Headache in your pelvis - Overactive Pelvic Floor
Have you ever had a long day at the computer, typing away for hours on end, and your neck just gets tighter and tighter? You then try and move your neck side to side and it feels sore and restricted. Perhaps your neck tightness is starting to give you a headache, with pain referring into your temples. The same thing can happen with your pelvic floor.
Just like any muscle in your body, your pelvic floor can become tight and sore.
This is known as ‘increased pelvic floor tone’. There can be many reasons why your pelvic floor develops ‘increased tone’, such as physical and/or emotional stress.
The International Continence Society defines ‘Over-active Pelvic Floor’ as a situation in which the pelvic floor muscles do not relax well after a contraction, or contract when asked to relax, and/or are resistant to stretch and tender to touch.
The thing about the pelvic floor is that it has multiple functions. For instance, someone may suffer from a ‘cluster’ of symptoms if their pelvic floor has difficulty relaxing and instead becomes tense or contracts.
Difficulty emptying your bladder and bowel is just one of these symptoms. This can manifest as a delay to start the flow of urine, a stop/start flow, constipation, a feeling of a physical block at the back passage, and incomplete bladder/bowel emptying. If you’re not quite emptying your bladder fully, this can lead to bladder frequency and urgency and recurrent urinary tract infections (UTI).
Just like tight neck muscles can cause a headache, a tense and sensitive pelvic floor can also cause a headache, but in the area of your pelvis!
A headache in the pelvis can feel like period pain when you don’t have your period, UTI-like symptoms when your urine test is negative, IBS and bloating, genital pain, pain with sex, pain with inserting tampons or pain with internal vaginal examinations.
Your GP, specialist or pelvic floor physio may diagnose you with an ‘Over-active Pelvic Floor’ when any of the above symptoms are combined with specific pelvic floor assessment findings. Your health professional with your consent may wish to perform an internal vaginal examination to assess your pelvic floor.
The overall prevalence of ‘Over-active Pelvic Floor’ in the community is unknown. However, a recent study found that it typically occurred in younger women, with a higher incidence in those with pelvic pain (81.6%), recurrent UTIs (62.1%), and bladder frequency, urgency and urge incontinence (42%).
An ‘Over-active Pelvic Floor’ has a slightly different treatment regime to an ‘under-active Pelvic Floor’. But sorry to disappoint ladies – those with over-activity still need to do their pelvic floor exercises! However, these exercises will be focused more on “relaxation” post contraction and often incorporates breathe work, meditation, stretching and exercise rehabilitation.
YES – exercise is KEY in the management of over-active pelvic floor. It’s important to not only maintain your general health and fitness but also to learn how to move well. Ensuring your body functions well will encourage your pelvic floor to relax better.
The trick is to have “ballerina” muscles, i.e. your muscles should be strong, turn on when you need them to and at the right intensity, and then turn off when not needed. Your muscles should also be flexible, and be able to lengthen to allow for a good range of motion and blood flow throughout your body.
For some people with overactive pelvic floor, certain forms of exercise such as high intensity training, running, weight lifting, cycling, and/or heavy core and glute work may worsen their symptoms. Signs that your exercise regime may be currently too much for you is an increase in pelvic pain during or after exercise, or an increase in your pelvic floor dysfunction symptoms (such as the symptoms mentioned earlier).
In this case, adding in a thorough stretch regime before and after exercise may be advisable. Others may need to modify their exercise regimes by either reducing the amount, the intensity or the style of exercise they are doing. Some great alternatives to high intensity exercise is walking, cross-trainer, swimming, yoga or Pilates.
If you suffer from ‘Overactive Pelvic Floor’ symptoms talk to your health professional to gain insight on your pelvic floor and get on the road to a happy, strong, yet flexible pelvic floor!
REFERENCES
MESSELINK B, BENSON T, BERGHMANS B, BØ K, CORCOS J, FOWLER C, LAYCOCK J, LIM PH, VAN LUNSEN R, Á NIJEHOLT GL, PEMBERTON J, WANG A, WATIERT A, VAN KERREBROECK P. STANDARDIZATION OF TERMINOLOGY OF PELVIC FLOOR MUSCLE FUNCTION AND DYSFUNCTION: REPORT FROM THE PELVIC FLOOR CLINICAL ASSESSMENT GROUP OF THE INTERNATIONAL CONTINENCE SOCIETY. NEUROL URODYN. 2005;24(4) 374-380.
AW H, RANASINGHE W, TAN P, O'CONNELL H. OVERACTIVE PELVIC FLOOR MUSCLES (OPFM): IMPROVING DIAGNOSTIC ACCURACY WITH CLINICAL EXAMINATION AND FUNCTIONAL STUDIES. TRANSL ANDROL UROL. 2017;6(2) S64‐S67.
AUTHOR
JACLYN THURLEY JACLYN THURLEY IS A TITLED PELVIC HEALTH PHYSIOTHERAPIST AND THE FOUNDER OF THE PELVIC STUDIO, A PHYSIOTHERAPY PRACTICE WITH EXPERTISE IN PELVIC HEALTH. SEE JACLYN’S FULL BIO HERE
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