#7.2 Low tone and high tone pelvic floor muscles

Low tone refers to muscles that lack strength so may have poor function, high tone refers to muscles that are literally too tight and may have poor function as a result.
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What may attribute to Low Tone Dysfunction

  • Going through menopause as oestrogen declines
  • Having had had one, or more, babies
  • Having had pelvic surgery, particularly with access through the perineum, which can damage the pelvic floor muscles
  • Irregular orgasms – This is because orgasmic contractions help keep the pelvic floor strong
  • Carrying a lot of body weight - This can stress the pelvic floor muscles
  • Being an athlete who experiences injury to the perineum from water-skiing, bicycle racing, or equestrian sports
  • A family history of pelvic organ prolapse
  • Having had radiation treatment to the pelvic region

What are the symptoms of Low Tone Dysfunction?

  • Weak or absent orgasms
  • Stress incontinence (losing urine or stool when you sneeze, laugh, cough, lift, or exercise)
  • Pelvic Organ prolapse (uterus, bladder, or rectum)
  • Back ache

How can we treat or prevent Low Tone Dysfunction?

  • Through practicing specific pelvic floor muscle exercises
  • Learning to ‘engage’ the pelvic floor along with correct breath techniques when lifting
  • Trying not to carry excess body weight
  • Avoiding activities and exercise programs that may put unnecessary stress on the muscles
  • Avoiding lifting anything too heavy
  • Obviously having regular orgasms!

High Tone Pelvic Floor Dysfunction

High Tone Pelvic Floor Dysfunction occurs when the pelvic floor muscles are overly tense, inflexible, or in spasm. The muscles are unable to move and stretch with daily activities. This causes uneven stress on the bones where they are attached, as well as uncomfortable stretching of the muscles themselves. The term “high tone” refers to the presence of high tension in the muscles. This can occur with either strong or weak pelvic floor muscles and can cause a wide range of problems.

What may attribute to High Tone Dysfunction?

  • Practicing lots of pelvic floor exercises without adequate relaxation both during and in between exercises.
  • Being an athlete, gymnast, dancer, martial artist or Pilates enthusiast who work with a focus on core strength without adequate focus on core flexibility and relaxation.
  • Menopause. Oestrogen supports muscle function, and oestrogen levels decrease during menopause, causing some menopausal women to gradually lose their pelvic floor flexibility.
  • Infrequent vaginal penetration. Relaxing to allow penetration helps keep the pelvic floor muscles flexible.
  • Having a high-stress lifestyle and/or difficulty coping with stress, because this increases the likelihood of carrying tension in the pelvic floor muscles.
  • Trauma to their pelvic floor including surgery

What are the symptoms of High Tone Dysfunction?

  • Pain as sexual arousal builds
  • Pain with vaginal penetration
  • Pain with orgasm
  • Inability to tolerate wearing tampons or having a pelvic examination
  • Constipation and/or pain with bowel movements
  • Painful urination and/or increased frequency of urination
  • Ache in the pelvis from constant muscle stress on the lower spine and tail bo

What should I do if I think I have High Tone Dysfunction?

There are many conditions that are easily confused with High Tone Dysfunction, so I always recommend you see your health care provider to obtain an accurate diagnosis.
A pelvic health specialist can perform treatment as well as teach you a series of individualized exercises that you can do at home, either alone or with the help of a partner, to facilitate normal coordination and flexibility of pelvic floor muscles. I recommend working with a therapist rather than attempting to treat this condition on your own.