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Understanding Levator Ani Syndrome: Relief for Pelvic Pain

Are you experiencing rectal or vaginal pain? Difficulty with bowel movements? Urinary urgency or urinary leakage? You’re not alone. Levator ani syndrome can explain all these symptoms and more, and the good news is there are treatments that can give you relief for the pelvic pain you are experiencing!

What is Levator Ani Syndrome?

The levator ani is group of muscles that is the pelvic floor. These muscles play a crucial role in supporting your bladder, bowel, and reproductive organs. In levator ani syndrome, these muscles become chronically tight or tense, leading to pain.

Symptoms of Levator Ani Syndrome

The most common symptom of levator ani syndrome is pain in the rectum or vagina. This pain can be:

  • Dull and aching

  • Burning

  • Sharp

  • Constant or come and go in waves

The pain often worsens with sitting and eases with standing or lying down. Other symptoms can include:

  • Constipation and difficulty having a bowel movement (needing to )

  • Incomplete bowel movements

  • Painful intercourse

  • Increased urinary urgency (getting very strong urges to pee you can’t ignore)

  • Increased urinary frequency (needing to pee often without having drank enough liquid to actually need to pee again)

  • Stress urinary incontinence (leaking pee with coughing, laughing, sneezing, yelling, jumping, running, etc)

What Causes Levator Ani Syndrome?

Since levator ani syndrome is a diagnosis based on symptoms, the exact cause can be different for each individual patient. There are several factors may contribute to it, such as:

  • Childbirth (muscle injury, tearing, prolonged second stage of labor)

  • Chronic stress

  • Muscle strain or injury in the pelvic floor, hips, back, or abdomen

  • Weakness in the core, back, hips, and legs

  • Certain neurological conditions

Treatment Options for Levator Ani Syndrome

Fortunately, levator ani syndrome is treatable. In determining treatment, a physical therapist will evaluate the pelvic floor and the rest of your body to figure out the root cause.

Here are the foundations of treatment programs we design at MTS, which are specifically made for each individual patient:

  • Improving strength in weak areas: often weakness in one muscle group can cause clenching in another muscle group. Strengthening a weak muscle will take demand away from the other muscle groups.

  • Improving range of motion of tight joints: limited range of motion in the ankles, hips, and back can impact the pelvic floor’s ability to do its job. Improving motion in those joints will decrease the strain on the pelvic floor.

  • Improving muscle extensibility in tight muscles: often improving length of the hip, back, and abdominal muscles, as well as the pelvic floor muscles directly, will relieve symptoms, which is an important part of getting better. 

  • Addressing breathing patterns: being able to take a full, deep, diaphragmatic breath will help the pelvic floor be able to lengthen. Working on rib cage mobility, abdominal mobility, and coordination of breathing is very important for any pelvic floor issue.

  • Addressing movement coordination: if you are moving in a way that overly stresses your pelvic floor, addressing the coordination of those movements will help improve symptoms.

physical therapy for pelvic floor condition

Living with Levator Ani Syndrome

While levator ani syndrome can be a frustrating condition, it's important to remember that you're not alone and there is help available. If you suspect you have levator ani syndrome, you can directly see a physical therapist here in CT. Or you can talk to your doctor about treatment options!


About the author: Dr. Caitlyn Hauswirth-Varis, PT, DPT, OCS, CFMT, CF-L1

Caitlyn Hauswirth-Varis

Caitlyn is a pelvic health physical therapist who has extensive experience treating pelvic pain, urinary, and bowel symptoms. She is also board certified as an orthopedic specialist, and understands the importance of treating the entire system when it comes to pelvic floor issues.

Disclaimer: This blog post is for informational purposes only and does not substitute for professional medical advice. Please consult with a qualified healthcare professional for personalized guidance.

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