Health blog

As conversations and awareness around pelvic health increases, more and more people are aware of the importance of their pelvic floor muscles for getting them through events like pregnancy and childbirth as well as everyday frustrations like incontinence or constipation.

But unlike other muscles in your body, your pelvic floor muscles are always working; whether you’re sitting or standing, sleeping or exercising. That means it’s not as easy to tell when they’re too tight until an issue arises like painful intercourse.

Fortunately, pelvic floor rehabilitation can address this and many other pelvic floor health concerns, and with a little training, you can rebalance these muscles effectively to provide the support and flexibility you need.

Is pain during sex caused by a tight pelvic floor?

Having pain during intercourse can feel isolating, but you’re not alone. Up to 1 in 5 people assigned female at birth report experiencing this issue at some point in their lives. While pelvic floor dysfunction can make intercourse painful, it’s important to remember that it might not be the sole reason.

The pelvic floor consists of a group of muscles that form a supportive hammock at the base of your pelvis. These muscles need to be strong yet flexible to function properly. When overly tight, they become less elastic and more prone to causing pain. This is referred to as hypertonic pelvic floor dysfunction.

However, it’s crucial to note that not all pain during intercourse stems from the pelvic floor. Conditions such as endometriosis, vaginal dryness, or hormonal changes may also play a role. This is why accurate diagnosis is vital for finding the right treatment path.

What causes a tight pelvic floor?

Pelvic floor tension develops over time due to various factors. Unlike an acute injury, which happens suddenly, a tight pelvic floor typically results from a chronic, gradual buildup of stress or as a result of changing movement mechanics. Below are a few common causes of pelvic floor tension that may be at play.

Stress and posture

One of the sneakiest culprits of pelvic floor dysfunction is stress. When under stress, people naturally tense their muscles—including the pelvic floor—without realizing it. Over time, this tension becomes chronic. Poor posture when sitting at a desk or standing also contributes to chronic pain by placing additional, often imbalanced pressure on the pelvis.

Childbirth and pregnancy

As you might imagine, pregnancy and childbirth significantly stress the pelvic floor muscles. The weight of carrying a baby, hormonal shifts, and the delivery process itself can leave these muscles either weakened or overly tight, which is a confusing but accurate possibility.

Fortunately, these changes are not irreversible. With the right diagnosis and targeted treatment plan, your pelvic floor can be re-balanced and your symptoms have a good chance of improvement.

Physical trauma or injury

Past surgeries and injuries to the pelvic area are key risk factors for future pelvic dysfunction. Additional non-pelvic injuries such as falls or chronic lower back pain may indirectly affect your pelvic floor health.

Symptoms of a tight pelvic floor

While pain during intercourse is a likely symptom of pelvic floor tension, it’s not the only symptom you might be experiencing. Other indicators that you’re dealing with a tight pelvic floor include:

• Urinary issues: Difficulty starting urination, frequent urges, incontinence, or incomplete bladder emptying
• Bowel problems: Trouble with bowel movements, constipation, or rectal pain
• Pelvic pain: An ongoing ache or discomfort in the pelvic region, hips, or lower back
• Pain during daily activities: Discomfort while sitting, standing, or exercising, sometimes made worse with certain types of clothing
• Pain during gynecological exams or the use of tampons
• Difficulty achieving orgasm or reduced sexual satisfaction

If you’re experiencing more than one of these symptoms, pelvic floor tension or weakness could be a contributing factor.

Treating pain during sex with pelvic floor therapy

While Kegels are often promoted as the go-to exercise for pelvic floor health, they aren’t suitable for everyone. If your pelvic floor is already too tight, strengthening it further can make the problem worse.

That’s why we don’t advise a lot of at-home care for pelvic therapy, since the symptoms can be hard to diagnose accurately on your own. By talking to and seeking an evaluation from a physical therapist you can have much more confidence and faster results from a treatment plan that’s tailored to your needs.

What to expect from pelvic floor physical therapy

A licensed pelvic floor physical therapist specializes in assessing and treating pelvic dysfunction of all types, including tight pelvic floor. Here’s what you can expect from the pelvic floor therapy process:

• Assessment: Your therapist will evaluate your symptoms and medical history to provide an accurate, specific diagnosis. There are a variety of ways to perform this assessment. Although an internal exam is recommended, we understand that not everyone is comfortable with it, and there are alternatives we can use.
• Manual therapy: Gentle, hands-on techniques help release tension and improve muscle function.
• Targeted exercises: Holistic exercises focus on relaxation and balance, rather than indiscriminately strengthening the muscles.
• Lifestyle adjustments: Your therapist might recommend changes related to posture, stress management, or daily activities to reduce pelvic tension.
• Biofeedback tools: External muscle stimulation sensors provide real-time feedback on pelvic muscle activity, helping you become more aware of what it feels like to relax, stretch, and contract these muscles.

Pelvic floor rehab in New Orleans

Pelvic floor dysfunction, including tight pelvic floor muscles, is a common but treatable condition. If you’re experiencing pelvic floor pain during sex or any other daily discomfort, don’t wait to get the relief you deserve.

At Rehab Access in New Orleans, our team of highly trained pelvic floor therapists takes intentional steps to make your evaluation and treatment process welcoming, professional, and effective. Start a conversation with our team to learn more about your options before committing to an appointment by calling one of our New Orleans clinics today.

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