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Physical Therapy | Women's Health

Hypertonic vs. Hypotonic Pelvic Floor Muscles: How Physical Therapy Can Help

June 15th, 2022 | 3 min. read

Hypertonic vs. Hypotonic Pelvic Floor Muscles: How Physical Therapy Can Help
Kelsey Harms

Kelsey Harms

Licensed Physical Therapist, PT, DPT // OCS Orthopedic Certified Specialist // Certified Dry Needling Specialist // EW Motion Therapy Homewood

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If you are experiencing issues with incontinence and pain during intercourse or gynecological exams, you might be unsure of where to go for treatment or even what is wrong with you in the first place. Your pelvic floor includes the muscles around your pelvis that provide support and stability, which helps to regulate bladder and bowel function. That muscle network may be the primary culprit responsible for the incontinence or pain you feel. So should you see a doctor or figure out other treatment options you can pursue? 


Figuring out whether your pelvic floor muscles are more naturally tight or weak can be essential to receiving the correct treatment and finding more ease in your daily activities. A pelvic floor physical therapist is one of the specialists who can help you better understand your pelvic health. Our physical therapists at EW Motion Therapy are experts in the science of movement and want to help you overcome pelvic floor dysfunction so you can move and feel better. This article will ultimately educate you on the difference between hypertonic and hypotonic pelvic floor symptoms and how physical therapy can be an excellent treatment option, even if you choose not to pursue physical therapy with us. With this information, you can choose the best treatment option for you and begin to restore your pelvic floor function.


What’s the difference? 

The prefixes hyper- and hypo- typically indicate high and low, respectively, and that definition applies here. When you have a hypertonic pelvic floor, that indicates increased muscle tone in your pelvic floor, which means that it naturally is tighter. If your pelvic floor is hypertonic, you may have more trouble relaxing and you may experience pain during intercourse. 


On the other hand, if you have a hypotonic pelvic floor, that means you have low muscle tone, and your pelvic floor muscles do not have the strength to properly position and stabilize your pelvis to support good bladder/bowel function. You may have symptoms of incontinence and regular leakage when you exercise, or even when you cough.


How does each affect daily function? 

Any incontinence-related symptom is not fun to deal with, especially if it becomes a barrier to you doing your favorite activities. With a hypertonic pelvic floor, you may have increased pelvic pain while trying to insert tampons or during gynecological exams. Pain from holding tension in your pelvic floor muscles is similar to some people having neck pain from holding tension in their shoulders. People with a hypotonic pelvic floor usually experience more incontinence symptoms, whether you are trying to exercise or simply go up and down stairs. Both of these bodily predispositions can affect your daily routine in many ways, and it is important to find the treatment option that best addresses your needs. 


How can physical therapy help? 

If you go to physical therapy for your pelvic floor dysfunction, there is a lot of education involved. Your therapist will talk about your lifestyle and daily routine to determine whether your pelvic floor muscles are more hypertonic or hypotonic. With hypertonic pelvic muscles, they want to determine what might be causing the tension, whether it is your natural anatomy or it is a stress response. From there, they will teach you exercises to stretch and relax your pelvic floor, including breathing exercises and some manual stretches. For hypotonic pelvic muscles, your therapist may want you to begin keeping a bladder diary, to find patterns in times of day with more leakage or whether you are drinking enough water. Since your pelvic floor is the base of your core, your therapist will do some strengthening exercises with you, including kegels, in order to help you better engage your core. 


What are other treatment options? 

Now you know more about how physical therapy can help issues related to hypertonic or hypotonic pelvic floor muscles. If you try physical therapy and are not seeing the results you want, your doctor may offer medications you can take for incontinence symptoms, and you can try modifying your diet to cut out bladder irritants. Some people try to live with their incontinence symptoms or pelvic pain, but both can eventually become larger issues down the road if not treated properly. 


Any kind of pain can be a barrier to you living your fullest life, and for anyone with pelvic floor issues, there are many areas of life where you are limited. But with the right treatment, you can get back to doing your favorite activities with less pain or leakage. When you can meet with a physical therapist concerning your pelvic floor issues, they can help you receive the right treatment to feel and live better. If you are interested in physical therapy with us, fill out the Request an Appointment form on our website, and someone from our staff will contact you within 48 hours with your next steps.