By Catherine Lewan, PT, DPT

Do tight muscles equal strong muscles? Not necessarily. Contrary to popular belief, tighter does not equal stronger.

In muscle physiology terms, muscle “tone” is the state of tension created by neurological input to the muscle that keeps it in healthy functioning condition. A muscle with not enough tone is flaccid, while a muscle that has too much tone becomes tight. Optimal strength occurs when muscles are in the mid-range of the length-tension spectrum.

For example, imagine you want to strength train your biceps. To get this muscle stronger, you do biceps curls with dumbbells until the muscle gets tired. For the muscle to get stronger, you also rest it for a day or two to recover before picking up your weights and repeating your reps and sets of curling. (Although there are variations on approaches to strength training, there is always a component of rest involved.)

Conversely, if you were to hold a bicep curl for hours at a time, you would not get stronger. Holding a muscle in a tight/short position for prolonged periods can contribute to excessive tone, and the muscle will be too tight and too tired to generate force. Adequate rest and stretching help the muscle to be strong, flexible, and functional.

While it’s easy to envision this illustration for an arm or leg muscle, the importance of healthy muscle tone holds true for other areas of the body we may not think about as much – until something goes wrong.

Anyone who’s suffering from incontinence or leaks a little urine when they sneeze might be interested to know that pelvic floor dysfunction can occur as a result of either weakness or tightness. Incontinence may indicate that the pelvic floor is weakened due to age, atrophy, or over-stretching that occurs with childbirth; or it could be a symptom of a tight pelvic floor – when the muscles are too short, tight, and fatigued to produce adequate force to support of the bladder and urethra.

As a pelvic physical therapist, a myth I hear about often is how to achieve pelvic floor “strength.” Many people have heard about Kegel exercises, a tightening contraction of the pelvic floor muscles. There’s a common misconception that we should be doing Kegels all the time to keep those pelvic floor muscles strong.

Just so we’re clear, the pelvic floor muscles are circular muscles that wrap around the genitals, urethra and the anus, and they play a critical role in the health of sexual function, lumbopelvic stability, and elimination of toxins.

If we only practice tightening these muscles without allowing them to relax fully, we can develop symptoms of a high-tone pelvic floor, which may include increased urinary frequency, hesitancy, and strong urge; constipation; erectile dysfunction or pain with sexual intimacy; low back, pelvic, or genital pain, and incontinence.

Female athletes have a high prevalence of pelvic floor dysfunction and urinary incontinence because they tend to over train the muscles around the pelvis and core, leading to excessive tightness and tone. One study found a high incidence of urinary incontinence among fitness instructors, including yoga and pilates teachers, which is likely due to excessive tightness and tone in the pelvic floor and core muscles. Just like you need to put down the weight and take a rest from doing your biceps curls, your pelvic floor also needs a healthy amount of rest to maintain a level of tone that adequately supports lumbopelvic stability and sexual and voiding functions.

One countermeasure to help these muscles relax is deep belly breathing, which relaxes and gently stretches the core and pelvic floor and can help restore healthy tone to these muscles. So when you strength train your pelvic floor, make sure you balance that effort with a few deep belly breaths to restore resting tone and flexibility to your pelvic floor.

If your current exercise program is not helping you reach your goals, you may be overtraining your muscles and creating more tone and tension instead of the strength you desire. Checking in with a Physical Therapist who can create an individualized program for your body and your goals can help you to develop true strength. If you have any symptoms of pelvic floor dysfunction, we recommend that you contact a PT who specializes in pelvic floor therapy.

For more information on anatomy, physiology and exercises to support healthy pelvic floor strength and flexibility, check out Yoga for Pelvic Floor Health on November 8th, presented by Catherine Lewan, PT DPT at Yoga Tree (https://www.facebook.com/events/303881219820337/)

or contact Catherine directly at clewan.andersonvillept@gmail.com.

References:

Bø K, Bratland-Sanda S, Sundgot-Borgen J. Urinary incontinence among group fitness instructors including yoga and pilates teachers. Neurourol Urodyn. March 30, 2011: 370-3. doi: 10.1002/nau.21006. Epub 2011 Feb 8.

Borin LC, Nunes FR, Guirro EC. Assessment of pelvic floor muscle pressure in female athletes. PM R. March 5, 2013:189-93. doi: 10.1016/j.pmrj.2012.09.001. Epub 2012 Nov 2.