Levator Ani Syndrome

Levator ani syndrome is a type of pelvic floor dysfunction in which the pelvic floor muscles spasm (are too tense). This can result in considerable vaginal and/or rectal pain, which can radiate to the groin, lower abdomen or buttocks. Learn more about this condition, and how Pelvic Health Physiotherapy can help.

What is Levator Ani Syndrome?

 The levator ani is a group of muscles that make up a large portion of the pelvic floor. They span from the pubic bone in the front of your pelvis to your tailbone in the back. They work as a team on the left and right sides of the body to provide support for the rectum and anus, as well as the bladder, urethra, vagina and prostate.  

Sometimes, these muscles can go into “dysfunction” and spasm (i.e., become overactive and tight), resulting in pain that may appear in the perineum, rectum or tailbone area. This is referred to as Levator Ani Syndrome. The most notable symptom of Levator Ani Syndrome is spasm of the pelvic floor muscles, which causes rectal pain. An episode usually lasts about 20 minutes. Other symptoms include:

• Pain is worse when sitting or during a bowel movement

• A sensation of fullness or pressure in the rectum (it can feel like a golf ball is present)

• Pain during or after intercourse

• Pain that radiates to the groin, lower abdomen, or buttocks

There are no specific tests to diagnose Levator Ani Syndrome. It is usually diagnosed based on the presence of the above symptoms and ruling out other conditions. If you have pelvic pain that is causing discomfort or interfering with your quality of life, see your doctor as soon as possible so that they can conduct a proper evaluation.

Both men and women can develop Levator Ani Syndrome, but it is much more common in women. The exact cause(s) are unknown.

What Is The Role of The Pelvic Floor in Levator Ani Syndrome?

 The pelvic floor is comprised of a group of muscles that support and protect the organs in our pelvic region, as well as provide stability and enable sexual sensation. When they are working properly, the pelvic floor muscles form a basket or hammock shape that supports the organs against gravity and intra-abdominal pressure (pressure in the abdomen).

In situations where the pelvic muscles are too tight/tense and unable to relax, the muscles become weak and symptoms of pelvic floor dysfunction may arise. The pelvic muscles become painful and sore, and the nerves that supply these muscles can become very irritated. A dysfunctional pelvic floor – where the muscles are in constant spasm – can also compromise bowel and bladder function, and make sexual intercourse painful.

How Can Pelvic Health Physiotherapy Help Me?

Pelvic health physiotherapy can play a significant role in helping those suffering from Levator Ani Syndrome.  Pelvic floor physiotherapists are specially trained in assessing the pelvic floor muscles, and identifying and treating muscles that are spasmed, sore and/or improperly coordinated. Treatment may include:

• Soft tissue release (through manual therapy)

• Desensitization techniques for irritated nerves

• Massage and muscle re-training

• Exercises to help you release tension

• Biofeedback to learn how to properly relax and contract the pelvic floor muscles

• Relaxation and stress management techniques

With the right care, many patients with Levator Ani Syndrome learn how to relax and coordinate their pelvic floor to help ease pain and return to the activities they love.

How Do We Approach Treatment For Levator Ani Syndrome?

At Proactive Pelvic Health Centre, we’re dedicated to helping destigmatize issues related to pelvic health, and empowering people to take control of their bodies. We work with you to understand your pain, identify the causes, and treat the symptoms.

Your dedicated Pelvic Health Physiotherapist will take your full medical history and discuss your symptoms, and then perform a complete physical assessment of the affected muscles and tissues. This can include an internal examination to reliably assess pelvic floor muscle tension, flexibility, and weakness. Based on the examination, your Pelvic Health Physiotherapist will work with you to put together a treatment plan specific to your symptoms.

We use a variety of clinically-proven techniques, from manual therapy to pelvic floor exercises, to help you relax your pelvic floor muscles, and re-train them to work for you, not against you. By educating you on your pelvic floor and how to better control it, you’ll be armed with ways to help manage your symptoms at home.

Did not see a lot of info on risk factors from reputable sources, so left this section out, and indicated here that the exact causes are unknown.