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The human body is designed to experience stress and to react to it.

Stress can be a very important protective mechanism whereby the body becomes very alert to a potential threat and responds to avoid danger. This positive stress is referred to as “eustress”. The opposite occurs when stress becomes negative and prolonged without relief. This type of stress is called “distress”. Symptoms of distress include irritability, anxiety, pain and muscle tightness.

What does stress have to do with the pelvic floor? Before diving into this topic we should start by discussing what the pelvic floor is and where it is located. The pelvic floor spans the bottom of the pelvis and attaches like a hammock to the tailbone and pubic bone. It helps to support our pelvic organs (ex., bowel, bladder and reproductive organs) and helps with overall bowel, bladder and sexual function.

Just like any other muscle in the body, the pelvic floor muscles can be directly affected by stress. When we experience stress, especially that of a prolonged nature, we hold our muscles (pelvic floor included!) very tightly. This occurs because of the pelvic stress reflex response in which the pelvic floor muscles actively contract in response to physical or mental stress.

Stress, fear or anxiety during pregnancy can cause muscles to tighten and these factors can lead to a hypertonic pelvic floor. Symptoms of a hypertonic pelvic floor include:
● Urinary or fecal incontinence (leakage)
● Urinary urgency
● Urinary frequency
● Pain with sex
● Constipation
● Low back and hip pain

These symptoms are common during pregnancy but are NOT normal. A tight pelvic floor can also affect labour and delivery! Consider how a puppy behaves when it is afraid – it runs away with its tail between its legs. Similarly, humans have a primitive response to fight or flight situations where the tailbone tucks under. The pelvic floor muscles are attached to the tailbone and this causes the muscles to shorten. Now imagine pushing a baby through this tight, shortened space?

Seeing a pelvic floor physiotherapist to assess whether your pelvic floor is carrying tension is helpful to treat those problems listed above. A pelvic floor physiotherapist will also teach you how to lengthen and relax your pelvic floor during active labour, show you labour positions and techniques that help with pain, and teach you other skills that can help manage the stress, fear and anxiety surrounding labour and delivery.

Karen Moreira
Pelvic Health Physiotherapist