Pelvic Floor Muscle Hypertonia

In this condition, pelvic floor muscles are contracted, tense and weak. Blood flow is restricted, which can cause an acidic environment in the area and this, in turn, can create an inflammatory cascade. When this “inflammatory soup” is generated, it’s harmful to the region’s muscles and nerves. The muscles become tender and the nerves begin to fire inappropriately, causing subconscious chronic pain and tensing of the pelvic floor.  Endometriosis is another factor that could lead to pelvic floor hypertonia.

What Is Pelvic Floor Muscle Hypertonia?

Hypertonia is defined as tight muscle tone and reduced capacity of the muscle to stretch when pelvic floor muscles are contracted, tense and weak, blood flow is restricted and oxygenation is reduced. In fact, a 10% increase in pelvic floor muscle contraction can cause up to a 50% decrease in blood flow and oxygen supply. This restriction can create an acidic environment in the area. That, in turn, can lead to an unhealthy inflammatory cascade.

This negative cycle produces a mixture of inflammation. The region’s muscles and nerves begin deteriorating. The muscles become tender and the nerves begin to fire inappropriately, causing chronic pain.

This visual is an easy depiction of contracting muscles of the pelvic floor. It’s showing how contractions can make the physical openings smaller causing painful intercourse, constipation and many other functions that interact with the pelvic floor muscles.

Our treatment protocols aim to bring relief to the contracted or tightness occurring in the pelvic floor which can drastically improve many problem areas in the body.

Hypertonic Pelvic Floor Symptoms & Conditions

A hypertonic pelvic floor is a constantly contracted pelvic floor. This constant contraction puts the uterus, bladder, bowel and other structures under enormous amounts of pressure. This can lead to:

  • Incontinence
  • Pelvic tilt
  • Hip instability
  • Weak core muscles
  • A lack of upper body strength

Several painful conditions can also result including painful sex, pain when sitting, constipation and rectal fissures, among others.

 

Pelvic Floor Muscle Hypertonia Causes

  • Gynecological: Endometriosis, Fibroids, PCOD, Pelvic Inflammatory Disease, Pregnancy
  • Genitourinary: Interstitial Cystitis, Cystocele, Prostatitis, Sexually Transmitted Disease
  • Gastrological: Irritable Bowel Syndrome, Chrons Dz, Ulcerative Colitis
  • Colorectal: Hemorrhoids, Anal Fissure, Proctalgia Fugax, Hx Colectomy
  • Neurological: Pudendal Neuralgia, Migraines, HSV, Shingles, MS
  • Rheumatic: Ankylosing Spondylitis, Fibromyalgia, Connective Tissue Disorder with Hypermobility
  • Musculoskeletal: Labral Tear Hip, Lumbar Radiculopathy Coccyx Injury

Pelvic Floor Muscle Hypertonia Risk Factors

  • Diagnosis of Abacterial Prostatitis
  • Hip Impingement
  • Pelvic Floor Muscle Hypertonia
  • Joint Hyper Mobility
  • Labral Tear
  • STD/UTI/Yeast Infection History
  • Hermia
  • Post Partum
  • Diastasis Recti
  • Interstitial Cystitis
  • Over Active Bladder
  • Prolapse
  • Hip Impingement
  • Joint Hyper Mobility
  • Labral Tear
  • STD/UTI/Yeast Infection History
  • Hernia
  • Post Partum
  • Diastasis Recti
  • Interstitial Cystitis
  • Over Active Bladder
  • Prolapse
Instead of doing the work of deep abdominal activity, many patients try to keep their stomachs flat by pulling or “sucking” in their abdomens and think they are using their muscles effectively. In reality, the pulling motion creates pressure that pulls the abdomen’s contents up, not in. This presses the internal organs uncomfortably up against the diaphragm while weakening the pelvic region.

Meet Pelvic Rehabilitation Medicine

At Pelvic Rehabilitation Medicine, we treat whole human beings, not symptoms. In the body, everything is connected; and the pelvic region is the vital center of the body’s connected functioning. Our physicians take an innovative approach, combining traditional medicine with holistic modalities and restorative and regenerative medicine. We treat both male and female patients who experience core muscle and nerve problems; chronic pelvic pain; and pelvic floor muscle dysfunction. Learn More »

Relevant Publications/Citations

Shrikhande A, Ahmed T, Shrikhande G, Hill C. A Novel, Non-Opiod Based Treatment Approach to Men with Urologic Chronic Pelvic Pain Syndrome (UCPPS) Using Ultrasound Guided Nerve Hydrodissection and Pelvic Floor Musculature Trigger Point Injections. The International Continence Society. 2018 Aug. Link to Article.

Allyson Augusta Shrikhande, MD. Interviewee on Pelvic Health Summit - CPPS. Pelvic Health Summit. 2018 May. Link to Interview.

Allyson Shrikhande, MD sits as the chair of the Medical Education Committee for the International Pelvic Pain Society. Link to Medical Committee.

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