Exercises for a Tight Pelvic Floor: Recognise the Symptoms and Restore Relaxation
An overly tense pelvic floor means that the muscles in the pelvic region are constantly contracted without sufficient relaxation. This can cause them to become overloaded and unable to function properly. It may lead to a range of complaints, including pain, erectile difficulties, vaginismus, reduced sensitivity, and other sexual problems.
Fortunately, an overactive pelvic floor can often be treated effectively with targeted relaxation exercises, breathing techniques, and mindful body posture. In this article, you will discover how to recognise whether your pelvic floor is too tense and what you can do about it. For additional information, you may also wish to read our article on exercises for strengthening the pelvic floor.
How do you recognise an overly tense pelvic floor?
An overactive pelvic floor can cause a variety of complaints, depending on whether you are a man or a woman.
In women: common complaints
- Pain during penetration (dyspareunia) - Because the pelvic floor is too tight, penetration can be difficult or painful. This may feel like a burning, stinging, or pressing sensation.
- Difficulty reaching orgasm - A tense pelvic floor can compress the nerves in the area, reducing sensitivity and making it harder to reach orgasm.
- Vaginismus (involuntary contraction of the pelvic floor) - This is a reflex in which the muscles contract unintentionally, making penetration (whether by a tampon, finger, intimate product, or penis) painful or impossible.
- Reduced lubrication (dryness) - Tension and stress can diminish natural moisture production, making intimacy less comfortable or even painful.
- Pain in the lower abdomen, lower back, or pelvis - An overactive pelvic floor can cause tension and pain in the lower back, hips, and lower abdomen, which may sometimes radiate down into the legs.
- Difficulty urinating or a weak urine stream - Because the pelvic floor muscles also influence the bladder, an overly tense pelvic floor can make urination laborious, weaken the stream, or leave you feeling as though your bladder is not fully empty.
- Constipation or difficulty with bowel movements - A tense pelvic floor can disrupt intestinal function, making bowel movements difficult or creating a sensation of straining.
- Unconscious tension in the abdomen or buttocks - Many women with a tense pelvic floor habitually hold in their stomach or clench their buttocks, which worsens tension in the pelvic region.
- Increased symptoms during times of stress - Tension and anxiety can cause the pelvic floor to tighten further, aggravating complaints both during intimacy and in daily life.
In men: common complaints
- Erectile difficulties (ED) - The pelvic floor plays a role in blood flow to the penis. When these muscles are too tight, blood cannot be retained effectively, making it difficult to achieve or maintain an erection.
- Reduced sensitivity or difficulty reaching orgasm - Tight muscles can compress the nerves, diminishing sexual sensation and delaying orgasm.
- Pain in the pelvis, groin, lower back, or testicles - An overactive pelvic floor can cause persistent tension in these areas, leading to discomfort during and after intimacy.
- Difficulty urinating or a weak urine stream - Because the pelvic floor also influences the bladder, a tense pelvic floor can make urination more difficult.
- Pain during or after orgasm - Due to muscular cramping, orgasm may feel uncomfortable or painful.
- Unconscious tension in the abdomen or buttocks - Many men with a tense pelvic floor habitually hold in their stomach or clench their buttocks, which worsens their symptoms.
- Shallow chest breathing or hyperventilation - Many men breathe high in the chest when under stress, which further increases tension in the pelvic floor.
- Increased symptoms during times of stress - The more tension there is in your body and mind, the tighter the pelvic floor becomes, which can exacerbate erectile difficulties.
The solution: relaxation exercises for a healthy pelvic floor
An overactive pelvic floor usually develops gradually, and it takes time and conscious relaxation techniques to restore balance. Below you will find exercises that help reduce tension and improve your intimate wellbeing.
Start by learning to breathe in a relaxed way
In both men and women with a tense pelvic floor, breathing tends to be too shallow. They breathe from the chest - a pattern associated with stress, anxiety, or tension. To achieve genuine relaxation, you need to breathe low, from your (lower) abdomen. Learning to breathe in a relaxed way is therefore an essential first step.
Breathing, tension, and relaxation are closely interrelated. Someone who breathes in a tense manner will find it very difficult to relax their pelvic floor. And someone who suffers from an overly tense pelvic floor will tend to breathe from the chest. In this way, a vicious cycle quickly takes hold.
Would you like to feel the difference?
Place your hand on your chest and breathe in and out from that area for a moment. Then place your hand on your lower abdomen and do the same. You will notice a clear difference. So begin here: relax and breathe from your belly.
Relaxing the body and the pelvic floor
Exercises for tense pelvic floor muscles: Contract and release
- Step 1. Choose a quiet spot and pay a visit to the toilet beforehand. Make sure you are lying somewhere comfortable and are not wearing any restrictive clothing. Soft, relaxing music can also help. If you are lying on your back, place a small cushion under your knees and, if you wish, under your head. Close your eyes and place one hand on your lower abdomen and the other on your chest. Now breathe in slowly through your nose. As you inhale, try to direct the breath to your lower abdomen first. Allow your belly to fill with air. Feel your abdomen rise and your hand move upwards with it. The hand on your chest should remain as still as possible - your chest should not expand. As you exhale, your abdomen gently contracts. Continue breathing slowly in and out, and notice the sensation of your belly rising and falling with each breath. Once this way of breathing feels comfortable lying down, you can try it seated or standing on another occasion.
- Step 2. Let your legs rest naturally, then fully extend your left leg, tensing all the muscles there. Feel the tension, then let it go completely. Notice the difference. Now do the same with your right leg. Keep breathing calmly throughout. If your thoughts wander, gently bring your attention back to where you left off.
- Step 3. After your legs, it is time for your arms. Stretch your left arm out firmly, feel the tension, then lay it down gently. Do the same with your right arm, and notice how heavy it feels when you let it relax completely.
- Step 4. Now try squeezing your buttock muscles as firmly as you can - then, of course, let go. Can you feel the difference? Lift your head slightly off the surface, feel the tension in your abdominal muscles, then lower your head again. Next, press your head gently back into the pillow and then relax. How is your abdominal breathing doing?
- Step 5. Once you are lying in a more relaxed state, try to feel your pelvic floor moving gently with your breath. As you inhale, the pelvic floor drops slightly downwards; as you exhale, it naturally springs back. Your abdominal muscles should also move freely during relaxation. It can sometimes help to give the pelvic floor a very slight squeeze and then release it - this can make it easier to achieve a full, conscious relaxation of the pelvic floor.
Tension in the pelvic floor tends to build up gradually. It therefore takes a little time to release it again.
Yoga exercises to help relax the pelvic floor
Yoga exercise 1: Happy Baby Pose
Lie on your back. Exhale and draw your knees towards your chest. Flex your feet so that the soles face upwards, and hold the outer edges of your feet with your hands. Open your knees wide and draw them towards your chest. Keep your back flat on the floor and allow your arms and shoulders to relax.
Gently press your feet into your hands and guide your knees towards the floor on either side of your chest, pressing your pelvis into the ground. Hold the position for 30 seconds to one minute. Then lower your feet to the floor and extend your legs.
Yoga exercise 2: Child's Pose
Begin by sitting on your knees. Then fold forward, resting your abdomen on your thighs. Turn your head and face towards the floor. For extra comfort, you may place a cushion beneath your head. Extend your arms out in front of you with your palms facing downwards, or lay them alongside your body with your hands reaching towards your feet. Allow your shoulders to relax completely. Breathe slowly and deeply in and out. Hold this position for thirty seconds to two minutes.
An exercise to learn how to relax the pelvic floor muscles: The Lift visualisation
Imagine your pelvic floor as a lift starting in the lobby of a building or hotel. This "pelvic floor lift" can move upwards, or descend to a gentle, non-threatening basement level.
Your baseline level of pelvic floor tension - that is, neither contracted nor relaxed - is the "lobby". Start here. Imagine the lift doors are closed.
Gently raise your pelvic floor lift to the first floor. Do not fully engage your muscles - only halfway. In other words, do not allow your pelvic floor lift to go all the way up to the second, third, or fourth floor. Just the first floor.
Then relax completely and allow your pelvic floor lift to descend - past the lobby, all the way down to the basement. Go down, all the way down. And let the tension truly, fully go.
Release all the tension held in your pelvic floor, while imagining the lift doors sliding open to reveal a brightly lit basement. Relax your pelvic floor to the point where you feel a mild urge to urinate.
Repeat 5 to 10 times. You can practise this technique in any position, though lying down is perhaps the easiest and most relaxing way to begin. A word of advice: visit the bathroom to urinate before starting this exercise.
Result: If you practise these relaxation exercises regularly, you should notice a gradual improvement.
Important: consult a pelvic physiotherapist
If you do not notice any improvement, we recommend consulting a pelvic physiotherapist near you. Seeking advice from a pelvic physiotherapist is, in fact, always a good idea if you are experiencing overly tense pelvic floor muscles. They can work with you to identify the underlying cause, draw up a personalised programme, and support your recovery through massage and physiotherapy.
Useful things to bear in mind
- Overly tense pelvic floor muscles are not automatically strong pelvic floor muscles. Tense pelvic floor muscles can also be weak pelvic floor muscles. However, strengthening the pelvic floor only makes sense once the muscles are able to relax properly.
- If you are unable to relax your pelvic floor, there may be knots in the muscles that cannot be resolved through exercises alone. Internal massage by a pelvic physiotherapist can help in such cases.
- A warm bath and a hot water bottle can also help to relax the pelvic floor muscles.
- If you hold in your stomach during intimacy, there is a good chance you are also tensing your pelvic floor muscles. For relaxed pelvic floor muscles, it is important not to hold in your stomach.
For more information on strengthening the pelvic floor, you may also wish to read our article on pelvic floor training with a vibrator or on Kegel balls for pelvic floor training.
Veelgestelde vragen
Wat is een hypertone bekkenbodem?
Een hypertone bekkenbodem betekent dat de bekkenbodemspieren chronisch te gespannen zijn en moeite hebben om te ontspannen. De spieren staan voortdurend aan, wat kan leiden tot pijn, plasklachten, problemen bij het vrijen en obstipatie. Het komt vaker voor dan gedacht, bij zowel vrouwen als mannen.
Welke klachten wijzen op een te gespannen bekkenbodem?
Typische klachten zijn pijn bij het vrijen, moeite met het inbrengen van een tampon, een brandend of drukkend gevoel in het bekkengebied, veelvuldig moeten plassen, moeite met het op gang brengen van de plas, obstipatie en pijn in de onderrug. Bij mannen ook erectieproblemen en pijn bij het zaadlozen.
Wat veroorzaakt een te gespannen bekkenbodem?
Oorzaken zijn chronische stress, een zittende levensstijl, overmatig sporten (te veel core-oefeningen), eerdere pijnlijke ervaringen bij seks, trauma, een bevalling, of onbewust aanspannen bij pijn of angst. Soms ontwikkelt het zich geleidelijk zonder duidelijke aanleiding.
Welke oefeningen helpen bij een te gespannen bekkenbodem?
Focus op ontspanning, niet op aanspannen. Diafragmatisch ademhalen is essentieel — bij inademing ontspant de bekkenbodem. Reverse kegels, happy baby pose, diepe squat en kindhouding zijn effectieve oefeningen. Vermijd klassieke kegeloefeningen — die maken een hypertone bekkenbodem erger.
Waarom mag ik geen kegeloefeningen doen?
Kegeloefeningen zijn bedoeld om spieren te versterken door ze aan te spannen. Bij een hypertone bekkenbodem zijn de spieren al te gespannen. Meer aanspannen verergert het probleem. Het is alsof u een verkrampte nek behandelt door nog harder te knijpen. De oplossing zit in ontspanning.
Kan een bekkenfysiotherapeut helpen?
Absoluut, een bekkenfysiotherapeut is de aangewezen specialist. Zij kunnen de spanning beoordelen en een gericht behandelplan opstellen. Behandelingen bestaan uit manuele technieken, biofeedback, ontspanningsoefeningen en houdingsadviezen. Vraag uw huisarts om een verwijzing.
Hoe lang duurt het voordat oefeningen effect hebben?
Bij dagelijks oefenen merken de meeste mensen binnen vier tot acht weken verbetering. Volledig herstel kan drie tot zes maanden duren. Consistentie is belangrijk — liever elke dag tien minuten dan één keer per week een uur. Combineer oefeningen met stressreductie.
