Tight Pelvic Floor (Overactive Pelvic Floor)
A tight (overactive) pelvic floor is common - and it’s not the same as being “strong.” If you have pain, urgency, constipation, or symptoms that worsen with Kegels, the first step is often learning to release and relax the muscles before strengthening.
If this sounds familiar
You may notice:
- Pain or discomfort during sex
- Difficulty inserting tampons, or pain during pelvic exams
- Pelvic pain, burning, or aching
- A constant urge to pee, or difficulty starting the flow
- Feeling like your bladder doesn’t fully empty
- Constipation, straining, or discomfort with bowel movements
- Pain that worsens with stress, running, or core workouts
If this sounds familiar, doing more Kegels can sometimes make symptoms worse.
What does a “tight pelvic floor” mean?
A tight pelvic floor (also called overactive pelvic floor) happens when the muscles don’t relax properly when they need to - such as during urination, bowel movements, or sex.
Can a pelvic floor be too tight?
Yes. Tightness isn’t strength.
Your muscles can feel “strong” but actually be overworked and tense, leading to pain and bladder or bowel symptoms.
What causes a tight pelvic floor?
Tightness often builds up over time. Common triggers include:
- Stress or anxiety (unconscious clenching)
- Chronic constipation or straining
- Postural issues and overuse of abdominal muscles
- Scar tissue after childbirth or surgery
- High-impact training without enough recovery
- Overtraining pelvic floor exercises without learning release
Pelvic floor health is about control and balance — not just strength.
What helps a tight pelvic floor?
The most effective first step is usually down-training (relaxation + coordination), not strengthening.
1) Start with a pelvic health assessment
A specialist pelvic health physiotherapist can check muscle tone and function (externally and, if appropriate, internally).
2) Focus on relaxation and down-training
This may include:
- Diaphragmatic breathing (slow belly breathing)
- Pelvic floor “drops” (letting go, not squeezing)
- Gentle hip and pelvic mobility work
- Biofeedback (if appropriate)
3) Address constipation and straining
Improving bowel habits and toileting mechanics can reduce ongoing tension.
4) Strengthening comes later (if needed)
Strength helps most once the muscles can fully relax again.
When to get help
Book with a specialist if you have:
- Pain during sex
- Ongoing pelvic pain
- Urgency/frequency that doesn’t improve
- Pain with tampons or pelvic exams
- Symptoms that worsen with Kegels
How Mothercore can help
Mothercore offers online 1:1 pelvic floor physiotherapy with specialists who can:
- Assess whether tightness is driving your symptoms
- Teach release strategies you can use at home
- Build a treatment plan that fits pregnancy, postpartum, or menopause
Frequently Asked Questions
How do I know if my pelvic floor is tight or weak?
A tight pelvic floor often causes pain, urgency, constipation, or symptoms that worsen with Kegels. A weak pelvic floor more commonly causes leaking, heaviness, or reduced support. Many people have a pelvic floor that is both tight and weak, so an assessment is the fastest way to get the right plan.
Can Kegels make a tight pelvic floor worse?
Yes. If your pelvic floor is already overactive, doing more squeezing can increase tension and worsen symptoms like pain, urgency, or difficulty emptying. Most people benefit from learning how to relax first, then strengthening only if needed.
What are the best exercises to relax a tight pelvic floor?
The most effective starting point is usually “down-training,” including diaphragmatic breathing, pelvic floor drops, gentle hip/pelvic mobility, and strategies to reduce straining. The best approach depends on what’s driving your tightness (stress, constipation, postpartum changes, training load, etc.).
Can online pelvic floor physiotherapy help a tight pelvic floor?
Yes. Online pelvic floor physiotherapy can help you identify tightness patterns, learn release techniques, improve bladder and bowel habits, and build a step-by-step plan you can follow at home. It’s especially useful if you need flexible support around pregnancy, postpartum life, or menopause.