Patients with pelvic floor hypertonicity are complex and unique in their varied presentations as they may present with incontinence; pelvic pain; constipation; incomplete bladder emptying and/or dyspareunia. Some may have more than one symptom. Many providers mistakenly strengthen these muscles which can make the symptoms worse. Once providers determine there is muscle hypertonus; they need to implement treatment strategies to reduce the tension; tailoring the treatment to the individual needs and symptoms of the patient. This lecture exposes the audience to the terminology used to describe increased pelvic muscle tone as well as educates the audience in various treatment strategies that can reduce symptoms while normalizing muscle tone. Case studies are reviewed at the end of this presentation.