Navigating the Complexities of Weak vs Hypertonic Pelvic Floors

Navigating the Complexities of Weak vs Hypertonic Pelvic Floors


The pelvic floor is a complex and vital part of the human body, playing a crucial role in maintaining balance and stability. Issues can arise such as a hypertonic pelvic floor where the muscles are excessively tight, or a weak pelvic floor that is often experienced by postpartum women. This article will delve into the differences between these two conditions, how to strengthen pelvic floor muscles, and the framework to address pelvic floor pain with Functional Patterns (FP). 

Understanding Hypertonic Pelvic Floor

A hypertonic pelvic floor is characterized by excessive tightness in the muscles of the pelvic region. This condition can lead to complications such as pelvic floor pain, discomfort during sexual activities, and urinary issues.1

An overactive pelvic floor often results from stress, trauma, or over-exercising. It can manifest as chronic tension and spasms in the pelvic muscles. Releasing the pelvic floor requires a combination of physical therapy, relaxation techniques, and specific exercises. At Functional Patterns, self-myofascial release methods are the foundation for building a structure to be particularly effective for a hypertonic pelvic floor.

Photo by Otto Norin on Unsplash

Weak Pelvic Floor: A Different Challenge

A hypotonic or weak pelvic floor, on the other hand, signifies difficulty in engaging or tightening the pelvic muscles. This condition is common among postpartum women but can also be experienced by men. Factors like childbirth, aging, obesity, and chronic coughing can lead to a weakened pelvic floor. Symptoms include urinary incontinence and pelvic organ prolapse. 

Targeted exercises based on the FP “First 4” - standing, walking, running, and throwing - that focus on the glutes, back, and abdominal muscles are essential on how to strengthen pelvic floor muscles. FP offers specific strategies that respect the fundamental movements of the human body, that have been shown by tens of thousands around the world to get long-term results.

Pelvic Tilts and Abdominal Development

The position of the pelvis, particularly anterior pelvic tilt, may have an effect on both hypertonic and weak pelvic floor conditions. An anterior pelvic tilt could exacerbate hypertonic pelvic floor by increasing tension in the pelvic muscles. Conversely, it may also contribute to a weak pelvic floor by misaligning the force transmission through the body, leading to inefficient muscle engagement. 

Proper abdominal development is crucial for maintaining a balanced pelvic position. FP techniques that focus on the entire body system ensure that the pelvis is tilted at the right degree during phases of walking and running.

That’s not to say an anterior pelvic tilt or lack of abdominal strength are the only problems to blame for pelvic floor dysfunctions. Many asymmetries in terms of joint positioning while standing and running can have an indirect relationship to pelvic floor pain. This is why FP takes a systems based approach to training the body instead of only focusing locally on symptoms. 

How to Strengthen Pelvic Floor Muscles

Traditional methods on how to strengthen pelvic floor muscles typically involve targeted exercises such as Kegels, squats, and bridges. Symptoms such as urinary incontinence and pelvic floor pain have been found to improve with these methods.2,3 

At FP, we commonly work with people that have tried all the traditional methods and still haven’t resolved their symptoms for the long term. The goal at FP is to alleviate these symptoms for years to come by optimizing exercise around the FP “Big 4” - standing, walking, running, and throwing. This is typically done by assessing someone’s standing posture and walking or running mechanics to find inefficiencies. Self-myofascial release and specific corrective exercises are used to better position joints at all phases of the walking or running cycles. 


The hypertonic pelvic floor and weak pelvic floor contrast in nature, but both present unique challenges and one common solution. That solution is prioritizing the FP “Big 4” - standing, walking, running, and throwing - to improve pelvic position relative to the rest of the body during walking or running. Understanding the underlying causes, symptoms, and treatments is essential on how to strengthen pelvic floor muscles and relieve pelvic floor pain. By addressing the system over symptoms as offered at Functional Patterns, individuals can achieve a more symmetrical body and enhance overall well-being.

If you're dealing with pelvic floor pain, we recommend you to work with a Certified FP Practitioner.

Learn more about Functional Patterns and pelvic function in the following resources: 

  • Fix pelvic dysfunction and back pain post pregnancy — Functional Patterns Atlanta

  • References

    1. "Pelvic Floor Disorders." University of Chicago Medicine,
    2. Curillo-Aguirre, César Adrián, and Enrique Gea-Izquierdo. "Effectiveness of Pelvic Floor Muscle Training on Quality of Life in Women with Urinary Incontinence: A Systematic Review and Meta-Analysis." Medicina, vol. 59, no. 6, 2023, pp. 1004,  
    3. van Reijn-Baggen, Daniëlle A., et al. "Pelvic Floor Physical Therapy for Pelvic Floor Hypertonicity: A Systematic Review of Treatment Efficacy." Sexual Medicine Reviews, vol. 10, no. 2, April 2022, pp. 209-230,
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