Kim Vopni (00:01.558)
Okay, so we are gonna get started with a list. This is not a completely exhaustive list, but pretty comprehensive, I would say, in terms of some of the signs that your pelvic floor would be too tight. So a big one is constipation. Constipation can create pelvic floor challenges, and a tight pelvic floor can also be the reason why you have constipation.
So if you have muscles in the pelvic floor that are not relaxing to allow the poop to come out, that can be a contributing factor to constipation. So if you struggle with constipation, you've tried drinking water, you've tried fiber, you've tried changing your diet, you're doing tummy massage, you're doing all the things and you're still struggling, if you haven't already seen a pelvic floor physical therapist, go get your pelvic floor evaluated, because it could be the fact that your pelvic floor muscles are too tight that is interfering with your ability to void.
on that same line, the inability to void completely. So maybe you can, you get the urge, you can go, but you don't feel like you get everything out. That could also be muscles that aren't completely relaxing. So you're not getting a full BM happening when you sit down to have a poop. So incomplete voiding can be another one. Another sign could be if you,
you feel like you have the urge to go to the bathroom and that could be urination or poop or defecation and you feel like you get the urge but when you sit down you can't get it started. It's almost like you have retention. You feel like stage fright and just it's not starting to flow. So the retention side of things can also be tightness or restriction in the pelvic floor.
and the inability to relax when the bladder is wanting to contract or when the rectum is wanting to get everything out. Another sign could be pain. So if we look at parts of the pelvis, here's a pelvis model without the muscles. If we have pubic joint pain, if we have pain in our hips, if we have SI joint pain, if we have tailbone pain, if we have
Kim Vopni (02:18.603)
painful sex, especially if that's with touch or with insertion and that could be with a penis, a finger, a toy, any sorts of pains, even pain with the thought of something touching or being inserted that could also be attributed to tightness. So the muscles, the pelvic floor muscles are attached to the pubic joint, the two sit bones and the tailbone. So they are closing off this
what's known as the pelvic outlet. So the pelvic floor muscles are here and when they are too restricted, they're not relaxing, they're tight, it can create pain in and around the joints and in the pelvis. And it can even translate up, especially when it's SI joint pain up into the low back. And of course, part of the, with sex, of insertive sex is to allow something to
go inside and again if the muscles are restricted that could be difficult. lots of different types of pain can be signs that you may have tightness in your pelvic floor. There could also be urgency so especially urinary urgency or bowel urgency where
you feel like all of a sudden you get an overwhelming urge and you have to race to the bathroom. You might feel like you can't get there in time and sometimes you may not get there in time. So you've got these really overwhelming urges. That could be a sign of tightness in the muscles. The bladder, let me show you different model. So here is the pelvis with the muscles inside or attached. So this is that same pubic joint, two sit bones, tailbone. Here's the pelvic floor. Here's the
vulva, the vagina, the urethra, the anus. Now if we look on the inside, you can see those openings, the anus, the vagina, kind of see the urethra there as well. If I put the organ in,
Kim Vopni (04:24.016)
So the organ being the bladder. If you can see the muscles are surrounding, they're nestled right where, the bladder is nestled right where those muscles are. So if we have again tension in this group of muscles, it can irritate the bladder. It could also irritate the bowels, which are also here as well, to create those sensations of urgency and feeling like you really need to go.
It could also create the sensations of frequency, meaning you're feeling like you have to go to the bathroom all the time. And this again can be excited, tight, overactive muscles that are non-relaxing. And that contributes to the urgency, but also the need to go more frequently. So normal voiding would be every two and a half to four hours. If you have taken out bladder irritants, if you're remaining hydrated, if you haven't had a huge volume of liquid,
and you feel like you're going every 20 minutes, 40 minutes, even every hour, it could be also the fact that you have tightness in your pelvic floor. I think we've talked most about the pain ones. We've talked about the joint pain. Incontinence and prolapse are also signs that your pelvic floor is too tight. And this can seem counterintuitive.
We think that if we are leaking urine, stress urinary incontinence, then that must mean my muscles are weak and we think of weakness always as lax. But tight is also weak. so tight muscles can also interfere with the ability of the pelvic floor to react at the right time for those increases in inter-abdominal pressure and also in its ability to generate enough force to close off the openings to prevent the leaks from happening.
So stress urinary incontinence, urgency, urgent continence, frequency, even overactive bladder. A lot of people will self-diagnose themselves as having overactive bladder. That can also be tightness in the pelvic floor. The same is true with pelvic organ prolapse. And again, when we think of pelvic organ prolapse where the bladder, the uterus, the rectum are starting to bulge into or descend into the vagina,
Kim Vopni (06:46.585)
We think of laxity. That must mean there's not enough tightness to hold everything in. But again, if we have muscles that are non-relaxing, they are hindered in their ability to do their jobs, one of which is organ support. And sometimes also other resulting challenges from tightness. We talked about constipation. If I'm constipated because I have tight muscles and now I'm straining to have a bowel movement, that is also
downward pressure that can contribute to pelvic organ prolapse as well. So even though it sounds counterintuitive, incontinence and prolapse are signs that your pelvic floor is too tight. Of course, people can have incontinence and prolapse and have laxity, but more and more I'm finding people reporting to me after they've seen a pelvic floor physical therapist that they have been told their pelvic floor is too tight.
Other terms could be hypertonic. Other terms could be non-relaxing, overactive. So those are terms that could all be indicative of tightness in the pelvic floor. So that kind of covers the main signs that your pelvic floor is too tight. Again, this isn't a completely exhaustive list, but I would say those are the most common signs. Now we wanna look at what are the reasons why we would...
develop those challenges in the first place. And so we talked about constipation, we talked about tight pelvic floor muscles contributing to constipation, but we also need to look at constipation can be a contributor to pelvic floor dysfunction as well. The downward pressure, the stress and the strain could be a contributing factor. Posture is a big one as well. So if we are constantly...
So this would be considered kind of neutral pelvis for those of you that are watching in the video where the hip bones and the pubic joint are in the same plane, we would have a gentle curve in the low back. If we are sitting on our tailbone, if we're sitting with a tucked pelvis position, if we're standing in sort of a slouched tucked under pelvic posture position, that can create tension in the pelvic floor, especially if we are sitting on the tailbone and we are.
Kim Vopni (09:08.034)
putting pressure on those joints and also encouraging the tailbone, I showed you that's one of the attachment points of the pelvic floor, encouraging it to move closer to the pubic joint so the muscles are adapting to a shorter, tighter position. So how we hold ourself can definitely contribute to sensations of tightness or a reason why we might be developing tightness as well. There's also even some...
some evidence that looks at hyper-kyphotic posture, meaning if you have excessive rounding in the upper back as a contributing factor to pelvic organ prolapse as well. So addressing constipation and posture are two of the very first lessons that I cover when I have people come into my Buff Muff membership, because we could do all the exercise in the world, but if we are constantly straining or if we are holding our skeleton in
non-optimal ways, we're never really going to make the progress that we like. The other thing that can happen is people who experience leaking, so stress urinary incontinence, people who have urgency and feel like they're not going to be able to get to a bathroom in time, people who are afraid of leaks, who are afraid of urgency, who are always going to the bathroom and thinking there's not going to be one around, people who have prolapse and feel vulnerable, they feel like something's going to fall out. We have this
often unconscious reaction to guard. And it may also be conscious as well. We want to overcome that kind of vulnerable feeling and we may end up creating more tension subconsciously thinking that's going to help stop the leaks or help hold the organs in place. But again, as I mentioned, tension, non-relaxing pelvic floor muscles can actually hinder the pelvic floor's ability to do those jobs. So posture.
and guarding are really, really common reasons why we may have tension. Another could be fear or somebody may have trauma in their past that even just thinking about the traumatic experience or a painful experience can create anxiety, can contribute to tension. We also could be people who've experienced falls, especially falls on their tail.
Kim Vopni (11:29.339)
on their tailbone. People who are equestrians who ride in the saddle, there's a lot of gripping that happens with horseback riders. Also, sometimes people who participate in lot of Pilates or yoga, even though we think of yoga as being very zen and calm and stretching, a lot of yogis also have tightness because there's a lot of root activation. They use terms like mula-bandha or root.
activation which can, when brought in repetitively, may contribute to over activation in the pelvic floor. Some people who maybe have had surgery in the past, so if you have had some sort of a pelvic surgery or an abdominal surgery, there could be scar tissue that results and scar tissue can be a contributing factor to pain and also to the reason why there might be tightness. So it can restrict blood flow and circulation and the ability of the muscles to
move freely and so that restriction can contribute to tightness especially in balances in the two sides or the global aspect of the pelvic floor. Somebody who's doing chronic Kegel exercises. So Kegels are an evidence-based pelvic floor exercise. They work when they're done correctly and consistently as I always say. However, most people do them incorrectly.
And sometimes people interpret a Kegel as just the squeeze. And so if they're just focusing on squeezing over and over and over again, that could contribute to the development of more tension. We need to have a engagement or a contraction. We need to have a lift and we need to have a let go. And that let go piece is often what is overlooked when it comes to pelvic floor muscle training. Just like if I do a bicep curl, I need to lengthen my arm again. The same thing is true with the pelvic floor.
contracting and lifting, we also want it to be able to lengthen as well. And that is so often overlooked. Those are the main reasons, again, not 100 % exhaustive. Also pain conditions like endometriosis or adenomyosis. If we are dealing with pain in and around the pelvis for some reason, then in response to the pain, we also could start to develop more
Kim Vopni (13:56.763)
which you get into the kind of cycle of that which is hard to break. So now then what do we do about it? You all, if you've been here long enough, know what my first answer is. You're going to see a pelvic floor physical therapist. That is always my number one recommendation. I think it's the most underused women's health resource we have. I think it should be standard of care that we see one once a year just like we see the dentist.
And the brushing and flossing we do before we see the dentist and after, even if they give us a clean bill of health, is the pelvic floor muscle training, the hypopressives, the contract and relax. That is the brushing and flossing that we do in between visits of seeing our pelvic floor physical therapist. So that's your number one. They can help you understand the status of your pelvic floor. They can also help provide exercises. They can do manual therapy. They can help mobilize scar tissue.
if that is what is contributing to your tightness or some of the reasons. So they help you get to the root cause as to why you have this tension. And then of course give you some tools to help overcome that. So seeing a pelvic floor physical therapist, paying attention to your posture and how you hold yourself through the day. Ideally not sitting or standing or being in one position for a really long time.
I promoted diversity of movement throughout the day. If you do sit, sit with as close to a neutral pelvic position as possible. So again, that's with your pubic joint and your hip bones in the same plane. So you would be sitting on your vulva and your tailbone would be free from the surface of whatever it is that you're sitting on. Sitting in different positions. So maybe on a chair, maybe on a floor, maybe with one leg extended, maybe you're on a stability ball.
but also getting up and down throughout the day. And then if you're standing, maybe you can have a stand up, sit down desk. So when you're standing, also make sure you're not in a tucked position. You wanna keep your pelvis in that same neutral posture. If you're in bare feet, that's great. But if you have shoes on, shoes can also play a role in creating tension up the chain. Tension in the calves, tension in the hamstrings, pulling the pelvis into a posterior tilt that can also contribute to tension. So paying attention to the footwear that you're wearing.
Kim Vopni (16:18.355)
and transitioning to minimal shoes. I'm a big fan of zero shoes. I really like Altras. I like Vibrams. I've tried Lems. Those are just a few brands. There's many, many different brands now. Pure Co is another one that I really like. And a great website to check out is Anya's Reviews. So Anya is a barefoot enthusiast or minimal shoe enthusiast, and she has a great website where she
provides education, but also looks at all the different brands and compares them and also shows you how to make them stylish because for a while they weren't so stylish, but they've come a long way and there's amazing products. So that's something I would recommend people transitioning to as a way to help release tension in the pelvic floor as well. You also want to look at, so we've talked about pelvic floor physical therapy, your sitting and standing posture, your breath work.
I teach what's called the core breath. So using your breath as a way to get that relaxation or that expansion or that letting go happening into the pelvic floor. You can also use exercises like I share one of my YouTube channel called the posterior pelvic floor release. Hamstring releasing is really effective. Wide leg child's pose, happy baby pose, sitting on a
hard surface chair and using a tennis ball or a yoga tune-up ball to release tension in the sides. Sitting on a rolled up towel or a pool noodle, I also showed an exercise one day where I sat on a semi-inflated football as a way to release tension. And those are kind of using tools that we have to apply pressure that we need to release around. There's also devices we can insert, so something like a pelvic wand.
I like Intimate Rose. She has amazing products and she also has just a bunch of different wands and there's also one that is it vibrates and the vibration can help elicit a relaxation response. Another one of my favorite devices is the V-Fit or the V-Sculpt from Joylux and this is a red light therapy device that has red light and infrared heat. The heat can be really soothing and help people relax as well.
Kim Vopni (18:38.769)
and the sonic vibration. we can use the vibration to, if we were doing Kegels with the vibration to kind of help get more recruitment, but from a relaxation perspective and we wanting to release tension, inserting the device, enjoying the heat, but also the vibration can help elicit a relaxation response and get things flowing again. So those are a couple of things that I recommend for at home self care, not to replace a pelvic floor physical therapist, but.
Some people may not have access to a pelvic floor PT, so those could be some devices that people could use at home for releasing kind of trigger points, helping mobilize scar tissue, and helping try to elicit that relaxation response. Heat is something that I do think is beneficial, and that could be heat in the form of red lights, so even red light therapy panels, or there are some that are pads that you can hold over your vulva externally. That could be potentially beneficial.
warm baths, saunas, those could also help kind of get you in that down regulation state. You could even do, if you have a big enough sauna, you could do some of your stretches in there. Another thing is hypopressives. So hypopressives is also called low pressure fitness. And it has a really good way of kind of down regulating our nervous system. And it's a breath practice, it's a posture practice, all of which can in turn over time,
lead to less tension in the pelvic floor as well. So those are kind of the top ones. One final thing I would say is if you are having painful sex and it can be sometimes because of tight muscles, it can sometimes be because of prolapse if there's some discomfort with that insertion, it can sometimes be low estrogen and lack of moisture and suppleness in the tissues. So using a moisturizer,
using a lubricant for sexual activity and using vaginal estrogen are also ways to help because if we have painful sex because of low estrogen or low tissue suppleness, that is going to create pain, which we will then guard against, which could indirectly be contributing to tightness in the pelvic floor as well. So there you have it, some of the most common signs of tightness in the pelvic floor.
Kim Vopni (21:00.782)
some of the reasons why we develop that, and then of course, what you can do about it. So I hope you enjoy this episode. We'll see you next week.
