If Your Pelvic Pain Won’t Quit, Read on for 5 Tips to Ease Pelvic Pain!
Here at Purple Mountain PT we have a heart for anyone who is experiencing pelvic pain that just won’t quit. We understand the despair you feel and the lack of answers when you go from provider to provider or experience “random” pains that are unpredictable. Our Doctors of Physical Therapy have many years experience working with people who, unfortunately, have lengthy and frustrating journeys to finding us and getting the real help they need. In fact, at Purple Mountain PT we are known especially for helping people overcome pelvic pain. Our patients tell us that the therapy they receive with us is life changing and the best thing that has ever been done to help them. Here, you’ll find 5 quick tips to ease pelvic pain.
What are Some Common Things That Our Patients Tell Us? Here’s an example.
Sarah’s Story: Do You See Yourself in Her Story? Names have been changed for privacy.
Sarah is a 44 year old female who came to us with lower abdominal pain and vaginal/pelvic pressure that bothered her most days. It had been going on for the last six years or so, and developed around the time her last child was born. In those six years she thought her problem was an ovarian cyst, but when the doctor found a cyst she was told that it should simply be monitored and no further treatment was recommended. She found herself taking ibuprofen more often than she liked and this also caused some issues related to her migraines, rebound headaches. She developed some back pain and went to physical therapy for this; the PT didn’t help. At one appointment they had her sit in a chair and march in place and she thought it was a silly exercise that wouldn’t help her, so she stopped going. The pelvic pressure was worse around her menstrual cycle, but occurred throughout the entire month and was bad enough that she avoided jogging and intimacy.
Review of Sarah’s symptoms:
- Abdominal pain
- Vaginal pressure
- Ovarian cyst present, but not thought to be the cause
- Ibuprofen usage has increased over the years
- Back pain
- Pelvic Pressure
She found us because one of her friends told her about us, but she had already been to physical therapy for her back and that PT told her that her pelvic floor was fine.
She was skeptical when calling Purple Mountain PT, but when her friend promised her that we were different and more effective, she scheduled an evaluation. At her evaluation, she told us that her pain was her main concern and was occurring nearly everyday and often causing her to feel out of shape and unable to workout to get into shape. Her pain seemed to be random and, therefore, she really felt like there was nothing in particular she could do to make it go away or help it to be better. We also discovered that she experienced urinary leakage and sometimes urinary urgency. Her constipation was an ongoing problem, with bowel movements once every 2nd or 3rd day. Intimacy was not comfortable and was not enjoyable, her libido was gone.
Additional pelvic symptoms we discovered for Sarah:
- Urinary incontinence
- Urinary urgency
- Painful intimacy & low libido
Our examination found that she had a variety of things that we needed to address to help her pain:
- Myofascial restrictions in her abdominal wall including trigger points in numerous muscles that were contributing to daily pain. These included tension in her hip flexors and abdominal oblique muscles as well as rectus abdominus.
- Diastasis Recti Abdominus: Sarah had a problem with the integrity of her abdominal wall, causing her to have a thinning and widening of her linea alba. This places excess stress and strain through the abdominal wall and pelvic floor, contributing to pelvic pain, bladder leakage, lower back pain and pelvic pressure. We specialize in helping women (and men) resolve their DRA. A DRA is a very common finding in our patients and we provide high quality assessment and treatment for this; this is unique to our clinic, as we find that for our patients a DRA is usually not properly addressed until they find us.
- Tension and muscle guarding and tightness in her hip muscles, inner thighs and low back. These were a major source of her problem and needed to be effectively treated with myofascial release, trigger point release, joint mobilization and pelvic and low back alignment methods. We also included treatment to improve the strength of her hips and core muscles.
- Pelvic floor dysfunction characterized by high tone pelvic floor, meaning her pelvic floor muscles were stiff and painful. These were a big driver of her pain and her urinary urgency and leakage and likely contributing to her constipation, also. By treating her pelvic floor dysfunction and her abdomen, hips and back, we were able to ease her pelvic pain and bladder symptoms.
- Misalignment in her pelvis Her SI joint was not happy and we found that her hips and pelvis were not aligned. She also had some postural changes that were making it more difficult on her pelvic floor. We worked with Sarah to optimize her pelvic alignment and posture. By doing this, the stress through the pelvic floor was reduced, thereby lessening her pelvic pain and pressure.
- The presence of migraines plus the chronic pelvic pain render us suspicious for her having a ramped up nervous system that easily experiences pain. We use a validated questionnaire to find out if this is the case and it was for Sarah. Because of this we use a combination of education, neural calming techniques, heart rate variability training and myofascial release and muscle calming hands-on methods to calm down her sensitized nervous system. Our patients find this treatment to be incredibly beneficial and a key thing we do that is not routinely provided. Our therapists have advanced training specific to calming the nervous system and restoring the bladder and bowel. We offer this because we know it helps our patients to feel better.
- Inability to exercise is a big problem and something we needed to improve. We found she was quite weak & often tight in many major muscle groups including her glutes, quads, inner thighs, hamstrings, low back, postural stabilizers in her upper back, abdominals and calves. Her weakness was from a combination of being sedentary and also from her condition inhibiting the proper firing of her muscles; we needed to retrain the muscles and restore her capacity to exercises.
At Purple Mountain PT we begin treatment on your very first day. You can expect hands-on treatment methods to include myofascial release, trigger point release, corrective alignment methods, neural calming and lots of education in exercises and things you can do to help yourself. Because Sarah’s case is common and, if you are reading this blog, you likely share some characteristics with Sarah, we can offer five tips to ease pelvic pain to help you today. These are things you can try that we also suggested Sarah begin on her first day of treatment. Give us a call at (616) 516-4334 or contact us here to see if we can help you get back to what you’re missing!
5 Tips To Ease Your Pelvic Pain that Won’t Go Away!
Tip 1: Practice Diaphragmatic Breathing
The diaphragm is a pathway to calming down high tone pelvic floor and chronic pain. Learning to effectively breathe with your diaphragm is a key skill that is usually dysfunctional when someone has chronic pain. This may seem like a simple, useless tip. But, take our word for it and our patients’ word for it: diaphragmatic breathing is an important skill to help nudge your body out of pain.
Tip 2: Lengthen Your Pelvic Floor Muscles
This is tricky to learn and, especially when someone has chronic pelvic pain, usually they have very limited capacity to let go of their pelvic floor muscles because these muscles are stiff and tight. For the most effective results, you truly need hands-on care from one of our Doctors of PT. But, please give this tip a good, solid try. Practice makes perfect, so you’ll have to work on it multiple times a day.
Here’s one way you can learn how to melt your pelvic floor muscles: lie down in a quiet location. Clear your mind. Soften your breathing. Relax your abdomen. Bring your awareness to your pelvic floor area. Relax your glutes. Let go of your tailbone, invite it to float back towards the floor. Soften and open the anus, let go of the back area. Drop your vagina by fully letting go of it. Simulate peeing and invite a release/opening of the area where you pee. Never push these muscles to get them to release.
Tip 3: Optimize your gut health
This is crucial when trying to resolve pelvic pain. You must have daily bowel movements that are well formed and without straining. Look closely at your nutrition and eliminate all foods that might constipate you and/or cause intestinal bloating or distress. Consider seeing a dietician for expert guidance. Aim to eat 30 grams of fiber a day, if you can tolerate fiber.
Tip 4: Optimize your water intake
Because Sarah had some issues with urinary control and urgency, she had slowly reduced her water intake. This actually worsens bladder wellbeing and can contribute to bladder spasms and ongoing pelvic pain. For your bladder to be happy you need optimal water intake. You should be urinating about every 2 to 4 hours and you want your urine color to be light yellow.
Tip 5: Movement is Needed
With chronic pelvic pain we know that movement is needed. You must move. The less you do, the more you hurt. The challenge is figuring out how much movement is well tolerated and which movements to do. In general, it is smart to begin with brisk walking and some light stretching. Think about stretching your hips, low back and legs. Be gentle with your movements, never forcing a stretch.
Bonus Tip 6: Prioritize Sleep, Relaxation and Meditation.
Sleep is how our body restores itself. You must prioritize sleep, address sleep apnea problems and keep a regular bedtime. By building relaxation and meditation into your daily routine, you will further nudge your nervous system towards a more balanced and less sensitized state and this will, in concert with everything else you are doing, help you have less pain. Research has shown us that individuals who have chronic pelvic pain experience higher rates of anxiety, depression and sleep disorders. We also know that multimodal (meaning a team of providers with various clinical expertise) care is best for you. For more on the benefits of physical therapy, check out this blog we wrote for a fellow PTs site. It is common that your team might consist of a physical therapist, counselor, psychologist, sleep specialist, gynecologist, physiatrist and other providers.
For our patient, Sarah, these 5 simple tips to ease her pelvic pain got her started with a plan for what she could do at home.
With our skilled therapy, which primarily comprised of hands-on treatments from her shoulders to her knees (because pelvic pain and fascia connections extend throughout the body), bladder calming treatments and parasympathetic nervous system activation, Sarah was able to gradually increase her exercise and daily activities and found that the “random” pains were not happening anymore. Once Sarah’s pain went away she told us that she couldn’t believe how long she had lived in pain and she wished she had found us sooner. Contact us today to speak with our knowledgeable and caring staff to learn more about our model of care and how we can help you.
A key feature of our treatment is our expert manual therapy methods and ability to diagnose and treat complex features of pelvic pain.
Of course, we assess and treat pelvic floor dysfunction and this is a hallmark of what we do. We are particularly skilled at identifying whether you have pelvic floor dysfunction. And, to be clear, if you have chronic pelvic pain you need holistic treatment to everything from your shoulders to your knees and maybe even your feet! Our doctors of physical therapy are fully trained in assess and treat all of these areas and provide you expert manual therapy methods + exercises to alleviate your pain. In addition to myofascial mobilization, trigger point release, pelvic balancing and postural corrections, we worked closely with Sarah completing specific exercises to reduce her pain while also building up better strength and function of her muscles, especially her core muscles, hips and thighs. Contact us here or call us at (616) 516-4334 to get your questions answered today.
While these tips to ease pelvic pain have worked for many of our patients, please keep in mind that you are not our patient and, therefore, this is not medical advice for you. Everything here illustrates what worked for Sarah and other patients. Please, if you are having pelvic pain that won’t quit, you deserve to be fully assessed by us. We are here to provide you the care that will give you results. Each appointment is upto 55 minutes long and in a private treatment room, with the same doctor of physical therapy every visit; we never bounce you around amongst lesser trained people. You can give us a call at (616) 516-4334 to learn more or contact us here! We wish you better days ahead. And our main message to you is that you don’t have to live like this! There is hope for you.
Dr. Maureen O’Keefe, DPT and the Purple Mountain PT Team
Clin Obstet Gynecol. 2019 March ; 62(1): 22–36. doi:10.1097/GRF.0000000000000412.