Hypertonic Pelvic Floor: Symptoms, Causes, Treatment

What are the symptoms of hypertonic pelvic floor?

Hypertonic pelvic floor, also known as overactive pelvic floor, is a condition characterized by an abnormal increase in muscle tone of the pelvic floor muscles. This can cause a range of symptoms that can affect a person’s quality of life. Here are some common symptoms of hypertonic pelvic floor:

Pelvic pain: Pain or discomfort in the pelvis, lower back, or rectum.
Urinary frequency: Frequent urination, especially at night.
Urinary incontinence: Loss of bladder control, leading to involuntary leakage of urine.
Stress incontinence: Leakage of urine with coughing, sneezing, or physical activity.
Pelvic organ prolapse: The feeling of pressure or bulging in the vagina or rectum.
Constipation: Difficulty passing stools or feeling constipated due to decreased rectal sensation and function.
Painful bowel movements: Pain or discomfort during bowel movements.
Difficulty with bowel movements: Straining during bowel movements or feeling like you need to push hard to have a bowel movement.
Feeling of pressure: Feeling like the pelvic floor muscles are tense or tight, causing discomfort or pain.
Emotional changes: Depression, anxiety, or emotional distress due to the impact on daily life and quality of life.

Hypertonic pelvic floor can be caused by various factors, such as:

Pregnancy and childbirth
Hormonal changes during menopause
Weakened pelvic floor muscles due to chronic straining during bowel movements
Prolonged sitting or standing
Heavy lifting or physical activity

If you experience any of these symptoms, it’s essential to consult with a healthcare provider to determine the underlying cause and develop a treatment plan to address the hypertonic pelvic floor.

What are the causes of hypertonic pelvic floor?

Hypertonic pelvic floor, also known as overactive pelvic floor, is a condition characterized by an abnormal increase in muscle tone of the pelvic floor muscles. The causes of hypertonic pelvic floor can be multifactorial and include:

Pregnancy and childbirth: Hormonal changes during pregnancy can cause an increase in pelvic floor muscle tone, which can lead to hypertonicity.
Childbirth trauma: Trauma to the perineum or anal sphincter during childbirth can cause damage to the pelvic floor muscles, leading to hypertonicity.
Hormonal changes: Hormonal fluctuations during menopause or premenopausal symptoms can cause an increase in pelvic floor muscle tone.
Weakened pelvic floor muscles: Weakness or atrophy of the pelvic floor muscles due to chronic straining during bowel movements or urinary retention can lead to hypertonicity.
Muscle imbalances: Muscle imbalances between the pubococcygeus and iliococcygeus muscles can cause hypertonicity.
Nerve damage: Nerve damage to the pudendal nerve or sacral nerves can cause hypertonicity.
Genetic factors: Genetic predisposition can contribute to hypertonic pelvic floor.
Diet and lifestyle: A diet high in processed foods, sugar, and saturated fats, combined with a sedentary lifestyle, can contribute to hypertonic pelvic floor.
Pelvic organ prolapse: Weakened pelvic floor muscles and ligaments can cause organs to prolapse, leading to hypertonicity.
Other medical conditions: Certain medical conditions, such as Parkinson’s disease, multiple sclerosis, and spinal cord injuries, can cause hypertonic pelvic floor.
Poor posture: Poor posture and sitting or standing for extended periods can contribute to hypertonic pelvic floor.
Anxiety and stress: Chronic anxiety and stress can cause muscle tension, including pelvic floor muscles.

It’s essential to note that the exact cause of hypertonic pelvic floor may be complex and multi-factorial, requiring a comprehensive evaluation by a healthcare provider to determine the underlying cause and develop an appropriate treatment plan.

How is the diagnosis of hypertonic pelvic floor made?

The diagnosis of hypertonic pelvic floor is made through a combination of physical examination, medical history, and diagnostic tests. Here are the steps involved in diagnosing hypertonic pelvic floor:

Medical history: The healthcare provider will take a thorough medical history to identify any symptoms, medical conditions, and medications that may be contributing to the symptoms.
Physical examination: A physical examination will be performed to assess the pelvic floor muscles, including the pubococcygeus and iliococcygeus muscles. The healthcare provider will also examine the perineum, rectum, and vagina to assess for any abnormalities.
Pelvic floor muscle function tests: The healthcare provider may perform tests to assess the function of the pelvic floor muscles, such as:
- Pelvic floor muscle contraction test: The healthcare provider will ask the patient to contract their pelvic floor muscles and assess the strength and tone of the muscles.
- Pelvic floor muscle relaxation test: The healthcare provider will ask the patient to relax their pelvic floor muscles and assess the tone and relaxation of the muscles.
Anorectal manometry: Anorectal manometry is a test that measures the pressure and tone of the anal canal and rectum.
Endoanal ultrasound: Endoanal ultrasound is a test that uses sound waves to visualize the anal canal and rectum.
Magnetic resonance imaging (MRI): MRI can be used to evaluate the anatomy of the pelvic floor muscles and organs.
Electromyography (EMG): EMG is a test that measures the electrical activity of the muscles, including the pelvic floor muscles.

The diagnosis of hypertonic pelvic floor is typically made based on a combination of these tests and examinations. The healthcare provider will also consider other potential causes of symptoms, such as chronic constipation, chronic straining during bowel movements, or other underlying medical conditions.

It’s essential to note that a proper diagnosis of hypertonic pelvic floor requires a comprehensive evaluation by a healthcare provider who has experience in diagnosing and treating pelvic floor disorders.

What is the treatment for hypertonic pelvic floor?

The treatment for hypertonic pelvic floor typically involves a combination of physical therapy, lifestyle changes, and in some cases, medical interventions. The goal of treatment is to reduce muscle tension and spasticity, improve pelvic floor function, and alleviate symptoms.

Physical Therapy:

Pelvic floor physical therapy: A physical therapist can teach exercises to strengthen the pelvic floor muscles, improve muscle tone, and reduce spasticity.
Breathing and relaxation techniques: Techniques such as deep breathing, progressive muscle relaxation, and yoga can help reduce muscle tension and promote relaxation.
Posture correction: Improving posture can help reduce strain on the pelvic floor muscles.

Lifestyle Changes:

Pelvic floor exercises: Regular exercises such as Kegel exercises can help strengthen the pelvic floor muscles.
Proper bowel habits: Maintaining good bowel habits, such as eating a high-fiber diet and staying hydrated, can help reduce straining during bowel movements.
Avoidance of constipation: Avoiding constipation by eating a balanced diet and staying hydrated can help reduce straining during bowel movements.

Medical Interventions:

Botulinum toxin injections: Botulinum toxin injections can be used to relax the pelvic floor muscles and reduce spasticity.
Sacral nerve stimulation: Sacral nerve stimulation is a procedure that involves implanting a device that sends electrical impulses to the sacral nerve to help relax the pelvic floor muscles.
Pudendal nerve block: A pudendal nerve block is a procedure that involves injecting local anesthetic into the pudendal nerve to temporarily numb the area and provide relief from pain.
Medications: In some cases, medications such as muscle relaxants or anticholinergics may be prescribed to help alleviate symptoms.

Surgical Interventions:

Sacrocolpopexy: A surgical procedure that involves attaching the vaginal wall to the sacrum to support the vaginal vault and alleviate symptoms.
Vaginal mesh repair: A surgical procedure that involves placing a mesh material to support the vaginal wall and alleviate symptoms.

It’s essential to work with a healthcare provider who has experience in diagnosing and treating hypertonic pelvic floor to determine the best course of treatment for your individual case.

What is a good diet for hypertonic pelvic floor?

A healthy diet can play a crucial role in managing hypertonic pelvic floor symptoms. A balanced diet that is high in fiber, low in processed foods, and rich in nutrients can help alleviate symptoms such as constipation, bloating, and discomfort. Here are some dietary recommendations for hypertonic pelvic floor:

High-Fiber Foods:

Fruits: Berries, apples, bananas, avocados
Vegetables: Broccoli, spinach, carrots, sweet potatoes
Whole grains: Brown rice, quinoa, whole wheat bread, whole grain pasta
Legumes: Beans, lentils, chickpeas, peas

Low-Fiber Foods:

Processed foods: Avoid foods that are high in added sugars, salt, and unhealthy fats
Refined grains: White bread, white rice, sugary snacks
High-fat foods: Fried foods, processed meats

Nutrient-Rich Foods:

Omega-3 fatty acids: Fatty fish, flaxseeds, chia seeds
Probiotics: Yogurt, kefir, fermented vegetables
Antioxidants: Berries, leafy greens, nuts and seeds
Vitamin D: Fatty fish, fortified dairy products

Beverages:

Water: Aim for at least 8-10 glasses per day
Herbal teas: Peppermint, chamomile, and ginger tea may help alleviate symptoms
Probiotic-rich beverages: Kombucha, kefir

Foods to Avoid:

Spicy or acidic foods: These can irritate the digestive system and exacerbate symptoms
Carbonated drinks: Avoid fizzy drinks like soda and beer
Raw or undercooked meat: Undercooked meat can contain harmful bacteria that can exacerbate symptoms

Meal Tips:

Eat regular meals: Aim for three main meals and one or two snacks per day
Incorporate fiber-rich foods into every meal
Avoid eating too close to bedtime
Try to avoid foods that trigger symptoms

Remember to consult with a healthcare provider or registered dietitian to develop a personalized diet plan that meets your specific needs and health goals.