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Pain Associated with Pelvic Floor Tightness

Do you have back pain that doesn’t seem to be going away? Does your back pain go away but easily comes back? Finding the root cause and contributing factors to pain is key in getting pain to fully resolve.

We’ve had quite a few clients lately where pelvic floor tightness was the missing piece to completely resolving their back pain. And sometimes it was missed for a long time! For many people it’s not necessarily a muscle group that’s on your mind when you have back pain (unless you’re a pelvic floor physical therapist of course!). So let’s talk about this connection and why back pain and pelvic floor tightness often go hand in hand!

The Roles of Our Pelvic Floor Muscles

Ok, let’s first talk about our pelvic muscles and why they’re so important. The pelvic floor is a group of muscles that are located between the pubic bone and tailbone and span the width between our sit bones. These muscles are like a hammock in our pelvis that form the bottom of our core.

pelvic floor tightness

Our pelvic floor muscles have 3 major jobs:

  1. Sphincter control around our 3 openings (urethra, vagina, and anus)
  2. Support our internal organs
  3. Stabilize our spine, pelvis, and hip regions

Why Pelvic Floor Tightness Can Cause Pain

This 3rd job of our pelvic floor (stabilization of our spine, pelvis, and hips) is key to explaining why pelvic floor tightness can cause back pain. We have 36 muscles (woah!) that attach to our pelvis that all need to work together. If any of these muscles are too tight, too weak, or are not functioning properly, other muscles are going to get overworked and angry. Thus, it’s actually quite common for pelvic floor tightness to present as back, hip, glute, SI joint, or tailbone pain.

Additionally, many of our pelvic floor muscles attach to the tailbone. The tailbone is the very end of our spine. Thus, if our pelvic floor muscles are too tight and are pulling too hard on the tailbone, it’s definitely going to affect how our spine moves and how those back muscles feel and function.

How it Affects the Whole Core System

Tightness in our pelvic floor muscles can actually affect our entire core system. Our core is far more than just our abdominals. Think of your core as a soda can. The top of our can is our diaphragm, the bottom is our pelvic floor, and the sides are the deep stabilizing abdominal and back muscles. These muscles all work together to regulate the pressure in our abdomen and create stability for our core. If one of these muscle groups is not functioning properly (like the pelvic floor), it is going to change how we move and that may result in pain.

Other Common Symptoms

If pelvic floor tightness is contributing to your back pain, you MAY OR MAY NOT have some of these other common symptoms of pelvic floor tightness:

  • Leaking
  • Difficulty relaxing to start your urine stream
  • Chronic constipation
  • Incomplete emptying of bowels or bladder
  • Urinary urgency or frequency
  • Discomfort with intercourse, tampon insertion, or gynecologic exams

How Do I Know if Pelvic Floor Tightness is Causing My Back Pain?

If you have back pain that doesn’t seem to be fully resolving or if you have back pain that continues to return despite doing all the right things, it may be a good idea to check out the pelvic floor. Especially if you have any other pelvic floor symptoms (such as the list above), pelvic floor tightness could be the missing piece to WHY your back is hurting or WHY it won’t go away.

Until we examine the pelvic floor muscles, we can’t really know their level of involvement. The best way to examine them and the only way to TRULY know if you have pelvic floor tightness is through an internal exam by a pelvic floor physical therapist. Once we know exactly what is going on in your pelvic floor muscles, then we know how to improve their function and finally get rid of that pesky back pain!

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