Pelvic floor muscles are a critical component of the human body, providing support for the bladder, bowel, and, in women, the uterus. These muscles stretch like a muscular trampoline from the tailbone (coccyx) to the pubic bone (front to back) and from one sitting bone to the other (side to side). While much emphasis is placed on the weakening of these muscles, leading to conditions such as incontinence and prolapse, less attention is often given to the opposite issue: high tension pelvic floor muscles. However, understanding and addressing this condition is just as important for maintaining pelvic health and overall well-being.

What are High Tension Pelvic Floor Muscles?

High tension pelvic floor muscles occur when these muscles become too tense, leading to a range of uncomfortable and sometimes painful symptoms. Unlike weak pelvic floor muscles that fail to provide adequate support, tight pelvic floor muscles are overly contracted, which can disrupt the function of the bladder, bowel, and sexual function.


Causes of High Tension Pelvic Floor Muscles

The causes of high tension in the pelvic floor muscles can vary, including but not limited to:

Chronic stress and anxiety: Constant tension in the body can lead to the pelvic floor muscles tightening up as part of a broader stress response.

Postural stress: Sitting or standing in ways that put unnecessary pressure on the pelvic region can contribute to muscle tension.

Overuse or misuse: Engaging in excessive high-impact exercise or incorrect pelvic floor exercises can lead to over-tightening.

Trauma or surgery: Past injuries, surgeries, or traumatic events can lead to protective tightening of these muscles.

Holding patterns: Some individuals may subconsciously hold tension in their pelvic floor as a response to pain or discomfort elsewhere in the body.


Symptoms of High Tension Pelvic Floor Muscles

Symptoms can vary widely but often include:

– Chronic pelvic pain

– Pain during or after intercourse

– Difficulty with bowel movements or constipation

– A frequent need to urinate

– Unexplained lower back pain

– Discomfort or pain when sitting for long periods




Diagnosing high tension pelvic floor muscles typically involves a thorough medical history and a physical examination by a healthcare provider, often a specialist in pelvic health therapist. This examination may include an internal assessment to check the pelvic floor muscles for tension, trigger points, contraction, relaxation and coordination. 


Management and Relief Strategies

Managing high tension pelvic floor muscles often requires a multidisciplinary approach, including:


Pelvic Physical Therapy

Pelvic floor physical therapists specialize in assessing and treating conditions related to these muscles. Therapy may include techniques to relax the pelvic floor muscles, improve posture, and reduce stress on the pelvic floor, manual therapy for lumbar spine, hips and attaching muscles that contribute to pelvic floor muscle tension. 


Relaxation Techniques

Since stress and anxiety can contribute to muscle tension, practices such as yoga, mindfulness, and meditation can be beneficial in promoting relaxation of the pelvic floor muscles.


Proprioceptive feedback– with your brain

This means, do you have awareness when you are clenching your pelvic floor muscles? In the case of pelvic floor muscle tension, awareness of your pelvic floor muscle tension can help patients learn how to relax their muscles effectively.


Collaborating Providers

In some cases, pelvic health therapists may refer a client to a pelvic pain specialist physicians or nurse practitioners to help with medications and/or suppositories to help with pain.


Lifestyle Modifications

Adjusting daily habits can also play a crucial role in managing symptoms. This may include dietary changes to prevent constipation, altering exercise routines to reduce pressure on the pelvic floor, adopting ergonomic practices to improve posture, and self care routines throughout the day to help with stress reduction and resilience. 



High tension pelvic floor muscles can significantly impact quality of life, but with the right diagnosis and management strategies, individuals can find relief. It’s essential for anyone experiencing symptoms of pelvic floor dysfunction to seek the guidance of healthcare professionals who can provide personalized treatment plans. Remember, addressing pelvic health is a crucial step towards overall well-being.

So I hope this blog post helps you realize that you definitely are not alone AND there are EFFECTIVE solutions. 

When considering seeing a Pelvic Physical Therapist, know that we always start with the evaluation and lots of talking, and you are in control of your session with us. We want to see changes within 3-5 visits, which is something we take pride in here at ReGenerate Physiotherapy!

We give you time and space to talk about your story (offering full one-on-one hours sessions), so we can get to the root cause of your pain and problem. We offer FREE Phone consultations, book a call here!  Set up a call to see if you are good fit for Pelvic Physical Therapy!