Could I be suffering from overactive pelvic floor muscles?


Overactive pelvic floor muscles refer to muscles that have difficulty with relaxing or letting go. These muscles hold a level of tension that is considered above normal and can be further subdivided as neurogenic or non-neurogenic in origin. Often, it can take a long time to be diagnosed with overactive pelvic floor muscles due to the poor awareness of pelvic floor muscles as a contributing factor for symptoms, especially when it involves a change to your bladder or bowel function.


Hypertonic and overactive pelvic floor muscles are one and the same. The usage of the word ‘hypertonic’ is aligned with more recent updates in terminology pertaining to pelvic floor dysfunction (Bo et al. 2017).


Patients will often describe difficulty in feeling the contraction and/or relaxation of pelvic floor muscles.

Unfortunately, symptoms of hypertonic pelvic floor muscles are quite generic, i.e. they could also result from weak pelvic floor muscles. A pelvic floor examination is a must and is performed to determine whether hypertonic pelvic floor muscles could be contributing to your symptoms which can include:

  • urinary incontinence
  • urinary urgency
  • frequent urination
  • incomplete emptying of the bladder
  • slow flow of urine
  • hesitancy or delayed start of the urine stream
  • painful urination
  • constipation
  • incomplete emptying of the bowels
  • straining when emptying the bowels
  • pelvic pain
  • low back pain
  • hip pain
  • coccyx pain
  • dyspareunia or painful sex
  • vaginismus
  • pain with tampons or Pap smears


There is no one cause for hypertonic pelvic floor muscles. That being said, we commonly see hypertonic pelvic floor muscles in people who:

  • hold their tummy in throughout the day. This is something I commonly see in postpartum mummies or in persons with pain as a protection mechanism.
  • ignore the urge to wee and poo consistently or perhaps don’t feel comfortable using public toilets, therefore hold on for long periods of time.
  • have high levels of stress or fear. Much like we can develop headaches, neck or jaw pain when stressed, we can also carry this tension to our pelvic floor muscles.
  • have inflammation or infection such as urinary tract infection
  • experience birth trauma such as a levator ani injury, perineal tears or episiotomy
  • undergo abdominal or pelvic surgery such as a hysterectomy causing scar tissue
  • suffer conditions such as irritable bowel syndrome, endometriosis, adenomyosis, interstitial cystitis which feeds a pain and tension cycle
  • are hypermobile in the hips resulting in pelvic floor compensation
  • pelvic trauma such as a fall onto the buttocks or sexual abuse


It is best to book in with your Women’s Health Physiotherapist. It is important to obtain a detailed history to determine the contributing factors to your symptoms. The gold standard of assessment is a pelvic or rectal exam, however, in some instances, it may not be appropriate to do so. Click here to learn more about our techniques.


There is the potential for the resolution of symptoms. This however is best ascertained in a case by case scenario, taking into account your story. We have to look for answers within and beyond the pelvis to reach the outcomes that matter to you. There is no point in stretching your muscles if the problem is the day-to-day movement patterns causing the tightness.

If you would like to know whether overactive pelvic floor muscles are contributing to your symptoms, please call/WhatsApp on 9780 7274 or get in touch over email to learn how we can work together.

You can also visit our website to learn about other women’s conditions we treat through physiotherapy and how we can help you.

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I had excellent experience at Embrace Physiotherapy with Brenda. She was so much helpful on my conditions with patience and caring. I can strongly see significant improvement on my body pains. If you want to know how amazing it is if you have physiotherapy demands, definitely go and meet Brenda there! Highly recommend her and of course Embrace’s friendly service.

Katrina Lu Avatar Katrina Lu
November 14, 2021

Went for physiotherapy (with Preet) and postpartum exercise classes (with Brenda). Embrace is an awesome place to recover after birth, and seeking their help after birth was probably one of the best self-care choices I've made. Preet is extremely professional, approachable and friendly. She goes above and beyond, and did a comprehensive check on me, even though my initial main concern was DR. Brenda's sessions are engaging and fun. Not too tough for the postpartum mum but not a walk in the park either (especially the first few classes). The sessions allowed me to feel more in control of my body (and stronger) after birth. They also helped me ease back into strength training. The client experience team is also amazing, so shout out to them. Highly recommend all postpartum mums to seek Embrace out!

Yenn Weii Lim Avatar Yenn Weii Lim
October 13, 2022

My experience with Embrace Physiotherapy has been very good. A very professional approach from the staff, right from the first call I made to seek appointments till the end of the therapy. A special note about my interaction with Alex, my consulting physiotherapist: Alex is very good at her work. She listens to her patients patiently to understand the issues being faced before exploring the solutions. She made me feel very comfortable and helped me to work with her to find the right solution to my needs. Her interactions have always been nice and with an added human touch, enabled me to feel comfortable working with her. She doesn't rush the treatment procedure and has helped me explore more than one solution keeping my condition and the history of complications in mind. She also keeps track of the progress and provides alternate solutions if the current approach isn't yielding the desired results. She is much more than a physiotherapist as she gave some great suggestions about lifestyle which helped me avoid the recurrence of issues.

Sowmya Krishnan Avatar Sowmya Krishnan
September 10, 2022

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