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Relaxation of the Pelvic Floor Muscles

Excess tension in the pelvic floor muscles may cause or increase pain in the coccyx, vagina, or perineum. Tense muscles restrict good blood flow, resulting in a build up of metabolites, which can irritate the muscle, causing pain and more muscle tension. Relaxing the muscle helps to break the pain pattern and will assist in your recovery.  Relaxing the pelvic floor does not always result in immediate pain relief, but this relaxation is necessary for full recovery.

Stress is a part of life. Causes of stress are very individual. You may not even know you are under stress. This is partly due to the fact that we get used to a certain level of stress and believe it to be normal. The same thing happens with muscle tension. Many people today have excess muscle tension and do not believe it. The tension has been there for so long that the body accepts it as normal. This makes it very difficult to determine if the muscle is relaxed or tense. You may need additional information about the muscle to tell if you are truly relaxed.  Surface electro-myography (or called biofeedback) can provide this information. Ask your health care provider about this modality.

In attempting to relax the pelvic floor muscles, it is best to try to determine the difference between relaxed and contracted. This is not a big difference and is very hard to describe. Be persistent and pay close attention to how the muscles feel. The following is a list of helpful hints in learning to relax the pelvic floor.

Ø  Rely on yourself, not others, to be the manager of your care. You have a responsibility to follow the instructions of the people caring for you and to participate in your care to the best of your ability.

Ø  Seek consultation when you are aware of unmanageable stress. Social workers, psychologists, relaxation therapists, self-help groups, clergy members, books, and tapes can help you learn how to manage stress effectively.

Ø  Set some time for yourself. You have a responsibility to take care of yourself. Do not wait until someone tells you to relax; make it your priority and take the time.

Ø  Stretch frequently during the day to avoid being in one position for too long.

Ø  Do not overexert yourself or tire yourself out.

Try several different relaxation techniques to determine the one that works for you. Then practice relaxation for at least 20 to 30 minutes twice per day. Relaxing is a skill that takes a lot of practice. You may not feel very relaxed the first time you try it. Be persistent and keep trying until you can relax quickly and easily and totally. Relax frequently during the day.


Specific Relaxation Techniques

Start with a quite environment: Have low lights, a comfortable position, and a comfortable temperature. Take the phone off the hook or turn your cell phone off. Do not fall asleep. If you want to learn how to relax in wakefulness, you must practice in wakefulness. Later you should practice relaxing with a less quiet environment.

Diaphragmatic breathing: Take a slow breath in through your nose, allowing your abdomen to expand. Exhale slowly through your mouth, allowing your belly to fall. This type of breathing should be relaxed and gentle, not forced.

Visualization:Imagine you are in a quiet, relaxing place (meadow, beach, mountains). Make the image as real as possible, imagine what you see, hear, feel, and smell in this quiet place.

Visualize the muscle:

Picture the muscle in your mind.

See the muscle relaxed with good blood flow.

Picture the muscle contracting and relaxing normally.

Imagine what the muscle would feel like without pain or problems.

Imagine the muscle sagging down.

Imagine a circle (the vagina) getting larger.

Imagine the sit bones separating.

Pretend you are passing gas, urinating, or moving bowels.


Body scanning: Periodically throughout the day, stop and bring your attention to the various parts of the body (eyes, cheeks, jaw, head, neck, shoulders, arms, hands, ribs, belly, buttock, legs, and feet).  Check each area for tension and pause to allow the tension to leave the body.  Tension in other areas of the body may contribute to tension of the pelvic floor muscles.


Strengthening the muscle: In many cases, painful muscles are weak. Strengthening the muscle can help decrease pain.  Follow the pelvic floor exercise program prescribed by your health care provider.

Perineal bulging: Place your hand over the cleft in your buttocks, resting your index finger near the anus. Gently push as if expelling gas. Feel the tissue bulge outward. This is relaxation. Practice reproducing this sensation with your fingers in place.

Overall fitness: Many patients have found that walking or swimming helps to relax the pelvic floor muscles. These types of rhythmic, alternating movements enhance circulation and relaxation.