Is a Stiff Pelvic Floor Even a Thing? It Certainly Is!

Today, I am delving into a topic that may not come up in everyday conversations but is undeniably essential for our well-being: a stiff pelvic floor. It is something many women might feel uncomfortable discussing, but it affects our health in more ways than we realise. So, let's take a moment to dive into the intricacies of this somewhat mysterious topic.

Before we get into the nitty-gritty, let's understand what a stiff pelvic floor is. The pelvic floor is like a network of muscles, ligaments, and connective tissues supporting our bladder, uterus, and rectum. These muscles can become stiff for a myriad of reasons which we are going to discuss in this blog, and when they do, it's called a stiff pelvic floor. This is different from a hypertonic pelvic floor. But what's most important to understand, is that this stiffness can limit the flexibility and responsiveness of these crucial muscles.

So what can cause it? For many women, giving birth can be a major contributing factor. It's not just the act of childbirth itself, but also the aftermath. Tearing or the use of forceps can leave behind scar tissue, this scar tissue is not elastic meaning that not only doesn't it stretch, but the trauma of the surrounding tissues can remain stiff following the healing period. The trauma and proceeding inflammation can cause structural changes to the tissue, preventing it form returning to its elastic and responsive state.You may be surprised to know that even how we breathe can play a role in how stiff our pelvic floors can be. Shallow breathing patterns prevent our pelvic floors expanding and contracting to their full  potential, making the pelvic floor stiffer over time. Just as an un-stretched calf or hamstring can feel tight and stiff so can a pelvic floor. With the decreased expansion during breathing, the pelvic floor is deprived of valuable oxygen and nutrients on a daily basis, preventing the muscles from achieving its full potential.  

Also, a weak pelvic floor can ironically lead to stiffness. It's lack of ability to contract and relax due to weakness can cause reduced range of movement and rigidity in the muscles. Yep, it’s not a one-size-fits-all scenario, which often makes it tricky to diagnose…and even trickier to heal.

Our modern, sedentary lifestyles also play a major part in the degeneration of pelvic floor performance. Prolonged periods of sitting can lead to a slow and stiff pelvic floor.  Sitting for long periods reduces blood circulation and oxygen in the pelvic area. Just like when you sit cross legged for too long and your legs go numb, sitting on your bum for too long can cause your pelvic floor not to get the blood flow it needs. For most women luckily it doesn't usually lead to pins and needles but for some it absolutely does.  

But it doesn't stop there. Nope, the list does go on! Let's look at some other causes of a stiff pelvic floor:

• Neurological conditions – Multiple Sclerosis is where the immune system attacks the myelin, the protective layer around nerve fibres and causes Inflammation and lesions. This makes it difficult for the brain to send signals to the rest of the body, such as the pelvic floor.
• Dyspareunia - Persistent or recurrent pain around the genitalia during or after intercourse can contribute to pelvic floor stiffness.
• Vaginismus – this strange-sounding word is the medical term for vaginal tightness and the resulting burning pain of the vagina during sexual intercourse. It results from the involuntary tightening of the pelvic floor muscles, which causes painful spasmodic contractions in the vagina…and, consequently, stiffness.
• Chronic bladder infections – infections of the bladder can cause inflammation in the pelvic muscle tissue, causing stiffness and can contribute to the frequent discomfort and urgency that they often bring with them.
• Menopause - the accompanying drop in oestrogen levels can reduce elasticity in the pelvic area, adding to the stiffness.

Symptoms: Where Do I Start?

Now, let's talk about the symptoms of a stiff pelvic floor, as recognising them is crucial for early intervention. Pelvic pain is a common indicator, as is painful intercourse, also known as dyspareunia. A stiff pelvic floor can mess with your bladder control, leading to unwanted leaks…something that many women experience and brush off as ‘normal’ after childbirth; it is absolutely NOT normal – common, yes, but normal, no! Difficulty in passing stools is another issue, and some women may even experience increased discomfort during their menstrual cycles. An inability to conduct a Kegel. Many women struggle to do Kegels not just because their pelvic floor is weak, but because it is stiff and unresponsive.  What makes it so tricky to diagnose, and why many women don’t even consider it a possibility, is that the symptoms are similar to a hundred other things. It is a minefield, and its impact on our daily lives cannot be underestimated.

It's important to distinguish between tight, weak, and stiff pelvic floors. They're not the same. A tight pelvic floor is characterised by constant tension, often leading to discomfort or pain. On the other hand, a weak pelvic floor lacks the necessary strength and can cause issues like urinary incontinence. As we've discussed, a stiff pelvic floor is excessively rigid and less responsive, causing a combination of pain and weakness. Confusing, I know. But don't worry; there are ways to address and alleviate the discomfort associated with a stiff pelvic floor. Pelvic floor physical therapy, specialized massage devices and vibrators, internal massage wands, breathing exercises, lifestyle changes, and hormone replacement therapy for menopausal women can all be helpful. Just remember to consult a healthcare professional like myself before starting any treatment.

Hey wait, I want you to realize that whilst the symptoms are physical, the causes aren't always.

It's Not Just Physical…

Now, let's delve deeper into the emotional and psychological aspects of dealing with a stiff pelvic floor. It isn't just about the physical discomfort and pain it brings. It can have profound emotional and psychological effects as well. The condition can lead to anxiety and frustration, affecting our overall well-being. It can also lead to avoidance of intimacy and a reduced quality of life. I see it every week in my clinic.

For many women, the emotional toll of a stiff pelvic floor can be significant. The pain and discomfort can be a constant source of worry, making it hard to enjoy simple things like sitting for extended periods or going for a walk without the fear of needing a bathroom urgently. A stiff pelvic floor can also impact your enjoyment of sexual intimacy. If you're struggling to find pleasure in foreplay or intercourse, it may be that your pelvic floor is unresponsive. These daily concerns can lead to heightened stress levels, impacting not just our pelvic health but our mental health as well. The first step is acknowledging that it's okay to feel this way and that you're not alone in your struggles. Many women go through similar experiences, and help and support are available. Speaking openly about your feelings and experiences with a healthcare professional can be incredibly beneficial. They can provide physical treatment and guidance on managing the emotional aspects of living with a stiff pelvic floor. They can connect you with resources, support groups, or therapists who can help you navigate the emotional challenges.

Building a support network among friends and family can also provide immense comfort. Sometimes, knowing you are around people who understand and care about what you're going through can make a difference. This is what I built the Pelvic Power Movement Community for…a place to find support from others who understand.

SO, Let’s Break the Silence

A stiff pelvic floor may not be something we chat about every day, but it's a crucial topic to address. By recognising the symptoms and exploring treatment options, you can regain control of your pelvic health and improve your overall quality of life. It isn't just about the physical symptoms; it's also about understanding the emotional toll it can take and seeking the support you need to improve your overall well-being. You're not alone in this journey; guidance is available to help you regain comfort and confidence in all aspects of your life.

So, break your silence, seek the help you need, and start your journey to a healthier and happier pelvic floor. You're not alone. I am here for you.