Hypertonic or Overactive Pelvic Floor in Men

Physiotherapy management of Hypertonic or Overactive Pelvic Floor in Men

The pelvic floor muscles play a crucial role in supporting the pelvic organs and maintaining urinary and bowel control in men, however sometimes these muscles can become hypertonic, or overly tense and tight, leading to a condition known as hypertonic pelvic floor. This can lead to a multitude of unusual symptoms around your pelvic floor, pelvis, genitals, and anus as muscle become too tense.

What are the causes of a Hypertonic Pelvic floor?

There can be various factors contributing to the development of hypertonic pelvic floor in men. Some of the most common causes include:

Chronic stress and anxiety: Psychological factors, such as long-term stress or anxiety, can lead to increased muscle tension throughout the body, including the pelvic floor.

Pelvic floor muscle dysfunction: Poor coordination or overactive contraction of the pelvic floor muscles can result in hypertonicity. This dysfunction can be a result of habits like excessive straining during bowel movements, holding urine for extended periods, or repetitive activities that strain the pelvic floor muscles.

Pelvic pain: Conditions like chronic prostatitis and chronic pelvic pain syndrome can cause pelvic floor muscles to become hypertonic as a response to ongoing pain or inflammation in the pelvic region.

Poor sitting posture: Sitting in a poorly supported chair (soft chair with no lumbar support or lounge) or sitting for excessive periods in a day (office work) can contribute to increased postural muscle tension and a “butt gripping” posture which further tilts the pelvis backwards and puts stress on the pelvic structures and pelvic floor.

Poor standing posture: This can lead to postural stress on the spine and pelvis contributing to poor core muscles and overactivation of muscles around the hip and pelvis. This is associated with low back pain.

Childhood History of abnormal bladder or bowel habits (“holding on” too long) or childhood trauma or stress associated with toileting or persistent bed wetting.

Poor Exercise technique especially with strength training and excessive weightlifting with overactivation of muscles around the hips and pelvis or repetitive exercise in wrong postures.

general exercise prescription for men

Symptoms of a Hypertonic Pelvic floor in men

Men experiencing hypertonic pelvic floor may present with a range of symptoms, which can vary in intensity and duration. These symptoms may include:

Pelvic pain: Discomfort or pain in the genital or pelvic region, which can be persistent or intermittent. The pain may radiate to the lower back, abdomen, groin, or perineum.

Urinary symptoms: Increased urinary frequency, urgency, hesitancy, or a feeling of incomplete bladder emptying and possible urinary incontinence.

Bowel symptoms: Constipation, straining during bowel movements, or pain during or after bowel movements, poor bowel habits, increased frequency of bowel opening, and anxiety associated with toileting.

Sexual dysfunction: Erectile dysfunction, pain with erection, pain during sexual intercourse (dyspareunia), or reduced sexual desire.

Musculoskeletal symptoms: Lower back pain, hip pain, or muscle spasms in the pelvic region and pain and spasm around the perinium or genital / anal region.

Management of a Hypertonic Pelvic Floor

Men’s health physios at East Gosford Physiotherapy can help men learn techniques to relax and “release” the tense pelvic floor muscles through manual therapy, biofeedback, stretching exercises, and relaxation techniques. We offer trigger point therapy, dry needling, and massage to reduce muscle tension in the pelvis and hips.

Your doctor may advise medications such as muscle relaxants, anti-inflammatory drugs, or pain relievers to alleviate symptoms and promote muscle relaxation and can work in conjunction with Physiotherapy.

Stress reduction techniques like deep breathing exercises, mindfulness meditation, and gentle exercise and movements can help in managing chronic stress and anxiety, which can contribute to hypertonic pelvic floor. East Gosford Physio has developed a program called the Chill Out Zone to help patients use breathing, relaxation, and gentle pelvic movement to help reduce stress and anxiety by dealing with the part of your brain which is responsible for “flight or fright” and the muscle tension associated with this. See the link for demo of Chillout zone in video to the left.

Adopting healthy habits such as maintaining regular bowel habits, avoiding constipation, and practicing proper techniques for urination can help in reducing pelvic floor muscle tension.

There is help out there for you
Hypertonic pelvic floor can significantly impact the quality of life for men, causing various uncomfortable symptoms. Recognizing the signs and seeking appropriate medical and physiotherapy attention is crucial for proper diagnosis and treatment. With advice and education from a Men’s Health physio who is expertly trained in managing the male pelvic floor, they are able to help with relaxation and gentle exercise, lifestyle modifications and behavioural change, so men can find relief from the symptoms and regain normal function of their pelvic floor muscles.

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