Yes, Your Pelvic Floor Muscles Can Spasm

It’s easy to brush off the random cramp in your foot when you first wake up in the morning or the charley horse you get in your calf during a run. But if you experience a pelvic floor spasm around your vagina or rectum, it can make you stop and wonder what the heck is going on. 

We get it. The pelvic area can feel like a mystery wrapped in an enigma. Any new, unpleasant sensation can bring up fears ranging from UTIs to STIs…and pelvis muscle spasms are no exception.

First thing to know: a muscle spasm can impact any muscle in your body, even the muscles you don’t always think about. Take your breathing muscle (the diaphragm) for example: hiccups are a form of diaphragmatic muscle spasm. 

Like the occasional bout of hiccups, the odd pelvic floor spasm isn't necessarily worrisome. However, if spasm of the pelvic floor bothers you on a regular basis, it may be a sign of pelvic floor muscle dysfunction that’s worth treating.

Read on to learn more about pelvic floor spasms and what you can do about them.

What is the pelvic floor and what does it do?

Your pelvic floor is a complex group of muscles, ligaments, and other tissues at the base of the pelvis. These tissues form a muscular “hammock” that supports your pelvic organs. Think: the bladder, rectum, vagina, and uterus, if you have one. 

Note that everyone with a pelvis has a pelvic floor (yep, even people with penises!) We’re focusing on the female pelvic floor in this article, but most of the concepts here apply across all sexes.

Regardless of your anatomy, your pelvic floor works in sync with your abdominal and hip muscles to perform its key jobs…and it has a lot of them. Your pelvic floor muscles have several important functions, including:

• Supporting healthy bowel and bladder function
• Allowing for pain-free sex and satisfying orgasms
• Providing stability to the low back and pelvis for pain-free movement and balance
• Promoting healthy blood flow and circulation in the pelvic area
• Regulating intra-abdominal pressure and helping you breathe normally

When the pelvic floor muscles are in good working order, they're strong, flexible, and agile. They can contract and relax as needed. 

But sometimes, the pelvic floor muscles can become weak, uncoordinated, and/or resistant to stretch. These changes can bring on pelvic spasms and a host of uncomfortable bowel, bladder, and sexual symptoms.

What is a pelvic floor spasm?

A pelvic floor spasm is the involuntary contraction of one or more muscles in your pelvic floor. This sudden contraction can cause uncomfortable or painful sensations in and around those muscles. A spasm can be quick or prolonged.

Regardless of the muscles involved, a muscle spasm or cramp can cause pain and muscle dysfunction. Fortunately, spasms are usually temporary: stretching, gentle massage and other treatments can help. More on this to come.

What does pelvic floor spasm feel like?

When the pelvic muscles spasm, the resulting sensations can vary a lot. This variation often depends on the muscle(s) involved, the intensity of the contraction, and the person experiencing the spasm. A muscle spasm may cause sensations around the vagina, anus, or bother. It can also feel like a deeper pain elsewhere in your pelvis.

A spasm can be so intense that it feels like a stabbing sensation. Less intense spasms may feel more like a gentle throbbing; some even feel similar to menstrual cramps. Some people describe pelvic spasms as a fast tremor, kind of like an eyelid twitch. The sensations can also vary depending on how long the spasm lasts.

Whatever you feel, make a note of where you feel it, how strong it is, and when it tends to happen. If it's too hard to describe or seems to happen at random, that's good information to share, too. All these details can give a pelvic floor physical therapist clues to what's happening and how to best treat it.

What causes vaginal spasms?

Vaginal and other pelvis muscle spasms are more common in muscles that are:

• Resistant to stretch
• Overused and fatigued
• Low on circulation 
• Controlled by irritable nerves
• Stressed and over-exercised (yes, this means it’s possible to overdo kegel exercises)

So what causes the pelvic floor muscles to become overused, stressed, or any of the above? Sometimes, it’s hard to tell for sure, but certain life events and conditions can certainly contribute.

In response to injury 

Whether it's a fall on your tailbone, muscle trauma from childbirth, or surgical procedures in the region, pelvic injuries can lead to pelvic floor spasm. The pelvic floor muscles can protectively “guard” in reaction to the pain and trauma. Without proper rehabilitation, this reactive tension may stick around or recur.

Behavioral habits

Humans are really good at holding tension in our muscles, often without realizing it. Perhaps you’ve noticed yourself squeezing your glutes, sucking in your stomach, or clenching your jaw/grinding your teeth at night. You can also hold tension in your pelvic floor muscles, though the symptoms may not be as obvious.

Stress responses 

Our muscles are like guard dogs: they often react to stress and anxiety by gripping, protecting, and holding tension. The pelvic floor muscles are no exception. Persistent life stressors and anxiety may keep your pelvic floor in a perpetually tense, guarded state.

Medical conditions

Pelvic spasms can develop following a pelvic infection or other medical conditions that affect the pelvic or abdominal organs. This is where things get really tricky: medical issues that impact your bowel, bladder, or reproductive system can cause symptoms that mimic those coming from tight pelvic floor muscles. 

This can also become a chicken-or-the-egg scenario: which came first, the illness or the pelvic spasms? While rare, certain nervous system conditions can cause muscle spasm. Sometimes, spasms are reactions to medications (Merck Manual).

Your healthcare providers are your best bet to solve this dilemma: they can help you rule in/out other medical conditions or reactions contributing to pelvis muscle spasms.

What are the symptoms of pelvic floor spasm?

When your pelvic floor muscles are in a spasm, it may not feel quite as painful and obvious as a charley horse in your calf. However, there are several telltale signs that can point towards spasm in the pelvic floor. The most common symptoms of pelvic floor muscle spasm include:

• A tight, tense band of muscle in the pelvic muscles. Pressing on the band may increase symptoms.
• Pain during vaginal penetration of any kind (with a tampon, speculum, finger, toy, etc.)
• Vulvar pain or itching: these symptoms may be present all the time or provoked by pressure or body position.
• Bladder urgency with or without leaking
• Bladder frequency (having to empty your bladder more frequently than once every two hours)
• Constipation and straining during bowel movements
• Anal pain during bowel movements
• Pelvic or low back pain that does not improve (or even worsens) with strengthening exercises

Note that this list is not exhaustive: pelvic floor muscle spasms can cause other symptoms beyond those listed here. Additionally, other conditions and triggers can cause the symptoms above. A pelvic floor physical therapist can help you figure out what’s happening in your unique case. 

How can you treat pelvic floor spasm?

Treating a spasm in the pelvic floor is a lot like treating any other muscles in spasm: the goal is to restore the mobility and function of the muscles. Pelvic floor physical therapists are experts at doing just that. At Origin, your treatment for pelvis spasms may incorporate any or all of the following:

Movement reeducation exercises

These individualized exercises help retrain your muscles to move without pain. They also improve strength and stability throughout the pelvis and spine so the pelvic floor doesn’t have to brace so much.

Mindful dilator training

Vaginal dilators (aka vaginal trainers) are a helpful tool to restore normal muscle range of motion in the pelvic floor. Your therapist can teach you how to gently and progressively use trainers to restore muscle stretch and mobility.

Hands-on manual therapy

Skilled manual therapy techniques include myofascial release, trigger point massage, visceral mobilization, and more. These can relieve pain and restore muscle function by dialing down muscle activity, releasing neural tension, boosting blood flow, and normalizing tissue flexibility and joint mobility.

Biofeedback

Biofeedback therapies are a great way to help reconnect your body and mind. This reconnection can help you increase your awareness of your pelvic floor and its coordinated motion. 

Biofeedback comes in many forms: it can be as sophisticated as displaying your muscle function on a computer, or as simple as watching your body movements in the mirror. Regardless of the method you use, biofeedback is invaluable in learning and recovery.

Lifestyle and Behavior Adjustments

Holistic physical therapy care includes helping you identify and adjust habits that may be contributing to your symptoms. Your pelvic floor physical therapist can help you with motivational strategies to keep you on track to positive habit change.

The takeaway

The occasional, random muscle spasm is not a reason to worry. However, you should always check in with your healthcare provider if spasms become chronic, are accompanied by any of the symptoms mentioned above, or if you suspect injury or infection in the area. 

After you’ve ruled out underlying medical concerns, pelvic floor physical therapy is an excellent and effective next step to address pelvic floor spasm.

At Origin, our clinicians are experts in treating pelvic floor muscle spasms. Book a visit with a pelvic floor physical therapist who can evaluate and address your symptoms on the spot.