Can Tight Adductors Cause Pelvic Floor Dysfunction? A Rolfing Perspective

Can Tight Adductors Cause Pelvic Floor Dysfunction?

Can tight adductors cause pelvic floor dysfunction? This is a commonly asked question, and the short answer is yes.

In our rush to strengthen every muscle and structure that seems to be a problem, we often overlook the fact that overly tight, hypertonic muscles can be just as problematic as weak ones. Many Western approaches focus on weakness and assume the solution is always strengthening. Some modern Western forms of Eastern disciplines, like yoga, often emphasize that most physical problems can be addressed by lengthening and stretching.

Rolfing looks at this a bit differently. Problems can often be addressed by:

1. Differentiating structures that are dysfunctionally adhered, and

2. Improving how we use those structures in posture and movement.

This boils down to body awareness and sensation—both in stillness and in motion—and that certainly applies to the pelvic floor.

What Are the Adductors?

The adductors are the muscles that run up the inner thigh. Their job is to bring the leg back toward the midline. Bodyworkers often use the image of “adding” a limb back to the body when we adduct it, as opposed to abduction, which takes it away from the midline.

The adductors originate from the bottom of the pelvis—the pelvic ramus and the ischium—and insert along the femur. Because of this, we can think of them as feeding up into the bottom of the pelvis.

The muscles themselves stop there, but the fascia continues up into the pelvic floor. That continuous web of connective tissue links the thigh to the pelvis and pelvic floor. When the adductors are hypertonic and the tissue is tight, the thigh can become adhered to the pelvis, and the leg can feel almost jammed up into the hip.

The Adductors and the Pelvic

How This Affects the Pelvic Floor

A myofascial worker like a Rolfer wants to create differentiation of the leg from the hip by working with the origins of the adductors and the pelvic floor. When that differentiation is restored:

• The leg can drop out of the pelvic floor more freely when walking.

• The stride can lengthen, and

• The hips gain more freedom of movement.

In the traditional Rolfing Ten Series, this kind of work is typically addressed in the fourth session, where we focus on the inner line of the leg and its relationship to the pelvis.

Hypertonic Pelvic Floor and “Just Strengthen It” Advice

Right alongside tight adductors limiting the leg, we often find a hypertonic pelvic floor.

If someone has urinary issues, such as incontinence or other pelvic floor symptoms, the common advice is usually to strengthen the pelvic floor. But if the pelvic floor is already too tight, more strengthening work can actually make the problem worse, not better.

The pelvic floor is essentially a diaphragm, and like our respiratory diaphragm, it needs to be flexible and responsive, not rigid.

The Pelvic Floor and the Breath

Just like our respiratory diaphragm, the pelvic diaphragm needs to move as we breathe:

• When we inhale, the respiratory diaphragm is pulled downward to create negative pressure in the lungs so they fill with air.

• As this happens, the contents of the abdomen must be able to shift downward to make more room.

• The bottom of that chain of motion is the pelvic diaphragm.

If the pelvic diaphragm is locked up, the abdominal contents cannot move freely and end up being more compressed. In women, who have an additional organ—the uterus—this can mean even more compression on the bladder, sometimes contributing to incontinence.

By working out excess tension in the pelvic floor, and by proxy in the adductors, we can sometimes help relieve the extra pressure and tension contributing to incontinence or other pelvic floor symptoms.

The Thigh and the Pelvic Floor

Differentiation First, Then Integration

In the beginning, Rolfers focus on differentiation:separating structures that are “glued” together to restore freedom of movement and a smoother, longer stride.

Later in the process, we focus more on integration:helping structures work together better in posture and movement.

The adductors and the pelvic floor are key players in this process of differentiation and integration. Freeing them can:

• Relieve strain in the pelvis

• Improve how the legs and knees function

• Affect the kinetic chain

  
  

Why the Adductors Deserve More Attention

The adductors are often ignored until they become an obvious source of pain. When they finally receive focused myofascial work, they tend to get noticed immediately.

In my experience:

• I would be a bit suspicious if someone doesn’t find adductor work at least a bit challenging

• I’ve never met a client who truly had “weak” adductors. They are almost always tight and overworking.

They probably don't need to be strong, and when the are they can lose flexibility and pliability, then problems arise—in the pelvic floor, hips, knees, and beyond.

In Summary

So, can tight adductors cause pelvic floor dysfunction?

Yes.

Through the continuous fascial connections between the inner thighs, pelvis, and pelvic floor, overly tight adductors can contribute to:

• Pelvic floor hypertonicity

• Restricted leg swing and shortened stride

• Increased pressure in the pelvis and lower abdomen

Rolfing and myofascial work aim to restore differentiation and balanced tone in these structures, allowing the pelvic floor to function more like the flexible, responsive diaphragm it is meant to be.