Hi, I’m Christina Bausch. I’m a physical therapist and pelvic floor specialist here at Rebound Physical Therapy. We are an outpatient clinic that’s located in Topeka, Kansas. Today we’re going to talk about pelvic pain and how physical therapy can help with that.
Anatomy of the Pelvis
First, it’s important to understand a little bit about the anatomy of the pelvis. In the front of your body, low on your abdomen, you have your pubic bone. It connects to your hip bones, which curve around back toward your spine. And at the bottom of your spine, you have your tailbone, which sits parallel to your pubic bone. If you look at a model of the pelvis, it almost looks like a bowl. At the bottom of this bowl in women, you have the pelvic floor muscles. These are what support all of our pelvic organs, and these muscles also help to provide stability for the pelvis itself.
Causes of Pelvic Pain in Women
When those muscles are at rest, they should be fairly relaxed. Think about your arm muscles. If your arm is just hanging there and we were to measure it, there would be a little bit of muscle activity going on but not very much. When we get up and move, or we’re active, we want that muscle to be able to engage and work and provide support. But once it’s done, it should be able to go ahead and relax and shut off. When we want to either empty our bladder or have a bowel movement, we want those muscles to be able to go from that relaxed state to actually shut off even more. So it’s going to relax even more, drop down, elongate and let everything empty through.
What happens sometimes is that, instead of those muscles being at rest, for some people, those muscles may actually be holding some tension all the time. If you imagine it like your upper shoulder or neck muscles, sometimes those muscles tense up and they might hold tension in them all the time. That same concept can happen in those pelvic floor muscles. In the same way that you might develop some trigger points or some knots up in your neck muscles, those muscles within the pelvis can develop trigger points or knots in them too. And that can lead to pain either when they are pressed on or it can cause chronic pain that is just there all the time.
There are other muscles that are involved. There may be pain that’s caused by the muscles within the pelvis. Sometimes there’s also pain that’s coming from other muscles too. You have muscles that attach around the brim of your pelvis and go across over to your hips. There are muscles in your lower back, your abdomen and your hip flexors. All of those muscles could be a source of pain. It may also be the fascia (the thin tissue that covers your muscles and organs). If there’s a history of abdominal surgeries or other conditions that might create scar tissue or some fascia restrictions, that can be a source of pain too.
How Physical Therapy Can Relieve Pelvic Pain
When you come in for an evaluation, we’re going to look at all those areas and then try to pinpoint what are the causes of your pain specifically. There may be multiple causes, and it’s going to look different for each person. But part of the treatment plan will be helping to retrain those muscles to not hold that tension in them. We’ll help to reset that resting level back to its normal state. For a lot of people, they’re holding tension and they don’t even know. It just feels normal to them, so they don’t even realize that they’re holding extra tension. And it’s hard too. When you’re in pain, your body automatically wants to guard and tense. That’s really common, and we can work on strategies to help with that.
One strategy that is helpful in decreasing that tension in the muscles is to use some diaphragmatic breathing. What that means is just breathing into your belly. Your belly expands as you breathe in and then relaxes as you breathe out. That’s just one basic technique that can help to start the process of relaxing those muscles. There are lots of other tools that we can use and hands-on techniques that we’ll use to help to get those muscles calmed down at whatever rate you’re comfortable with. If you’re in a lot of pain, we may start really slow to whatever you’re able to tolerate.
Let Us Help You Get Back in Action
If you are experiencing pain, either in the pelvis or anywhere within the low back or hip area, just remember that it could be caused by pelvic floor dysfunction. And that is something that a physical therapist who specializes in pelvic floor therapy would be able to help you with. Please just reach out to me. I’d be happy to sit down and talk with you about what’s going on specifically, and we can put together a plan to help relieve your symptoms.
Call us today at (785) 271-5533, or visit our website at https://reboundphysicaltherapy.com/ to schedule a FREE Physical Therapy Screening with me!
