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Understanding Pelvic Floor Pain

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If your calf muscles ache after you go running for the first time in months, it’s pretty clear why. It’s not that surprising if your back throbs after you spend all day lifting boxes. But not every cause, or even location, of pain is so obvious — especially when it comes to your pelvic floor.

Your pelvic floor is a group of muscles that is shaped like a bowl at the bottom of your torso, stretching from the pubic bone in the front to the tailbone in the back. Just like the muscles anywhere else in your body, those in your pelvic floor can develop pain too.

Not many people are familiar with pelvic floor pain. Approximately 15% of women of childbearing age in the United States report chronic pelvic pain symptoms.1 (But it can affect anyone — men and women, regardless of age.) Pelvic floor pain is part of this umbrella category, which could also include conditions like endometriosis (when uterine tissue grows outside the uterus), fibroids (benign growths in the uterus), or infection.

Pelvic floor pain refers to issues with your pelvic floor muscles, such tightness or tension. This can make it hard for your pelvic floor to relax and perform such usual functions as helping you go to the bathroom. Pelvic floor pain can disrupt your life, including your ability to work, socialize, and be intimate with your partner. But it is treatable with a combination of lifestyle changes, exercise, and physical therapy.

What Are the Signs of Pelvic Floor Pain?

Pelvic floor pain can present in a number of ways, such as:

  • Pain during urination or bowel movements

  • Pain during gynecological exams

  • Pain inserting or wearing tampons

  • Pain during intercourse

  • Pain while sitting, riding a bike, or wearing tight-fitting clothing

  • Pain or heaviness deep inside your pelvis

Pelvic floor pain might feel like dull aching or be sharp and crampy. It can come and go or stay steady.

What Causes Pelvic Floor Pain?

Pelvic floor pain is often related to a combination of factors, such as:

  • Stress, which can increase muscle tension in the pelvic floor

  • Overuse or injury in the pelvic area (e.g., trauma with childbirth, falls)

  • Other orthopedic issues (e.g., sacroiliac joint pain, hip labrum tears)

  • Imbalance in strength and flexibility of muscles around the pelvis

  • Certain conditions (e.g., interstitial cystitis, vulvodynia, endometriosis)

  • Emotional trauma (e.g., history of abuse, sexual shaming)

How Do You Relieve Pelvic Floor Pain?

Try these tips, noting which ones work best for you, and keep track of changes in your pain levels.

Ask your Hinge Health physical therapist or coach to work with you on:

  • Deep belly breathing. Also known as diaphragmatic breathing, deep belly breathing helps you relax your pelvic floor and nervous system.

  • ‘Reverse’ Kegel exercises which relax, stretch, and lengthen your pelvic floor muscles.

  • Pelvic floor stretches, which help reduce tension in the pelvic floor muscles.

Use supportive pillows (to sit on or place behind your back) that are designed to relieve pelvic pain, such as a pressure relief seat cushion or a donut pillow.

Move into a position that relaxes your pelvic floor. You can try lying with your legs elevated up on a wall or with your hips on top of a bolster pillow for 15-20 minutes.

Consider self-therapeutic massage of the pelvic floor. Ask your PT if this is right for you.

Perform a body scan. Unclench your buttocks and let your belly relax. “Sucking in” your abdomen all day can lead to pelvic tension and pain. Reach out to your PT or coach for guidance on how to do this.

Experiment with relaxation techniques, such as yoga, Tai Chi, guided meditation or journaling. These help reduce stress that contributes to pelvic floor pain.

Practice good sleep hygiene, such as limiting screen time in the evening, reducing stimulant intake throughout the day, and doing calming activities before bed.

As with any new symptom, it’s important to see your provider to rule out possible causes that can lead to pelvic floor pain.

Living with pelvic floor pain can be emotionally draining, but you’re not alone and it is treatable. Seek support from a therapist, a loved one, or someone on your Hinge Health care team if you need support or experience any emotional distress associated with your pain.

Key Takeaways

  1. Pelvic floor pain occurs because of issues with pelvic floor muscles, such tightness or tension.

  2. Pelvic floor pain is usually due to many factors, such as stress, overuse or injury (such as during pregnancy and birth), or related orthopedic issues in the hips or back.

  3. Lifestyle changes can help relieve or eliminate pelvic floor pain symptoms, such as pelvic floor exercises and mindfulness techniques.

References

  1. Chronic pelvic pain in women - Symptoms and causes. (2019). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/chronic-pelvic-pain/symptoms-causes/syc-20354368

  2. How many women have pelvic pain? (2017, January 31). NIH National Institute of Health. https://www.nichd.nih.gov/health/topics/pelvicpain/conditioninfo/howmany

  3. Pelvic pain: know the different causes and when to seek help. (n.d.). Jean Hailes. https://www.jeanhailes.org.au/news/pelvic-pain-know-the-differences-and-when-to-seek-help

  4. Seehusen, D. A., Baird, D. C., & Bode, D. V. (2014). Dyspareunia in Women. American Family Physician, 90(7), 465–470. https://www.aafp.org/afp/2014/1001/p465.html