A Holistic Approach to Pelvic Floor Relaxation: Down Training Techniques
Pelvic Floor Relaxation: More Than “Just Relaxing”
"Just relax" is often easier said than done, especially when it comes to pelvic floor muscles. Often times, the pelvic floor is stuck in a tense holding pattern due to factors like stress, trauma, compensatory weakness in other muscles, or mobility restrictions. This is why “just relaxing” those muscles won’t always work, and especially for long term results. Getting the pelvic floor muscles to truly let go, takes a holistic top down and bottom up approach, which the term down training encompasses.
What is Pelvic Floor Down Training?
Pelvic floor down training involves various techniques for promoting relaxation. It may include direct, conscious relaxation of the pelvic floor muscles or indirect methods such as:
Activating the "rest and digest" (parasympathetic) nervous system.
Releasing tension in surrounding muscles that may contribute to pelvic floor tightness.
Strengthening nearby muscles so the pelvic floor doesn’t need to overcompensate.
While it might seem like tight muscles are a sign of strength, muscles should be able to both contract and relax. Chronic tension actually weakens the muscles. Down training tight pelvic floor muscles enables the pelvic floor to return to a natural resting position where it can function through its full range of motion.
Causes of Overactive Pelvic Floor Muscles
Understanding the causes of overactive pelvic floor muscles is essential for effective, long-term relaxation. Overactivity, or a hypertonic pelvic floor, can stem from various factors, including:
Direct trauma or injury to the pelvis (e.g., childbirth, surgeries, STDs, or infections)
Indirect trauma (e.g., low back pain, hip pain, groin injuries, SI joint pain, hernias, c-section scars)
Overtraining or improper exercise form
Weakness in surrounding muscles (e.g., glutes, core, inner thighs) that shifts the load to the pelvic floor.
Tightness in nearby muscles or joints, leading to compensatory pelvic floor tension.
Nerve damage or irritation (e.g., pudendal neuralgia).
Gastrointestinal issues (e.g., IBS, constipation)
Gynecological disorders (e.g., endometriosis, PCOS)
Urinary issues (e.g., overactive bladder syndrome, interstitial cystitis)
Hormonal changes
Emotional or mental stress, or past trauma
Signs of Overactive Pelvic Floor Muscles
Symptoms of overactive pelvic floor muscles include:
Pain with penetration (sexual, medical exams, tampon or menstrual cup insertion)
Incomplete urinary or bowel emptying
Difficulty initiating urination or bowel movements
Pelvic floor pain and tension, both during activity and at rest
Genital pain or pressure
Sensation like sitting on a golfball
Tailbone pain or discomfort
Normal Pelvic Floor Function
When functioning efficiently, pelvic floor muscles contract and relax in a way that acts like a trampoline. This allows for shock absorption during activities like walking, jumping, or sneezing, and supports essential functions like urination, defecation , and sexual activity. The pelvic floor plays a critical role in core stability and pelvic organ support, all without conscious effort.
Implementing Down Training Strategies For Your Pelvic Floor
Since down training encompasses a wide range of aspects, there are several options to help relax your pelvic floor.
Diaphragmatic Breathing
Diaphragmatic breathing coordinates the diaphragm and pelvic floor. During inhalation, the diaphragm moves downward, causing the pelvic floor to lengthen and release tension. On exhalation, both the diaphragm and pelvic floor return upward. This movement is key for core stability and pelvic function. For a guide, check out our previous blog on diaphragmatic breathing.
Stretching Exercises
Incorporating stretches that involve the back and hips can help reduce pelvic floor muscle tension. Recommended stretches include:
Happy Baby: Lie on your back, reach for your feet, and gently pull your legs apart.
Childs pose: Sit back on your heels with arms stretched forward.
Hip Flexor Stretch: Lie on the edge of a bed, pull one knee to your chest, and let the other leg hang off the side.
Hip External Rotator Stretch: Lie on your back, place one ankle over the opposite thigh, and pull both legs toward your chest.
Cat-Cow: On hands and knees, arch and then lower your back to feel pelvic floor relaxation.
Mindfulness
Mindfulness techniques activate the "rest and digest" system, helping to calm the nervous system and release pelvic floor tension from the top down. By quieting our nervous system, our body’s alarm system is calmed which allows for our pelvic floor muscles to also let go of those holding patterns. One method of mindfulness can involve checking in with your body physically and emotionally and connecting your thoughts to what you are feeling.
Direct Pelvic Floor Relaxation Techniques
If global relaxation doesn’t seem to be relaxing your pelvic floor muscles, more direct pelvic floor relaxation might be the next step.
Pelvic Floor Imagery
Since the pelvic floor muscles aren’t a muscle you can see, imagery can be very helpful to get those muscles to lengthen and release. Imagine the” sits bones” widening or the vaginal/rectal canal opening to help to get the muscles to relax. Visualizing initiating a bowel movement or starting the flow of urine can also be helpful.
Pelvic Wands and Dilators
These tools can provide non-threatening stimuli to help down train pelvic floor muscles. Use them under the guidance of a pelvic floor therapist, as it is important to know what size to start on and how to use these tools to set you up for success.
Pelvic Floor Dysfunctions Influenced by an Overactive Pelvic Floor
Prolonged pelvic floor tension can contribute to several dysfunctions, including:
Pelvic Pain Syndromes: Chronic pelvic pain, levator ani syndrome, vaginismus, and vulvodynia can arise from overactive pelvic floor muscles.
Dyspareunia: Pain during intercourse, often due to tight or hypertonic pelvic floor muscles.
Urinary Dysfunction: Symptoms such as urinary urgency, frequency, and incomplete emptying can result from an inability to relax the pelvic floor. Conditions like interstitial cystitis or over active bladder syndrome often involve overactive pelvic floor muscles.
Bowel Dysfunction: Constipation, straining, and incomplete evacuation may occur when the pelvic floor muscles do not relax properly.
Prostatitis in Men: Chronic pelvic pain and prostatitis can be linked to overactive pelvic floor muscles.
Sexual health dysfunctions: This can include erectile dysfunction, reduced ability to orgasm, or persistent genital arousal disorder.
Pelvic Organ Prolapse: Overactive muscles can contribute to improper support of pelvic organs, leading to prolapse.
Musculoskeletal Issues: Back, hip, tailbone, and abdominal pain can be exacerbated by pelvic floor dysfunction, affecting overall mobility and stability.
When to Seek Professional Help
While some down training techniques can be practiced at home, professional guidance can significantly improve results. A pelvic health physical therapist can help diagnose the causes of pelvic floor overactivity and tailor a treatment plan needed for your specific body’s need’s. Coordination with other specialists may also be needed for conditions such as hormonal changes, autoimmune disorders, or gastrointestinal issues.
Conclusion
Pelvic floor down training is a multifaceted approach for managing overactive pelvic floor muscles. By addressing the underlying causes and implementing effective relaxation techniques, you can help alleviate tension in your pelvic floor and get back to enjoying your life unrestricted.
Want more personalized guidance for your relaxing your pelvic floor- schedule your consultation with Chicago Pelvic Health and Wellness today.
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Written by:
Dr. Jana Richardson, PT, DPT, WCS, PRPC, CIDN
Dual Board Certified Pelvic Floor Therapist and Owner of Chicago Pelvic Health
Dr. Jana Richardson is a highly accomplished pelvic floor therapist with dual board certifications and extensive experience in treating complex pelvic floor dysfunctions. As the owner of Chicago Pelvic Health, Dr. Richardson is dedicated to providing personalized and effective care for her patients. With a Doctorate in Physical Therapy, and specialized certifications in Women’s Health and Pelvic Rehabilitation, Dr. Richardson is a leading expert in her field. She is also certified in Integrative Dry Needling, further enhancing her ability to offer comprehensive treatment plans. Dr. Richardson’s commitment to patient-centered care and her passion for helping individuals achieve optimal pelvic health make her an invaluable asset to the community.
