Hypertonic pelvic floor is a condition where the muscles in the lower pelvis have a higher resting tone and difficulty relaxing. This can cause several symptoms that affect bladder and bowel function.

Muscle tone defines the amount of tension and resistance to movement in a muscle or muscle group.

Hypertonic pelvic floor may affect a person’s daily function. However, treatment is often effective in reducing condition severity and improving quality of life.

This article details the causes, symptoms, and treatments of hypertonic pelvic floor.

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Hypertonic pelvic floor is a medical condition where the resting tone of the pelvic floor muscles is higher than typical levels.

The effects of this tone increase can be passive but may also lead to active contractions or spasms, which can affect the organs it supports.

Typically, hypertonic pelvic floor results in pain during intercourse and gynecological exams. Hypotonic muscles are also more likely to result in leakage. However, this depends on the person and their motor control and coordination.

The pelvic floor is a group of muscles and ligaments that support the following organs:

  • bladder
  • rectum
  • uterus
  • vagina
  • penis
  • prostate

The causes of pelvic floor dysfunctions are often unclear and vary between people. Potential causes include:

Complications from pregnancy can also cause hypertonic pelvic floor. Pregnancy-related causes include:

Learn more in our dedication pregnancy hub.

The most common symptom of hypertonic pelvic floor is pain or pressure in the pelvic region. People with the condition may experience pain only during certain activities, such as a gynecological exam or sexual intercourse.

Urinary symptoms include:

Bowel symptoms include:

Sexual symptoms include:

To diagnose hypertonic pelvic floor or other pelvic floor dysfunctions, a healthcare professional will assess a person’s symptoms and take a full medical history.

A physical examination will often include a visual inspection of the pelvic region, a digital rectal exam, and a pelvic exam.

Diagnosis after these physical assessments is common, but a healthcare professional may order further tests, including the following:

  • Anorectal manometry: To perform this test, a healthcare professional inserts a thin tube and balloon into the rectum, which they then inflate. This causes the muscles in the rectum to contract, providing a measurement.
  • Cystoscopy: In this procedure, doctors insert a thin camera into the bladder through the urethra. The resulting images can help assess bladder function and the effects of any conditions.
  • Electromyography: Doctors can place electrodes on the muscles of the pelvis and rectum to assess muscle function.
  • Defecography: This test involves packing the rectum with a thick barium paste and then having a bowel movement on a special toilet. During this, healthcare professionals will take X-ray or MRI imaging scans.
  • Urodynamic testing: This is a series of tests that collects data on urination, which help interpret how well the bladder works.

There are multiple treatment avenues for hypertonic pelvic floor, including physical therapy, medications, surgery, and therapy. Doctors will recommend the most effective treatment course on a case-by-case basis.

Typically, the primary treatment for the condition is physical therapy. The goal is to retrain the muscles through in-office and in-home treatments and exercises.

Treatment varies from person to person, and difficult-to-treat cases may take longer and usually require a team-centered approach.

Treating hypertonic pelvic floor may also include a referral to a:

At-home exercises can help reduce symptoms of hypertonic pelvic floor. Working with a physical therapist can help a person perform stretches exercises in the correct form. These include:

Learn more about the best exercises for the pelvic floor muscles and how to perform them.

Hypertonic pelvic floor is a condition where the pelvic floor muscles continuously contract or spasm.

The condition can cause painful symptoms, but physical therapy and other treatments can effectively treat it.