Pelvic Pain May Be Coming From Your Pelvic Floor

Pain in and around your pelvis can occur for many reasons. One cause of pelvic pain is hypertonicity (= tightness) in the pelvic floor muscles. If your pelvic floor muscles are too tight and have difficulty relaxing, you may experience tailbone pain, deep butt pain, pain around your sit bones, or anywhere in between. You may also experience pain around your sacroiliac joints (where your pelvis meets your low back) or pubic symphysis (where your pelvic bones meet in the front), as tight pelvic floor muscles may not allow your pelvis to move as it should.

How Do I Know If I Have A Hypertonic Pelvic Floor?

Take a deep breath in and pay attention to what you feel in your pelvic floor. Do you feel like your inhale hits a wall? Does it feel difficult to take a deep breath in? If you answered yes to these questions, a hypertonic pelvic floor may be contributing to your pelvic pain.

Here are some other common symptoms of pelvic floor hypertonicity:

  • Difficulty beginning urination
  • Constipation
  • Pain with intercourse
  • Leaking with sneezing, coughing, jumping, or lifting
  • Trouble controlling gas
  • Difficulty performing a Kegel
  • Increased pain with holding a Kegel
  • Low back or hip pain

Ways to Ease Your Pelvic Pain

Deep Breathing

The diaphragm moves together with the pelvic floor. When you breathe in, your diaphragm and pelvic floor both move down. As you breathe out, your diaphragm and pelvic floor move up. Thus, you can use breathing to stretch and relax your pelvic floor. When hypertonicity is the problem, your focus should be on taking a big, deep inhale.

360 Breathing is a deep breathing technique that encourages movement of your entire diaphragm and is a great technique to calm your pelvic pain. With this deep breathing technique, you should feel movement in your chest and belly, the sides of your ribs, and your back. It should feel like an umbrella opening and closing. You should also feel a downward movement in your pelvic floor as you breathe in. This technique should be practiced throughout the day, as well as while you are exercising. Check out the video below to learn how to do 360 Breathing.

Pelvic Floor Stretching and Relaxation

Positions that stretch and lengthen your pelvic floor muscles can be helpful to reduce tightness and ease pelvic pain. Combining 360 Breathing with these stretches can make them even more effective. Check out the 2 videos below for some great pelvic floor stretches combined with 360 Breathing.


Studies have shown that meditation can be very helpful in relaxing the pelvic floor, as many women carry stress here. If you find yourself clenching your jaw when stressed, you may also be clenching your pelvic floor. A few great apps for guided meditation and mindfulness are Calm, Headspace, and UCLA Mindful.

Strengthen Other Muscles Surrounding Your Pelvic Floor

Your pelvic floor muscles may be tight due to compensating for weaknesses in other muscles in your core and hips. Beginning with exercises lying down will help your pelvic floor muscles relax while you strengthen your hips and core.

Here are some of those surrounding muscles and examples of exercises that strengthen them:

In order to know exactly which core, hip, or thigh muscles may be tight or weak and contributing to your pelvic pain, it is best to be evaluated by a physical therapist. (There are several muscles that could be involved.)

Manual Therapy

There are a few manual techniques in physical therapy that can be especially helpful in relaxing the pelvic floor muscles and reducing pelvic pain. Some women benefit from soft tissue massage – both internally to the pelvic floor muscles and externally to the hip muscles. Dry needling has also been quite successful for women with hypertonic pelvic floor muscles and pelvic pain. This technique can be done where your pelvic floor muscles attach to your sit bones, as well as the butt and outer hip muscles (2 of which do double duty and are also pelvic floor muscles). Check out this blog post to learn more about what dry needling is and how it can help.

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