Physical therapists (PTs) are experts in movement and function, which sounds like a pretty broad topic to be an expert in, and it is. After physical therapists graduate PT school (now-a-days at the doctoral level), they find their niche and specialize. You can find PTs working with high-level athletes, children, infants, people who are recovering from injuries, people with neurological conditions and many other types of clients.
“I intentionally try and distract you during treatment, so that you don’t focus too much on the pain of the treatment. Furthermore, talking during our sessions continues to build rapport which is so important — it builds trust, makes you feel more comfortable, and also makes it more likely that you will return for your follow-up visits so that you will get better,” she says.
The muscles of the pelvic floor must work together and in coordination to perform specific tasks. The pelvic floor has to contract, elongate and relax in very precise ways to perform basic functions like urination, defecation, support the pelvis and organs, and sexual function and pleasure. If your pelvic floor muscles and/or nerves fail to do what they are supposed to do at the right time, problems like painful sex, erectile dysfunction, constipation, and incontinence can occur.
It’s highly unlikely that someone will head into a therapist’s office for a stand-alone “vaginal massage.” Why not? “It’s one small aspect of the whole therapy,” says Laura Y. Huang, MD, assistant professor of physical medicine and rehabilitation at the University of Miami Miller School of Medicine. She notes that pelvic floor muscle training, biofeedback, soft tissue release, and education are some of the many pelvic floor physical therapy treatments used to relieve pain or retrain muscles. Learning techniques and strategies to manage the condition at home is also part of treatment.
May is Pelvic Pain Awareness Month (#PelvicPainAware), supported by the International Pelvic Pain Society (www.pelvicpain.org). As physical therapists who specialize in abdomino-pelvic pain disorders, one of the toughest parts of the job is meeting men and women who have suffered with pelvic pain for years, only to be told by their doctors/healthcare providers that there is no help for them. It is not uncommon to meet a patient who has suffered for 5- 10 years without help before finding us. Musculoskeletal causes of abdomino-pelvic pain are treatable conditions and often times we can start to improve a patient’s symptoms within just a few visits. We are promoting Pelvic Pain Awareness Month because it is our mission to ensure that people know that help exists so they can start living richer and fuller lives. In honor of Pelvic Pain Awareness Month we want to take some time to explain what we do and how it can help with the symptoms of pelvic pain. Please read on to see how we can help you with your pain.
Hip bridges: Engage your abdominals and pelvic floor before you start to bridge up, then bring the hipbones up to the sky. Then hollow out even more and really engage the pelvic floor. Then slowly lower your back to the mat, starting with your upper back, middle back, then lower back. Once you reach the mat, you can release your pelvic floor, and then re-engage as you do this move again.
As physical therapists, are our hands are amazing gifts and phenomenal diagnostic tools that we can use to assess restrictions, tender points, swelling, muscle guarding, atrophy, nerve irritation and skeletal malalignment. We also use our hands to treat out these problems, provide feedback to the muscles, and facilitate the activation of certain muscle groups. There have been a great number of manual techniques that have evolved over the course of physical therapy’s history. Let’s go over a few.
Neural mobilization as the name implies, involves the restoration of neural structures back to their normal mobility: to glide and slide. Neural structures that cannot move properly can cause pain that can radiate down an extremity or into the trunk and can give the sensation of burning, zinging, and stabbing. Some orthopedic therapists practice this type of mobilization; common examples include the sciatic nerve in the leg and the ulnar nerve in the arm. Pelvic floor PTs focus on these nerves when they cause issues, but they also pay attention to nerves that innervate the perineum and genital region (bicycle seat area), such as the pudendal, iliohypogastric, obturator, ilioinguinal, genitofemoral and the femoral cutaneous nerves. By allowing these nerves to move freely, symptoms such as vulvovaginal, penile, rectal, clitoral and testicular pain, itching and burning can be greatly improved.
The term “vaginal massage” may not be legit—practitioners don’t like to use it—but the treatment is. In fact, it’s part of a well-rounded therapy regimen for pelvic floor physical therapy. Certified specialists in this field can help women who are dealing with pain during sex—something 75% of women experience at some point in life, according to research.
Nerves, organs, and joints can lose their natural mobility over time and cause a whole host of symptoms from pain, to loss of range of motion, and poor functioning of the bodily symptoms. Skilled and specialized therapists can use a variety of active techniques (patient assisted) and passive techniques to free up restrictions in these tissues and organs and improve overall function.