Why Is It Important To Find Out What Type Of Pelvic Floor You Have
Overactive or Underactive? Which one are you?
A lot of people assume that just because they have incontinence, then they must have a weak pelvic floor. That’s not always true. Often times, the symptoms of an underactive or weak pelvic floor are very similar to people who have an overactive pelvic floor. There can be pain associated with both, however it is more common to have pain associated with an overactive pelvic floor. You can also have incontinence with both types of pelvic floors.
So, when people go for a general exercise program where somebody automatically tells them, “Okay you need to kegel and do all the things,” that might not be the best way to go. You first need to understand which type of symptoms you are dealing with. Sometimes that can be accomplished with a self assessment, or an assessment by your provider either a therapist or physician. This is important, because if you fall into the overactive pelvic floor category, and you start with certain exercises, and begin kegeling with every rep: it can sometimes exacerbate your symptoms and make things worse. If you fall into an underactive pelvic floor, you could require different cueing in order to activate certain muscles to actually obtain a proper contraction of the pelvic floor. We also see a lot of uncoordinated pelvic floors, in which case you could be feeding into that incoordination and making already bad habits, even harder to stop.
Before we get into treating either kind of pelvic floor, you need to know what type of floor you’re actually working with.
The Ideal Condition
Our pelvic floor muscles should be able to support the internal organs, the bladder, bowel movement, and sexual activities. Further, a healthy pelvic floor must be reflexive as in there are equal amounts of contraction and relaxation. If one of these is not present, complications could arise. There are many factors that lead to weakening the pelvic floor muscles thus resulting to the lack of contraction and relaxation functions it needs to have.
When there is weakening of the pelvic floor muscles, it will result to an overactive or underactive pelvic floor. Neither of these conditions is good and both need to be addressed properly. With that, let’s check the differences between underactive and overactive pelvic floor and their symptoms.
The Differences And The Symptoms
Underactive Pelvic Floor
When you have an underactive pelvic floor, it means the muscles cannot hold or fully contract when they need to. The pelvic floor muscles are already weak and loose so they can no longer perform the proper urinary, bladder, and sexual functions they need to perform.
The symptoms you need to watch out for to know if you have an underactive pelvic floor includes:
- Leaking
- Heaviness after a workout
- Passage of gas
- Low back pain
- Hip pain
- Urinary and Fecal incontinence
- Frequent or urgent urination
- Painful sex
- little sensation during sex
- difficulty to achieve orgasm
These symptoms are usually observed in women who have just given birth or are nearing menopause. But to be honest, since pelvic health hasn’t really gotten the attention it deserved until more recent years, we see this is many women who had symptoms persist at their 8 week postpartum check up and never addressed…. and are still experiencing symptoms 40 years later. So even the 60 year old postpartum woman can still address these issues, it’s never too late.
Overactive Pelvic Floor
As for an overactive pelvic floor, the muscles constantly contract thus there will be pain, spasm, and increased tension in the pelvic floor area. Basically, the muscles in this area are working so hard without any rest and without any need to work hard. Because they are overworked, the muscles become exhausted and weak so they can no longer function properly.
When you already have an overactive pelvic floor, it can be worsened by factors like trauma or injuries during pregnancy and labor; frequent holding of urine and bowels; existing infection or inflammation; chronic stress, anxiety or fear; rigorous exercises; excessive Kegels; unhealthy lifestyle; obesity; pelvic-related surgery; sexual assault or abuse; and other abdominal or pelvic issues.
As for the symptoms, although you still need to check in with physical therapists or other health practitioners, you will find that these are the common indicators:
- Incontinence
- Painful urination or defecation
- Delayed start of urine flow
- Slow urine flow
- Inability or difficulty to empty the bladder and the bowels
- Constipation and frequent urination
- Painful sex and inability or difficulty to achieve orgasm
- Chronic pelvic or lower back pain even if you are sitting still
- Instability in the hip area
What Should You Do
Now that you know the differences and the symptoms of underactive and overactive pelvic floors, understand that these are not normal. There is a way to heal from all of these and you need to seek the help of physical therapists or other practitioners so they can give you an individualized plan as to what to do.
More importantly, do not feel ashamed or embarrassed when you have these conditions. Because SO. MANY. WOMEN…. AND MEN!!! DEAL WITH THESE CONDITIONS! And that’s OKAY! What is NOT OKAY, is hiding from them, hoping they go away or magically get better, when you can actually address them and improve them! What you need is to work with someone who specializes in treating pelvic floor disorders so you get the support and the treatment you really need!
I hope this helps someone out there understand their symptoms a little better and give them the confidence to talk with their providers and address these issues sooner rather than later. If you have any questions, don’t hesitate to reach out! I’m happy to help.