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Pelvic Floor Spasm

By Dr. Brooke Meinema, DPT, FAFS

The pelvic floor consists of a group of muscles whose job is to support the organs within our pelvis. Much like the muscles in our neck and shoulders, the pelvic floor muscles may have increased tension for a variety of reasons leading to increased pain and symptoms. It’s commonly known that we can have tension headaches from tight neck muscles, so how would this present if our pelvic floor muscles are tight or spasm?

Potential symptoms:

Both male and female anatomy may have resulting symptoms such as:

  • Abdominal pain or cramping
  • Rectal spasm (also known as proctalgia fugax)
  • Pain with orgasm
  • Difficulty urinating
    • Initiating flow of urine
    • Asymmetrical streamPelvic floor anatomy, pelvic floor spasms, pelvic health
    • Spraying during urination
    • Pain/burning with urination
  • Difficulty defecating
    • Difficulty beginning
    • Feeling like you have not fully voided
    • In some cases, even anal fissures
  • Insertional pain

Male anatomy:

  • Scrotal pain
  • Penile pain
  • Ejaculatory pain

Female anatomy:

  • Ovarian pain (pain mimicking menstrual cramps)
  • Vaginal tearing from insertion

What can I do about this?

If symptoms are being caused by increased muscle tension or muscle spasms, the first goal should be to work on reducing tension. Recognizing triggers is a great place to start. Some people may notice they clench their jaw or scrunch up their shoulders when they are stressed, but it can be harder to notice they are clenching their pelvic floor muscles. Rule of thumb: if you notice you are clenching muscles somewhere in your body, assume the pelvic floor is clenching as well. Once you become aware of this, work on letting the muscles go (think of the muscles being heavy and allowing them to “drop”).

Pelvic opening stretches such as child’s pose, happy baby, and deep squats can help open up the muscles in your pelvic floor. In these positions, focus on your breathing. It can even help to imagine you are breathing down into your pelvic floor.

Massage can also be a great tool! For external massage, sometimes sitting on a foam roller (the foam roller sits in between your sit bones so you are straddling the roller) and doing a small rock side to side or “windshield wiper” motion with your knees to work on stretching the pelvic floor muscles is a nice stretch. If you don’t have a foam roller, you can try placing a tennis ball between your sit bone and tailbone and sitting on the ball; you can either roll over the ball, work on deep breathing, or windshield wiper your knee for the side you are sitting on. Internal massage can be a bit more finesse (for handouts on this, see my previous blog “internal work – pelvic floor massage”).

Do not do Kegels! Kegels are isolating the pelvic floor and making them contract more. If you are already clenching overactive muscles, making them work harder is not likely to be the best option. There is a time and place where Kegels can be helpful, but for the time being, give your pelvic floor a break!

And, lastly, see a trained pelvic health physical therapist! The pelvic floor is a group of muscles, and we need to take care of our muscles! If you have been experiencing muscle spasms, pelvic floor dysfunction, or chronic pain, seeing a physical therapist trained to address these issues can be a game changer. You don’t need to do this on your own!

If you have any questions or are curious about how physical therapy can benefit you, feel free to contact us 616.847.1280 to schedule a complimentary consultation with one of our skilled pelvic health physical therapists.

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