Muscles
Levator Ani Trigger Points
Symptom Area: Lower Torso
Levator Ani Trigger Points are explored here through their location and referred pain pattern. Muscle knots is an everyday term used for tender muscular spots; myofascial pain describes pain involving muscle and its surrounding connective tissue. Main pelvic floor sheet; trigger points cause deep pelvic, rectal and tailbone pain that is often worse when sitting.
Where you feel it
When the Levator Ani holds active trigger points, you usually notice it as menstrual problems, pelvic pain and si joint pain (base of the spine). Where the pain spreads: Deep aching pain in the pelvis, rectum, perineum and tailbone; sometimes referred to the low back or sacrum and provoked by prolonged sitting or bowel movements. What often sets it off: Pelvic floor overactivity, chronic straining or constipation, childbirth, pelvic surgery or trauma, persistent bracing under stress, chronic urinary or prostatic irritation.
Overview
Levator ani comprises pubococcygeus, puborectalis and iliococcygeus, forming the muscular floor of the pelvis. It supports the pelvic organs, contributes to continence and works with the diaphragm in pressure regulation. Its trigger points are a well recognised cause of chronic pelvic pain syndromes.
Trigger point locations
Points along the muscle sheet on either side of the midline, accessible on internal pelvic floor examination.
Referred pain pattern
Deep aching pain in the pelvis, rectum, perineum and tailbone; sometimes referred to the low back or sacrum and provoked by prolonged sitting or bowel movements.
Palpation & testing
Internal vaginal or rectal palpation by a clinician trained in pelvic health; taut bands reproduce the patient's familiar deep pelvic pain.
Common causes
Pelvic floor overactivity, chronic straining or constipation, childbirth, pelvic surgery or trauma, persistent bracing under stress, chronic urinary or prostatic irritation.
Self-care & clinical treatment
Pelvic floor down-training with diaphragmatic breathing, sitting modification, bowel habit and hydration management, warm baths. Clinically: internal manual release by a pelvic health physiotherapist, with medical work-up of urogenital and colorectal causes.
Treatment protocol
For Levator Ani, the general protocol applies: sustained pressure release on the taut band, then stretch and active movement in the newly gained range.
Position and palpation: Internal vaginal or rectal palpation by a clinician trained in pelvic health; taut bands reproduce the patient's familiar deep pelvic pain.
Regional precaution for clinicians: In the flank and abdominal wall the kidney (behind the twelfth rib and the quadratus lumborum), the abdominal viscera and the lower lung fields are the structures at risk.
Primary Symptoms
Often confused with
These muscles cause the same primary symptoms, so they are checked together:
Related muscles in this region
Related articles
References
- • triggerpoints.net — reference
Medically reviewed by: Marco Aruffo — physiotherapist since 2006, specialised in myofascial pain · Last reviewed:
