Pain with penetration can be a symptom of pelvic floor hypertonicity or having pelvic floor muscles that have too much tension. When your pelvic floor muscles have too much tension you might experience these other symptoms as well:

-Pain with penetrative sex (during or after)

-Pain or inability to use tampons or menstrual cups

-Urinary urge and frequency

-“Shy” bladder or having to strain to urinate

-Constipation or straining with bowel movements

-Pain with bowel movements or urination

-Painful orgasm or difficulty reaching orgasm

-Tailbone pain

-Clitoral or penile pain

-Perineal or anal pain

-Hip pain

How do I know if I have a hypertonic pelvic floor?

A hypertonic pelvic floor can be identified with an exam by a Pelvic Floor Therapist. Your therapist can determine if pelvic floor muscle tone is normal or abnormally high. For more information regarding what to expect on your first visit with a pelvic floor therapist, check out this article.

How can Pelvic Floor Therapy help a hypertonic pelvic floor?

A pelvic floor therapist will help facilitate the lengthening of your pelvic floor muscles. Treatments with a pelvic floor therapist can include:

-Manual therapy (external, intravaginal, or intrarectal, depending on patient needs)

-Patient training to use vaginal dilators

-Biofeedback

-Home exercises including stretching and coordination exercises

What about other treatments?

Medical management of hypertonic pelvic floor muscles can include pharmaceuticals or procedures such as trigger point injection or botox. These options will have to be discussed with your doctor. 

How do I schedule with a Pelvic Floor Therapist?

Consult with your doctor to see if you are a good candidate for pelvic floor therapy and to get a referral for pelvic floor therapy. The pelvic floor therapy team at MOTI have undergone additional training to be able to perform pelvic floor examination and treatment and are ready to help you on your healing journey!

Exercises to Try Today

The following exercises are helpful to relax your pelvic floor, give them a try today.

Diaphragmatic Breathing

The diaphragm and pelvic floor are both soft domes of muscle in the abdomen that move together when you breathe. Diaphragmatic breathing can help restore rhythm between the two and balance tension in your abdomen. Start in a seated position or lying down on your back. Place one hand on your chest and one hand on your stomach. As you inhale, allow the pelvis, belly, and lungs to expand and fill with air. Both hands should rise and fall at the same time. As you exhale, you’ll feel the air gently leave the body, without any strain. Repeat for 5-10 minutes.

SINGLE KNEE TO CHEST

Begin laying on your back. Bring one knee to your chest, cradling the knee with the arm/hand. Hold the stretch for 30-90 seconds. Breathe. Repeat on the other side.

MODIFIED HAPPY BABY

Laying on your back, hug both knees to the chest, using your hands or a stretching strap/towel behind the thighs. Hold the stretch for 30-90 seconds while performing your diaphragmatic breath.

CAT COW

Start on all fours, exhale as your round the spine like an angry cat. As you inhale, come into a back extension, allowing the belly to sink towards the mat and eyes towards the sky. Move slowly with controlled movement. Perform 5-10 reps. 

CHILD’S POSE WITH SIDE STRETCHING     

From all fours, stretch the glutes towards the heels, walking fingertips forward. Hold the stretch for 30-60 seconds while perform deep breaths. Walk the fingertips toward the right side of the mat, until you feel a side stretch on the left. Hold for 30-60 seconds. Repeat on the other side. 

SUPPORTED SQUAT STRETCH

Come into wide leg squat onto a low stool, a stack of sturdy books or yoga blocks. Focus on dropping the pelvic floor and perform diaphragmatic breathing. Hold for 30-90 seconds. 

The post Pain with Sex or Tampons? How Pelvic Floor Therapy May Help You and Five Exercises You Can Try Today appeared first on MOTI Physiotherapy.

As with orthopaedic physical therapy, pelvic floor rehabilitation starts with examination to understand what different factors may be contributing to your dysfunction.
 
An intial pelvic floor therapy exam will typically involve the following elements:

-A thorough intake of your health history. 
Your pelvic floor therapist may ask you questions regarding your bowel and bladder habits, sexual function, and pelvic pain.  Any prior abdominal or pelvic surgeries will be discussed, as well as any falls, accidents, or traumas involving the area. For those with female anatomy, this may include asking about any gynecological issues such as endometriosis, pain with menstruation, previous pregnancies, labors, and deliveries. 

-External examination 
The external examination is typically done fully dressed and may resemble other orthopaedic physical exams, your therapist will assess your full body movement, strength, and flexibility in order to take the whole system into account. 

-Internal examination
Internal exams are performed intra-vaginally or intra-rectally, depending on the condition being treated. Your therapist will discuss with you what type of exam is recommended and what you’re comfortable with. The internal exam will help your pelvic floor therapist determine factors such as pelvic floor muscle strength, coordination, and whether your pelvic floor muscles are hypertonic (too active) or hypotonic (underactive). 

After getting a complete picture from the examination, your pelvic floor therapist will discuss their findings and share your plan of care with you.

Treatment:

After your initial examination, follow-up visits will focus on treating the issues that were identified. Treatment will depend on what your condition is and what your therapist finds upon examination. Pelvic floor rehabilitation may include:

• Internal and external manual release of restricted muscles
• Pelvic floor muscle strength training with or without biofeedback
• Pelvic floor muscle relaxation training
• Bladder and bowel behavioral retraining strategies
• Dilator training for increasing penetration tolerance
• Core and gluteal training
• Body mechanics training

For more information regarding the pelvic floor conditions we treat, check out this page.

The post Pelvic Floor Therapy: What to expect on your first visit and follow up visits appeared first on MOTI Physiotherapy.