor and Exercise
So your pelvic floor is super tight and painful but you want to work out – and keep those muscles buff!
There are some exercises that can lessen the chances of increasing the tightness of your pelvic floor. Here is a great article from Pelvic Floor First that will get you are the right track. I have listed their exercise do’s and do not’s below – but their article is well worth reviewing.
Pelvic Floor Safe Resistance Exercises
Here is a list of more safe exercises to undertake – but you must consider the number of repetitions, weight lifted, number of sets, length of rest and your fatigue level – which also effects your pelvic floor function.
seated exercises (e.g. shoulder press, rows, bicep curls, knee extensions)
dumbbell triceps extensions (e.g. lying or one arm and leg propped on a bench)
dumbbell exercises on a Swiss ball
shallow and narrow leg squats
shallow Swiss ball wall squats
prone leg curl
shallow forward lunges
supine bench/Swiss ball press
wall push ups
Resistance Exercises to Avoid
You might want to lay off the following for awhile until you are pain free. After that I would discuss with your pelvic pain physiotherapist if any of these can be re-introduced.
abdominal exercises (e.g. sit ups, curl ups, crunches, double leg lifts, exercises on machines)
deep lunges or side lunges
wide legged or deep squats
lifting or pressing heavy weights
lat pull down with heavy weights
leg press machine with heavy weights
high bench step up step down
exercises with both feet off the ground (e.g. chin ups, tricep dips)
full push ups, and
any exercise where there is direct downward pressure on the pelvic floor.
This is a great article to show you the – BEST Exercises for Abdominals, Glutes, and Adductors – by Pelvic Guru! This may help you notice the exercises that may be exasperating your abdominals and/or your pelvic floor. Either way, it is worth a read.
Exercises and Activities to Avoid with Pelvic Floor Muscle Tension
Exercises that load the pelvic floor increase pelvic floor muscle tension and exacerbate pelvic pain.
These exercises and activities can increase pelvic floor muscle tension:
- Pelvic floor exercises (Kegel exercises)
- Intense core abdominal exercises
- Heavy lifting or heavy activity
- High impact exercise e.g. running
- Painful intercourse/ painful vaginal penetration
- Prolonged sitting or standing
Further Tips to Prevent Pelvic Floor Tightening
Listen to your body – I would stop any exercise that makes you feel like you are clenching your pelvic area too tightly
Avoid heavy lifting – do you hold your breathe or grunt or strain with the lift? You need to breathe out, ensure you are not clenching your pelvic floor.
Exhale with every effort – I have started breathing out when I lift a weight – checking in with my pelvic floor to ensure it is relaxed.
Lift with good posture, keeping your feet close together– use correct form – go online and research your exercise – make sure you are doing it right
Sit or lay down – use a swiss ball – this seems to support your pelvic floor better
Increase weight gradually – start small and move up slowly
Rest between exercises/sets – when you are fatigued, stop
Check in with your pelvic floor – during and after each move, check in with your pelvic floor to make sure you are not clenching
Michelle Kenway has a fantastic video series on helping with Pelvic Pain prolapse. Check it out.
New Dawn Pilates also has an exercise video for sufferers of Chronic Pain.
Runners and the Pelvic Floor
If you are a runner – you may consider doing the following exercises to help with the pelvic floor. These are from an article at Runners World by pelvic floor Physical Therapist and Educator Julie Wiebe, PT. Wiebe’s strategy is shown in the side picture – and she has a great video produced by Runners World as well. It features exercises that teach you how to engage your inner core. Practicing them as regularly as possible will teach your body to actively recruit these muscles and connect them with the outer core, which will eventually carry over to your running.
Consider doing the Pelvic Floor Drop
This relaxing move is the right choice if you have signs of tightness such as pelvic pain, constipation, or pain with sex or have to push to empty your bladder completely—and for everybody who wants to cut their risk of tightness, says Amy Stein, DPT. “Do it every morning and throughout the day to release tension,” she says.
The move: Sit, stand, or lie down in a quiet place. Relax your whole body with some deep, calm breaths. Then take a long, deep breath, and as you exhale, imagine your breath pressing down and out through your pelvis and your muscles relaxing and dropping. Don’t push. Aim for the same feeling you get when your urine stream starts to flow when you go to the bathroom.
Do you do CrossFit? Great article from The Physio Detective – CrossFit, Your Pelvic Floor and Peeing During Workouts
Do you do Crunches? Great article by Kim Vopni on “Six Reasons You Were Right to Hate Crunches.” – Crunches only weaken your core, mess with your alignment and set you up for back pain and pelvic floor dysfunction such as incontinence and, for women, pelvic organ prolapse, which is the descent and eventual protrusion of an organ into and out of the vagina.