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Our physiotherapist Cat Ryan takes us through the Top Stretches to help an overactive pelvic floor. 

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    What is an overactive pelvic floor?

    The term 'Overactive Pelvic Floor' relates to a pelvic floor that has too much tension or tightness. To learn more about what it is and why it may occur in some people, read the following blog that I’ve written on the topic.

    What is an Overactive Pelvic Floor?

    Why incorporate stretching into a program for an overactive pelvic floor?

    One of the aspects of managing pelvic floor overactivity, alongside ‘pelvic floor down training’ exercises, diaphragm breathing techniques, mindfulness and awareness, is implementing a stretching program for tight muscles around the pelvis and hips to assist the pelvic floor to relax. 

    Cat Ryan, who works at FitRight HQ as a Pelvic Health and Musculoskeletal Physiotherapist, is the perfect team member to write a blog about this. First - a bit about Cat and what types of patients she sees at FitRight HQ:

    About Cat Ryan

    What drew you to work in the area of Pelvic Health Physiotherapy?

    “I’ve been a Physiotherapist since 2007. I’ve always been fascinated with the amazing capacity of the human body and our ability to adapt and evolve, despite injury or adversity.

    I’ve worked in the Musculoskeletal Physio world for the first 10 years of my career and was particularly interested in helping those with chronic or persistent back, pelvic and hip pain. It was then that I began my post graduate certificate in Musculoskeletal Physiotherapy.

    Yet after having my children, I started to become more curious about the Pelvic Health world, and how interconnected and intelligent our body systems are. I then commenced my Masters degree in Pelvic Health and Continence Physiotherapy.

    I love to treat both Pelvic health concerns, like incontinence, prolapse or pelvic pain, as well musculoskeletal injuries like back or neck pain. I like to consider the different aspects that may contribute to a person’s symptoms and address these in a holistic way for a better outcome.

    I’m very excited to be completing my Master’s this year and I am involved in a research project looking into the relationship between pelvic pain, abdominal pain and pain sensitivity in young females. It’s a full circle moment where my worlds of MSK and Pelvic Health collide, and I’m hoping we’ll one day be published!

    Why do you particularly enjoy helping women with pelvic pain, and/or increased pelvic floor tension?

    “I like to help people problem-solve the contributing factors that may lead to pain. Pain is a message from our body that there is or “could” be a threat. I am a naturally curious person, but I like to help others become their own personal investigator to make sense of their symptoms. I like to empower clients to have a better understanding of how their body works, and what we can do to support it to reduce or manage these issues in the future.

    Most of us will unfortunately experience some kind of pain in our lives, but I think we can find a way to learn from this and become stronger as we rebuild from this.”

    Tell us a bit more about what type of patients you might give a home stretching program to, and why this can be an important puzzle piece for them. 

    “I have a selection of stretches that may focus on hip opening to assist in pelvic floor rebalancing. Since the deep hip muscles form part of the pelvic “wall,” it can be helpful to do some movements that focus on mobilisation and stretching through the hips.

    I have completed a Graduate Diploma in Pilates Instruction (Polestar) and I am a certified Yoga teacher, so I love to use pilates and yoga-inspired movement as a way to help the body heal and recalibrate.

    Often people can manifest stress in their body in a variety of ways. This might be seen with neck pain, headaches, back ache and even pelvic floor tension. It means that the pelvic floor muscles may stay on, they might move with less range of motion or they might even develop points of pain or tension. Overactive pelvic floor may create symptoms like pain with intercourse, difficulty feeling “empty” when toileting, incontinence or a feeling of tension in the pelvic region.

    I like to help provide some guidance to help people use their body as a vehicle to help them regulate their nervous system and provide tools integrate in every day life reduce pain and tension over time."

    Cat’s Top 4 Stretches to help an Overactive Pelvic Floor

    Now let's hear from Cat about her Top 4 Stretches that she often prescribes for patients with 'Overactive Pelvic Floor', and tightness around the pelvis and hips:

    1. Figure 4 stretch (sitting, plus or minus the baby!)
    “This stretch targets the inner thighs and hip rotators. It’s a great one to use when you may not have much time, whether busy with little ones or working in a seated position. 

    How to do it: When seated, lift your leg and place your ankle on the top of your thigh. Send your knee on the bent leg towards the floor as far as you can go until you feel a nice stretch.

    And if you forget…do these when bathing the kids, waiting for a coffee or watching kids swimming lessons.”

    2. Child's pose
    “This stretch is beneficial to reduce tension through the hip and lower back muscles. This can also be done through all stages of pregnancy and can be helpful to reset the nervous system.

    How to do it: Start in a kneeling position (or you can also spread your knees out to the side for a wide-leg child's pose - this variation is excellent for pregnancy) and fold your body towards the floor. Stretch your arms out until you feel a nice stretch.

    Bonus points for deep breaths and your favourite music or outdoor setting for an extra nervous system reboot with this one!”

     

    3. Mermaid Stretch
    (in either 'Z sit' or cross-legged)

    “This is a side stretch of the body with a side lean. I love this exercise for the whole body stretch; it helps to reset a deeper diaphragmatic breath and by adding the rotation of the hips, it lengthens the pelvic floor- allowing a sense of a softening into the “sit” bones. This is one of my favourite exercises as it integrates the lower and upper body with the breath. 

    Using the “Z sit" creates asymmetry across the pelvic floor muscles. This can be helpful to challenge our awareness when practising pelvic floor exercises, or allow a different feedback mechanism for our brain to adapt and learn another way to move.”

    How to do it: Sitting on the ground, either keep your legs in a crossed leg position or maneuver your legs into a 'Z sit' as shown in the image below. Then, lean your arm over your body until you feel a nice stretch.

    4. Happy baby variations
    “The variations of this one are either on your back with both legs up, one leg up or lying on the side with one leg up. 

    This one is great for stretching the hip muscles and lengthening the pelvic floor and pelvic “wall” muscles. I often use this one in the clinic when helping people learn how to relax and allow more movement of the pelvic floor muscles.

    Sometimes, using a more significant movement like this deep hip bend can allow the deeper muscles of the pelvic floor to soften and allow a better range of movement.

    How to do it: Lay on your back and lift your legs so you can grab your toes - keeping your knees bent. You can also incorporate a gentle side-to-side motion for a nice back massage. Alternatively, lift one bent leg at a time and pull it to the side for a nice deep stretch.”

    A big thanks to Cat for sharing this insight into the benefit of a stretching routine for tightness in the pelvic floor and surrounding muscles!

    We are very lucky to have Cat's expertise in the FitRight Physio team. You can book a Women's Health or a Musculoskeletal Assessment with her at the link below. If you would like a pelvic floor assessment (including assessing for 'overactivity'), book a Women's Health Initial Assessment with Cat or one of the other practitioners:

    Book Women's Health Physio Appointment 

    Book Musculoskeletal Physio Appointment 

    Or you can exercise every week with Cat in one of her Clinical Exercise sessions - the first step is to book a Clinical Exercise Assessment:

    Book Clinical Exercise Assessment 

    FitRight

    Perth’s Leading Centre for Women’s Health and Exercise

    Physiotherapy, GP services and physio-led exercise classes specifically for women

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