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Pelvic Floor Tension Myalgia

Written by Emma McGeorge

What Is Pelvic Floor Tension Myalgia?

Pelvic floor tension myalgia, a form of pelvic floor dysfunction, is an involuntary tightening of the pelvic floor muscles that results in severe pelvic pain, constipation, difficulty when urinating, incontinence, and often embarrassment. Luckily, pelvic floor tension myalgia is curable, but if left untreated it can cause many problems with urination, defecation, and sexual dysfunction. 

Read on, for a full guide to pelvic floor tension myalgia, including possible causes, symptoms, and suggested treatment options. 

Also defined as a form of pelvic floor dysfunction, pelvic floor tension myalgia is just that – a dysfunction of the pelvic floor muscles where they remain tight all the time instead of loosening and contracting in a coordinated manner as needed i.e. for bowel movements, sexual pleasure, or emptying the bladder. Essentially acting as a protective sling or hammock for the pelvic organs (bladder, bowel, rectum, reproductive organs & vagina), the pelvic floor muscles are designed to naturally tighten and relax. However, when they remain permanently tensed, pelvic pain occurs and eventually the pelvic organs suffer too.     

Pelvic Floor Tension Myalgia Symptoms

Although symptoms of pelvic floor tension myalgia will vary from woman to woman, for many, the first physical symptom is discomfort or pain in the lower abdomen and a feeling of heaviness in the pelvic area. This type of pain typically worsens with movements that tighten the pelvic floor and eases when the body is settled in more relaxing positions. It is also common for this type of pelvic pain to start during the reproductive years and worsen with age.  

Additional symptoms can include some or all of the following:  

  • Abdominal bloating & gas
  • Constipation
  • Discomfort when urinating
  • Inability to empty the bladder
  • Lower back pain
  • Urinating more frequently
  • Urine leaks (incontinence)
  • Pain during sex (dyspareunia)  
  • Pain with sitting or tailbone pain

What Causes Pelvic Floor Tension Myalgia?

While the exact cause of pelvic floor tension myalgia remains unknown, several factors and life experiences are known to contribute to the tightening of the pelvic floor muscles. These include: 

  • Childbirth & Pregnancy
  • Endometriosis
  • Extra weight/overweight 
  • Getting older
  • Holding urine or stools for too long
  • Injured pelvic floor muscles during surgery
  • Irritable bowel syndrome
  • Interstitial cystitis
  • Nerve damage
  • Pelvic trauma due to an accident
  • Poor posture
  • Pushing too much to pass a stool – leads to overuse of the pelvic muscles
  • History of sexual abuse

Is Pelvic Floor Dysfunction the Same as Pelvic Organ Prolapse? 

Pelvic organ prolapse is when the pelvic floor muscles become weak and loosen, providing little support to the pelvic organs, to the point that they often protrude from the vagina. Pelvic floor dysfunction, or pelvic floor tension myalgia, is when the pelvic floor muscles become so tight that pain ensues and the pelvic organs can no longer function correctly for defecation, sex, or urination. 

Activities Make Pelvic Floor Tension Myalgia Worse?

Yes, activities that require the engagement (or tightening) of your pelvic floor muscles can intensify symptoms of pelvic floor tension myalgia. Standing or sitting for too long, horseback riding, habitually crossing your legs, and prolonged bike riding can also intensify pelvic pain associated with the condition. 

Is Pelvic Floor Tension Myalgia Curable? 

Yes, pelvic floor tension myalgia is treatable and can be cured if caught early enough. Should you notice any of the above-mentioned symptoms associated with pelvic floor dysfunction, don’t be embarrassed by the lack of control over your pelvic organs. Instead, make an appointment with your healthcare provider for a proper diagnosis and treatment options to regain your quality of life. 

Treatment for Tight Pelvic Muscles aka Pelvic Floor Tension Myalgia

As soon as your healthcare provider has diagnosed pelvic floor tension myalgia, they will normally suggest some lifestyle changes and more than likely refer you to a pelvic physical therapist who will work with you to relax the tight pelvic muscles. If the pain is severe, medication to reduce it is also prescribed.

Physical Therapy 

Depending on the severity of your case, this might involve massage, releasing trigger points, heat & cold therapy, exercises, electrical stimulation, and biofeedback. 

Pelvic Wand for Tigger Point Relaxation

Pelvic physical therapists will also teach you how to massage your pelvic muscles at home and may recommend the at-home use of pelvic wands to continue the relief of trigger points. For example, this uniquely designed pelvic wand from physical therapist, Amanda Olson, was created to reach even the deepest pelvic muscles to address and relieve tightness. Covered in silky smooth, medical-grade silicone that feels safe and comfortable inside the body, using it daily will help return pelvic floor muscles to a healthy elasticity. 

Kegels for Pelvic Floor Tension Myalgia – Yes or No? 

Kegel exercises are not recommended to relieve tight pelvic floor muscles. However, once tight pelvic floor muscles are relieved, your physical therapist may recommend Kegel exercises to re-strengthen the pelvic floor to a healthy coordination pattern.

Lifestyle Changes 

In connection with physical therapy for tight pelvic muscles, ensuring your diet is rich in fiber and whole foods can help with constipation and make bowel movements easier. It also helps to stay hydrated by drinking at least 8 glasses of water per day, however, it is also vital to empty the bladder, even when it is uncomfortable. 

Managing your weight with the correct type of exercise is another important lifestyle change when it comes to pelvic floor tension myalgia, and exercise also helps to improve posture. Hot baths, as well as soft cushions to sit on, are comforting during the recovery period.   

How Long Does it Take to Treat Pelvic Floor Tension Myalgia?

The good news is that the majority of cases of pelvic floor tension myalgia can be cured, however, noticing an improvement could take several weeks, and complete recovery can take several months. The key to complete recovery is sticking to a routine with physical therapy sessions and following any additional recommendations your healthcare practitioner advises. It might be uncomfortable at first, but it will be worth it when you recover. 


Pelvic floor tension myalgia occurs due to an unintentional tightening of the pelvic floor muscles and often leads to chronic pelvic pain, constipation, and urinary incontinence, among other symptoms. The good news is that pelvic floor tension myalgia is treatable and curable with physical therapy, at-home pelvic wands, and some minor lifestyle changes.  

If you can relate to any of the symptoms mentioned above, don’t be embarrassed, contact your doctor for a consultation and get the help you need to return to your regular lifestyle. 


OBGYN Academy – Chronic Pelvic Pain: Pelvic Floor Tension Myalgia - https://obgynacademy.com/wp-content/uploads/2019/07/Chronic-pelvic-pain-pelvic-floor-myalgia-updated.pdf

Cleveland Clinic – Pelvic Floor Dysfunction - https://my.clevelandclinic.org/health/diseases/14459-pelvic-floor-dysfunction

National Library of Medicine – Pelvic Floor Tension Myalgia - https://pubmed.ncbi.nlm.nih.gov/926848/

Mayo Clinic – Chronic Pelvic Pain: Diagnosis & Treatment - https://www.mayoclinic.org/diseases-conditions/chronic-pelvic-pain/diagnosis-treatment/drc-20354371