Pelvic Floor Hypertonia | What it is, symptoms, causes and treatment


When you talk about pelvic floor dysfunctions We all think of hypotonia or weak muscles. Pelvic floor hypertonia is the opposite, the pelvic muscles have an excess of tone. Do you want to know what it is, what its symptoms are and what exercises are best to solve it? Keep reading…


pelvic floor hypertonia
Pelvic floor hypertonia

The problems and pelvic floor dysfunctions not only due to weakened muscles or hypotonia (lack of tone) and its consequent urinary incontinence. The hypertonia of the pelvic floor is the opposite, it is a excess tension in the perineum musculature. This excess tone can cause problems such as urinary incontinence or pain. These are just some of the symptoms that are frequently confused with pelvic floor hypotonia, but that correspond to excess muscle tone in the area.

The concept that a muscle is better the more tension present, should not be confused. A hypertonic muscle that is not able to relax, and is not a healthy muscle in any case.

An excessively tense musculature is not a healthy musculature.

A healthy muscle should be able to contract and relax. And so the excess tone in the perineum is a dysfunction.

The perineum or pelvic floor is the musculature that lies at the bottom of the pelvis. This set of muscles has a rhomboid shape, and is formed between the ischiopubial branches, the ischia and the coccyx. In cases of hypertonia, this musculature is not able to relax, and always has excessive tension. People who present this dysfunction, notice painful points during the assessment.


Main symptoms of pelvic floor hypertonia they are those related to urination such as frequency or urgency, sudden desire to urinate, and those of a sexual nature, such as pain during sexual intercourse or the inability to penetrate.

symptoms of hypertonia
Symptoms: urinary frequency and urgency, choppy urination, constipation, pain during sex …

How can I know if I have hypertonia? These are the alarm symptoms:

  • Urinary frequency
  • Urinary urgency or sudden urge to urinate.
  • Urinary incontinence due to urgency
  • Distressed urination, because the pelvic floor muscles cannot relax to urinate.
  • Feeling of incomplete bladder emptying.
  • Anal incontinence
  • Pain during or after defecation.
  • Constipation.
  • Pain during sexual intercourse (dyspareunia).
  • Inability to perform penetration during sexual intercourse.
  • Low back pain
  • Impossibility or pain during insertion of a tampon.
  • Hip pain

Although these are the symptoms that correspond to hypertonia, they can also occur for other reasons, so it is always recommended to consult a specialist. A physiotherapist specialized in pelvic floor, a midwife, or a gynecologist should be consulted, since such symptoms may not be related to hypertonia.


The hypertonia of the woman's pelvic floor muscles They can lead to some complications. Among the possible associated complications To this hypertonia we find the following: overactive bladder, vaginismus, pudendal neuralgia, cystitis or prostatitis. In addition to the above, excessive tone in the perineum can cause lumbar problems, pains, and hip problems.


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<p>The causes for which this perineal dysfunction can be suffered are varied. The most common in women are those related to a traumatic birth and those related to psychological causes such as stress or anxiety. These are the causes of hypertonia:</p>
<li>Traumatic births in which instruments have been used</li>
<li>Episiotomy in childbirth</li>
<li>Tear during childbirth</li>
<li>Hip Compensations</li>
<li>Lumbar pathologies</li>
<li>Lesions in the pelvic area</li>
<p>In some of these cases an injury occurs that will gradually increase. The more time passes and normal activities and sexual relations resume, the musculature will try to "protect itself" by becoming more and more tense. In this way a vicious circle or loop is produced from which it is necessary to sarlir.</p>
<p>At this point, inverse kegel exercises or pelvic floor relaxation are not enough. In these cases, manual therapy by physiotherapists specializing in pelvic floor is necessary.</p>
<h2><span id=Treatment to improve hypertonia

The treatment for this dysfunction is to relax the perineal muscles. There are a number of practices to be carried out to improve pelvic floor hypertonia, to prevent it from going over.

  • Manual physiotherapy in the painful points.
  • Myofascial release techniques in that area
  • Osteopathy
  • Relaxation techniques

The person with him hypertonic pelvic floor should avoid practical bursts that may increase tension, like the famous Kegel exercises, which in this case are contraindicated (unless it is inverse Kegel, which we will talk about later). Also those abdominal exercises that increase intra-abdominal pressure, such as abdominal crunch.

treatment for excess muscle tone in the perineum

Therefore, the solution is to avoid increasing tension in the pelvic floor that is hypertonic happens to relax the muscles. For this, the following tips can be carried out:

  1. Kegel exercises. We must avoid practices that can increase tension more like kegel exercises. In this case they are contraindicated, the goal is to relax the muscles.
  2. Avoid exercises with Chinese balls.
  3. Do NOT do contraction and relaxation exercises of the pelvic muscles. Hypertonia worsens with contraction and relaxation exercises. Before doing this type of exercise, you should consult a physio, doctor, gynecologist or midwife.
  4. Should be avoid abdominal exercises (which increase intra-abdominal pressure) classics such as abdominal crunch.
  5. Apnea should be avoided by effort. That is, avoid holding your breath and pushing, such as when we go to the service. The musculature should be relaxed. Do not hold your breath during exertion.
  6. Avoid clothing that is too tight, as it favors excess tension in the pelvic area.
  7. You should also avoid bad postures prolonged for a long time.

Exercises for a hypertonic pelvic floor

You should always do exercises that help you relax.

Diaphragmatic breathing The diaphragmatic breathing It is the one used to reduce tension in the abdominal muscles, diaphragm and perineum. This breathing also serves to reduce blood pressure, stress and anxiety. You can practice diaphragmatic breathing at home, but you should also know that it is the breathing that is used to perform hypopressive exercises, which are also very effective in this case and we will talk about them below.

Some classes can help you relax your pelvic muscles:

  • Hipopressive abs
  • Yoga to relax the pelvic floor
  • Pilates (if the origin of hypertonia is a postural problem)

How to relax the pelvic floor

In the following video you can learn in detail how to relax the muscles of the perineum:

Kegel inverse exercises

The main objective of Kegel exercises is to strengthen the pelvic floor muscles. In the case of Inverse kegel, the objective is the relaxation to compensate for the excess produced by hypertonia. The best way to learn these exercises is with the help of a physicist specialized in pelvic floor. These inverse Kegel exercises consist of developing the conscious ability to relax the pelvic muscles.

The exercises of Inverse kegel they will contribute actively to progressively relax this musculature and recover that hypertonic. In this way, the tension and pain caused by this dysfunction of the perineum is eliminated.

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