Leaking urine, heaviness, pain during intercourse and urgency can all come either from muscles that are too weak or from muscles that are permanently too tight. From the outside they look the same.
A muscle held in constant tension is weak — not because it is slack, but because it has no range left to contract from. It is already shortened. Adding strengthening exercises makes it worse, which is why so many women find that “doing Kegels” changes nothing or makes their symptoms worse.
This is the reason the first visit always includes a functional examination: resting tone, contraction strength and, just as importantly, the ability to release completely.
Therapy
- Detailed history
- Assessment of resting tone of the pelvic floor
- Assessment of contraction strength and endurance
- Learning correct contraction and release
- Manual release of overactive muscles
- Trigger point therapy
- Individual training programme
- Breathing work