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Tight Pelvic Floor After Hysterectomy

Updated: Nov 20

Today I want to dive into a topic that's close to my heart: overactive pelvic floor symptoms after a hysterectomy. As a physical therapist specializing in women's health, I've seen firsthand how this common surgical procedure can profoundly impact pelvic floor function. So, let's unpack why you might be experiencing these symptoms and what we can do about it.


Core Disruption: The Foundation of Pelvic Health

Let's start by exploring the core—literally. A hysterectomy, whether it's done laparoscopically or through open surgery, disrupts the efficiency of our core musculature. Picture it like this intricate web of muscles, tissues, and organs that work together seamlessly. But when you undergo surgery, that web gets a bit tangled. The connection between the core and the pelvic floor becomes less coordinated, which can lead to pelvic floor tension and overactivity.


Think about it like this: anytime you interrupt the layers of the core—skin, dermis, fascia, muscles, and organs—you're disturbing a highly efficient system. Our core and pelvic floor have this deep-rooted connection, and when that connection is disrupted, things can start to go awry. Our core isn't coordinating with the pelvic floor as it should, which can result in tension and tightness.

Scar Tissue: The Lingering Reminders of Surgery

Now, let's talk about scar tissue. Surgery inevitably leaves its mark, quite literally. Scar tissue forms in the abdominal cavity or vaginal area, and it's not as flexible or responsive as our normal tissues. This can make it harder for our core and pelvic floor to communicate effectively, disrupting that delicate balance of pressure and movement.


Scar tissue can act like a barrier, hindering the natural movement and responsiveness of our pelvic floor. And when that communication between the core and pelvic floor is disrupted, tension can build up, leading to discomfort and dysfunction.

Protective Mechanisms: Guarding Against Injury

Our bodies are incredibly smart—they have protective mechanisms in place to guard against injury. 


After surgery, we might instinctively tense up, sort of like curling into a protective ball. This tension can manifest in the pelvic floor, leading to even more tightness and discomfort.

It's like our bodies go into defense mode, trying to protect the vulnerable areas that have been affected by surgery. But sometimes, this protective response can do more harm than good, leading to pelvic floor dysfunction and discomfort.

Anatomical Changes: Adapting to a New Normal

When we remove the uterus, we're left with an empty space in the pelvis. This can throw off the support system for our organs, affecting everything from breathing to pelvic floor dynamics. Tension can build up as our bodies adjust to these new conditions, exacerbating pelvic floor symptoms.


To learn more about the benefits of proper breath mechanics for your pelvic floor, check out my blog post here.


Imagine it like this: our pelvic floor is like a foundation, supporting everything above it. When that support system is altered, it can throw off the balance of our entire pelvic region. This can lead to tension, discomfort, and pelvic floor dysfunction.


Strategies for Recovery and Wellness

So, what can we do about it?


First and foremost, awareness is key. Understanding how your body is responding to surgery can empower you to take control of your pelvic health. Pay attention to any symptoms you're experiencing and don't hesitate to seek help.


Restoring proper breathing patterns is essential. Deep diaphragmatic breathing can help reestablish the connection between your diaphragm, abdomen, and pelvic floor, promoting relaxation and mobility.


Pelvic floor physical therapy can also be a game-changer. A skilled therapist can guide you through exercises, hands-on techniques, and neuromodulation approaches to address scar tissue, relieve pain, and improve pelvic floor function. If you’re wondering what to expect at a pelvic floor physical therapy appointment, check out my blog post here.


And let's not forget about the holistic approach. Stress management, relaxation techniques, and lifestyle modifications can all play a role in supporting pelvic health.

To learn more about how chronic stress can impact our overall wellness, read my blog post here.

Conclusion: Empowering Your Pelvic Health Journey

If you're experiencing symptoms of pelvic floor dysfunction after a hysterectomy, know that you're not alone. Reach out to a pelvic floor specialist who can help you navigate this journey to pelvic wellness.


I'm passionate about helping women reclaim control over their pelvic health, and I hope this information has been helpful to you. Remember, your journey to pelvic wellness starts with understanding and proactive management. Let's work together to support your pelvic health and overall well-being.


If you’re interested in learning more about this topic or have questions, feel free to reach out to us at 502-939-8564. 


If you think that pelvic floor physical therapy sounds right for you, we’d love to help. Book a consultation call with us here!


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