The 7 best pelvic floor stretches to help relax tight pelvic floor muscles
Pelvic floor stretches can help reduce pain and symptoms due to tight pelvic floor muscles. Find relief with these PT-recommended pelvic floor stretches.
Table of Contents
Key Takeaways:
Tight pelvic floor muscles can be caused by stress, holding in urine or bowel movements, or weakness in nearby muscles like the hips, core, and lower back.
Gentle movement and regular stretching can help relax tense pelvic floor muscles and ease discomfort.
Simple pelvic floor stretches can help relieve symptoms and support relaxation (see videos below).
If your pelvic floor is both tight and weak, which is common, physical therapists address the tightness first, before strengthening work like Kegels.
Hinge Health offers virtual physical therapy and more to help you manage pelvic floor issues. Learn more.
To build your biceps, you pick up dumbbells. To work your quads, you’re all about the lunge. And to strengthen weak pelvic floor muscles, your go-to is Kegel exercises, which can help improve bladder and bowel control and sexual health.
But for any muscle to be healthy and function properly, it needs to be both strong and flexible. That applies to the muscles in your arms, legs, and particularly those in your pelvic floor. In fact, some pelvic floor problems (like pelvic pain, trouble emptying your bladder and other symptoms) can be related to pelvic floor muscles that are too tight, or hypertonic. In this case, you might need to relax and lengthen your pelvic floor muscles before you strengthen them. Read on to learn about what can cause tight pelvic floor muscles and the best pelvic floor stretches physical therapists recommend to help relax and loosen your pelvic floor muscles.
Why pelvic floor muscles need to relax
Your pelvic floor is a group of muscles and connective tissues that stretches from your pubic bone in the front to your tailbone in the back. It helps support the pelvic organs, such as your bladder and rectum, and plays a role in bladder and bowel control and sexual function.
Just like any other muscle in your body, your pelvic floor muscles can become too tight. Our muscles are designed to both contract and relax, and your pelvic floor is no different. For it to function properly, you need to be able to tighten the muscles when needed and then fully relax and release them. When the pelvic floor muscles stay tight or have difficulty relaxing, it can contribute to a variety of pelvic health symptoms, including pelvic pain, painful sex, constipation, certain types of urinary incontinence, trouble emptying your bladder, and needing to pee urgently and often.
Benefits of pelvic floor relaxation
Helping tight pelvic floor muscles relax and lengthen may ease symptoms and make everyday activities more comfortable. Benefits may include:
Reduced pain in the pelvic area, lower back, hips, or bladder
Less discomfort with urination or bowel movements
More comfortable sex
Improved bladder and bowel control
Fully Covered Pelvic Care
Pelvic Floor Stretches
Also known as deep belly breathing, slow, deep breathing can help lengthen the muscles in your pelvic floor so they remain flexible.
Think of your diaphragm (the muscle that sits on top of your rib cage) and pelvic floor as dance partners: They move together with each breath. As you inhale, your diaphragm moves downward, and your pelvic floor gently drops and lengthens. Try to feel (or even just visualize) your pelvic floor descending to help enhance the stretch. As you exhale, both rise back toward their resting position. This natural rhythm can help you practice relaxing your pelvic floor, which can help release tension.
How to do it:
You can perform this exercise in any position (sitting, lying, or standing). For your first time, it’s best to start by lying on your back with your knees bent and your feet flat on the floor.
Rest one hand on your chest and the other on your belly.
Now, slowly inhale as you fill your belly with air so your hand on your belly rises up towards the ceiling. The hand on your chest remains mostly still.
Focus on staying relaxed as you hold that breath in your belly.
Then, slowly breathe out so the hand on your belly lowers with you.
With each rep, you should feel your hand on your belly move more than the one on your chest.
This move stretches your inner thighs, hips, and pelvic floor muscles. The deep squat position gently opens up your hips and creates space through the pelvis, which can make it easier to release tension in your pelvic floor muscles. It can also improve hip mobility, easing any tension or discomfort from your pelvis and lower back.
How to do it:
Start standing with your feet a bit wider than shoulder-width apart and your toes turned slightly outward.
Lower your body by bending your knees and sending your hips backward, as if aiming for a very low seat or stool, until your hips are as low as they can go. (You can support yourself by resting your lower and mid back against a wall behind you.) You may feel like you are sitting between your feet.
Maintain the squat and place your elbows on the inside of your knees to create a passive stretch in your inner thighs, pelvic floor, and perineum (the area between your anus and genitals).
Consider extending your squat while practicing diaphragmatic breathing. Take 10 deep diaphragmatic breaths while relaxing your pelvic floor (it should feel like you’re trying to pass gas).
Slowly return to your starting stance.
This stretch helps improve flexibility in your hips, glutes (butt muscles), and lower back. Because these muscles work closely with your pelvic floor to support movement and stability through your pelvis, keeping them mobile may help reduce tension throughout the surrounding area. The lying position also makes this a gentle, supported way to open your hips.
How to do it:
Lie on your back and bring the foot/ankle of one leg to rest on top of your opposite knee. This is sometimes called a Figure 4 stretch.
Loop your hands around the back of your other thigh or knee and bring your knees up toward your chest.
Hold for 20 seconds. Repeat on the other side.
The hip flexors are a group of four muscles along the front of your upper thigh. Sitting for long periods of time can make these muscles feel tight. When that happens, it can pull your pelvis into a forward-tilted position. That puts pressure on the pelvic floor, increasing tension in these muscles.
How to do it:
Start by kneeling on a soft surface (i.e., a yoga mat or pillow).
Put your left leg out in front of you so your left knee sits directly over your left ankle and your right knee is underneath your right hip.
Slowly lean forward, gradually stretching into the front of your hip.
Stop when you feel a comfortable stretch.
Hold for 15 (or more) seconds and then return to the starting position.
Repeat two to three times on each side.
Many people carry tension in their hips. The happy baby exercise opens up your hips and stretches your deep pelvic floor muscles. It can help reduce pelvic pain, decrease the urge to urinate, and improve constipation.
How to do it:
On a yoga mat, lie on your back with your knees bent and your feet flat on the floor.
Now, draw your knees up toward your chest, and reach your hands to grab the outside of your feet or ankles.
Move your legs gently apart, stopping when you feel a gentle stretch in your inner thigh muscles. Breathe deeply and slowly. Focus on relaxing your pelvic floor muscles as you hold this position.
Relax back to the starting position.
As you do each rep, you should feel a stretch in your hips and inner thigh area.
This forward-bending stretch helps improve flexibility and mobility in your back and pelvis. As you sink your hips toward your heels and breathe deeply, the supported position can help ease tension throughout your lower back and pelvic area. Pairing child’s pose with slow, diaphragmatic breathing can also encourage your pelvic floor muscles to gently release tension with each inhale.
How to do it:
Get into a comfortable kneeling position with your shins and feet flat on the floor.
Sit your hips back toward your heels with your feet together and your knees wide apart.
Slide your arms out in front of you on the ground while moving your hips toward your heels.
Relax your head and chest down toward the floor as far as is comfortable for you.
Take slow, deep breaths as you hold this position.
Walk your hands back toward your knees and return to an upright position.
The butterfly stretch gently opens your hips and inner thighs, areas that work closely with your pelvic floor. Pairing the stretch with slow belly breathing can make it easier to focus on releasing tension throughout the pelvis.
How to do it:
On a yoga mat, lie on your back with your knees bent and your feet flat on the floor.
Bring the soles of your feet together, allowing your knees to fall comfortably out to your sides and toward the floor.
Take slow, deep breaths and focus on relaxing your hips and pelvic floor as you hold this position.
As you do this exercise, you might feel a gentle stretch in your groin area and inner thigh muscles.
The above exercises recommended by Hinge Health pelvic floor physical therapists can help relax pelvic floor muscles and reduce symptoms from pelvic floor muscle tension.
The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.
Pelvic floor physical therapy is more than just kegel exercises. Various exercises tailored to your symptoms and needs are key to getting relief. Pelvic floor PT can relieve many different pelvic issues, such as pelvic pain, painful sex, and urinary incontinence.
Members of the Hinge Health pelvic health program experience an average 67% reduction in pelvic pain and 54% reduction in urinary incontinence within the first 12 weeks. Learn more*.
Causes of Pelvic Floor Tightness
Pelvic floor tightness may be due to many different factors. One common reason is holding tension in your pelvic floor, similar to how some people carry stress in their neck, shoulders, or back. Other factors include frequently delaying urination or bowel movements or injury to your pelvic floor.
The health of nearby muscles may play a role, as well. Pelvic floor muscles work closely with your hip, core, and low back muscles. If any of those areas are weak, unstable, or not functioning well, your pelvic floor muscles may need to compensate — which can make them tense and tight.
Certain health conditions may also contribute to pelvic floor tension, including irritable bowel syndrome (IBS) and interstitial cystitis, also known as painful bladder syndrome.
Symptoms of a tight pelvic floor
Wondering how to know if your pelvic floor is tight? Symptoms can vary and may overlap with other pelvic health conditions. They may include:
Pelvic pressure or discomfort, especially after sitting for a long time
Pain with urination, during bowel movements, or during or after sex.
Difficulty starting a bowel movement
Feeling like you’re straining when pooping, or are unable to empty completely
Difficulty starting a stream of urine
Slow urine stream
Feeling like your bladder hasn’t emptied completely
Urinary urgency and frequency (feeling like you need to pee right after you go)
Urinary incontinence (having a sudden urge to urinate, followed by leaking pee)
Pelvic muscle spasms or cramping
Lower back, hip, or tailbone pain without a clear cause
Note: Because these symptoms can have many causes, they don’t necessarily mean your pelvic floor is tight. A healthcare provider or pelvic floor physical therapist can help determine what may be contributing to your symptoms.
How pelvic floor therapy helps tight pelvic floor muscles
Pelvic floor physical therapists will evaluate your symptoms and determine the appropriate exercise therapy plan to best address them. If your pelvic floor muscles are both tight and weak — which is common — PTs will address the tightness first.
“Trying to strengthen an overly tight muscle could worsen your symptoms,” says Kandis Daroski, PT, DPT, a Hinge Health pelvic floor physical therapist. “If you spend all day doing bicep curls, after a while your arm would ache and not work as well. You would need to relax and stretch, or lengthen, the bicep before doing anything else.” The same is true with your pelvic floor muscles, explains Dr. Daroski. PTs can help you lengthen these muscles — with effective pelvic floor stretches — before you strengthen them.
Pelvic floor physical therapy is a comprehensive treatment that may include exercise, education, behavioral and lifestyle strategies, and manual therapy.
Depending on your symptoms, a pelvic floor physical therapist may also suggest strategies that support your overall pelvic health, such as:
Stress management techniques, including mindfulness meditation or talk therapy
Nutrition changes, such as adding more fiber to support bowel health
Sleep strategies, such as adjusting your sleep routine or incorporating sleep hygiene habits
You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT who specializes in pelvic health via telehealth/video visit.
When to see a doctor
Tight pelvic floor symptoms may improve with targeted stretches, breathing exercises, and other lifestyle strategies. But if your symptoms are severe, getting worse, or making it difficult to go about your day, talk to a healthcare provider or pelvic floor physical therapist. It’s also a good idea to get care if you notice:
Tightness or pain that is persistent, worsening, or affecting daily life
Pain with sex, urination, or bowel movements
New bladder or bowel changes, including leakage, constipation, or difficulty emptying
Severe or sudden pain, heavy bleeding, fever, or dizziness/fainting
These symptoms can overlap with other pelvic health conditions, so an evaluation can help you better understand what’s going on and what type of treatment may be best for you.
PT tip: Kegels aren’t for everyone
Kegels can be helpful when pelvic floor muscles need strengthening, but they aren’t the right starting point for everyone. If your pelvic floor is already overly tight, repeatedly contracting those muscles may worsen your symptoms.
“There is a time and place for them in your program,” says Sarah Fogle, PT, DPT, a pelvic floor physical therapist at Hinge Health. “I have people avoid Kegels until I know they can relax or drop their pelvic floor. Once they can do that, then we can start Kegels and strengthening exercises. Think of your body like a three-legged stool: it needs a balance of strength, mobility, and flexibility.”
A pelvic floor physical therapist can help determine whether your muscles need more strength, more relaxation and mobility, or a combination of both.
Frequently asked questions
What does a tight pelvic floor feel like?
A tight pelvic floor can feel like pressure, aching, cramping, or tension in your pelvis, hips, lower back, or tailbone. You may also notice symptoms when urinating, having a bowel movement, or having sex. Because these symptoms can overlap with other conditions, a healthcare provider or pelvic floor physical therapist can help identify the cause.
How do you know if your pelvic floor is tight or weak?
It can be difficult to tell based on your symptoms alone because pelvic floor muscles can be tight, weak, or both at the same time. Difficulty relaxing to urinate or have a bowel movement, pelvic pain, or discomfort with sex may point to excess tension, while leaking can occur with several types of pelvic floor dysfunction. An evaluation with a pelvic floor physical therapist can help clarify what your muscles need.
What causes a tight pelvic floor?
Pelvic floor muscles can become tight for many reasons, including stress and muscle guarding, repeatedly delaying urination or bowel movements, pelvic injury, and changes in nearby muscles of the hips, core, or lower back. Conditions such as IBS or painful bladder syndrome may also contribute.
Can Kegels make a tight pelvic floor worse?
In some cases, they can. Kegels involve repeatedly contracting the pelvic floor, so doing them when those muscles are already overly tight may worsen some symptoms. If you aren’t sure whether your pelvic floor needs strengthening or relaxation, a pelvic floor physical therapist can help you determine the right approach.
Can a tight pelvic floor cause bloating or constipation?
Tight pelvic floor muscles can contribute to constipation by making it harder for the muscles to relax and coordinate during a bowel movement. Bloating can have many causes, so if it’s something you regularly experience or comes with other symptoms, talk to your healthcare provider.
How Hinge Health can help you
If you have pelvic pain, bladder, bowel, or other pelvic symptoms that are affecting your quality of life, you can get the relief you've been looking for with Hinge Health’s online exercise therapy program.
The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you. Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.
See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.
This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.
References
1. Faubion, S. S., Shuster, L. T., & Bharucha, A. E. (2012). Recognition and Management of Nonrelaxing Pelvic Floor Dysfunction. Mayo Clinic Proceedings, 87(2), 187–193. doi.org/10.1016/j.mayocp.2011.09.004
2. Grimes, W. R., & Stratton, M. (2021). Pelvic Floor Dysfunction. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559246/
3. Shaheed , H. (2019, June 13). The hypertonic pelvic floor. Continence Foundation of Australia. https://www.continence.org.au/news/hypertonic-pelvic-floor
4. van Reijn-Baggen, D. A., Han-Geurts, I. J. M., Voorham-van der Zalm, P. J., Pelger, R. C. M., Hagenaars-van Miert, C. H. A. C., & Laan, E. T. M. (2021). Pelvic Floor Physical Therapy for Pelvic Floor Hypertonicity: A Systematic Review of Treatment Efficacy. Sexual Medicine Reviews, 10(2). doi:10.1016/j.sxmr.2021.03.002