Tight, Tense, and Anxious? Why Your Pelvic Floor Might Be to Blame

The Surprising Link Between Anxiety and Pelvic Floor Tension

Raise your hand if you’ve ever felt like your shoulders were glued to your ears during a stressful day. Now imagine what the rest of your body is doing — including the part most of us don’t talk about: the pelvic floor.

It might surprise you to learn that anxiety and pelvic floor tension are tightly connected. In fact, some of the most common pelvic health complaints — leaking, painful sex, urinary urgency, constipation — often have a nervous system component.

And if you’ve been told to “just relax” or “do more Kegels,” without understanding why your muscles are gripping for dear life, you’ve likely been missing a key piece of the puzzle.

Fight, Flight... or Floor?

When you're stressed or anxious, your body shifts into fight-or-flight mode — your nervous system goes on high alert to prepare you to act quickly. Your heart rate increases. Your breath gets shallow. Your muscles — including your pelvic floor — tense up to guard and protect.

That’s a helpful survival response… if you’re running from a bear.
But not so helpful if you’re stuck in traffic, answering a mountain of emails, or chasing toddlers on 3 hours of sleep.

Over time, this chronic stress state leads to what we call "hypertonic pelvic floor" — when the muscles stay tight and clenched, even when they’re supposed to relax.

How Pelvic Floor Tension Shows Up

A tight pelvic floor doesn’t always feel like tension. In fact, it often shows up as:

• Leaking when you sneeze or laugh
  

• Urinary urgency (gotta go RIGHT NOW)
  

• Pain with intimacy or gynecological exams
  

• Constipation or straining
  

• Low back, hip, or tailbone pain
  

And here’s the kicker: many of these symptoms worsen when someone is under emotional stress.

In other words — it’s not “just in your head.”

It’s in your nervous system, which affects your muscles, which affects your function.

How We Help You Break the Cycle

At Practically Perfect Physical Therapy, we’re not just treating a muscle group — we’re treating the whole human. That’s why our pelvic floor therapy approach often includes:

• Breathwork and mindfulness techniques to regulate the nervous system
  

• Gentle manual therapy to teach the muscles how to release
  

• Education so you understand your body’s stress response
  

• Customized home programs that feel doable (and not one more thing on your plate)
  

• Collaboration with mental health providers when needed
  

We also bust the myth that pelvic floor therapy is just “doing Kegels” — spoiler alert: Kegels can make things worse if your pelvic floor is already too tight.

A Surprising Tip: Breathe Into Your Butt

Yes, really.

Try this: Lie on your back with your knees bent. Place one hand on your belly and the other on your chest. Take a slow inhale through your nose and imagine the air traveling all the way down into your pelvic bowl — like you’re inflating your butt like a balloon.

You might feel a subtle release, a drop, or warmth in your pelvic floor. That’s the start of reconnecting your breath and your body — and telling your nervous system, “You’re safe. You can let go.”

Want to Learn More?

We made a free video just for you!

Learn about how anxiety, tension, and pelvic health connect — and what you can do to break the cycle.

▶️ Watch it here on YouTube:
https://www.youtube.com/@practicallyperfectphysical6926/videos

And if you're ready to get personalized help from a pelvic floor expert who gets it, give us a call at (609) 300-3963 or book an appointment online.