Pelvic Floor Physical Therapy
Pelvic floor dysfunction (also sometimes called pelvic floor tension myalgia) is much more common than you might think.
Pelvic floor dysfunction is often the underlying culprit responsible for chronic pelvic pain, issues with voiding, dysfunctional bowel movements, and painful intercourse. Pelvic floor dysfunction can also be the body’s response to another issue, like endometriosis.
What does that mean? Often when the body is experiencing constant pain, our response is to clench the nearby associated muscles. Imagine someone suffering from endometriosis. With a pain trigger in the pelvis, the pelvic floor muscles may respond by contracting and spasming. Unfortunately, most people do not have an established mind-body connection with the pelvic floor, and these muscles are never consciously relaxed. Holding tension in your muscles 24/7 eventually causes pain itself, and the cycle of pain à muscle tension and spasm à pain continues. In addition, an inappropriately contracting pelvic floor will lead to dysfunctional voiding and defecation.
An obvious, and very important step, is to address any underlying triggers for pelvic floor dysfunction. If endometriosis is suspected, surgery to remove it should be expedited. Generally speaking, pelvic floor physical therapy is also required to improve symptoms, especially if pain has been present for a long time.
What is pelvic floor physical therapy?
The goal of pelvic floor physical therapy is to establish a mind-body connection with your pelvic floor. In addition, manual release and stretching of muscles of the lower back, hip flexors, pelvic floor, and abdominal wall is performed to improve pain symptoms.
What is a pelvic floor physical therapy assessment like?
The first assessment is performed to understand what musculoskeletal contributors may be impacting your pelvic pain. Your physical therapist will generally perform a thorough assessment of your lower back, perform SI joint maneuvers, evaluate your hip mobility, posture, and your gait. Next, they will have you contract and relax your pelvic floor muscles and assess your coordination, tone, and strength. If you are comfortable with internal evaluation, an assessment of trigger points of the pelvic floor can be performed.
You and your therapist will work together to form a therapy plan. Generally, this consists of weekly treatments for at least 8 weeks. You will also learn self-therapy exercises, breathing techniques, and proprioception exercises to perform on your own.
Bottom line: Pelvic floor therapy can work miracles for those suffering from pelvic floor dysfunction and is an integral part of a treatment plan for those living with chronic pelvic pain.