Despite the diagnosis your physician may have given you, I am here to tell you that pain down there is NOT normal. Yes, there are a plethora of diagnoses relating to pelvic pain. Many of them are directly related to the pelvic region such as vulvodynia, vaginismus, endometriosis, adenomyosis, pelvic pain syndrome and interstitial cystitis. Other diagnoses may refer pain to the pelvic region. These include Crohn’s disease, ulcerative colitis, irritable bowel syndrome, gastritis, and other gastrointestinal disorders. Furthermore, musculoskeletal diagnoses can also refer to that region. Hamstring tendonopathy? Adductor strain? Low back pain? You bet any muscle that attaches to the pelvis can refer pain to the pelvis.
Unfortunately, this is not an all inclusive list. However, let me repeat myself. Despite your diagnosis, pain in the pelvic region is NOT normal. Even if you have a laundry list of diagnoses, pelvic floor dysfunction can be treated. Often times, my patients tell me that because of their fibromyalgia, bulging disc or endometriosis, they have learned to just “live” with the pain. These comments always make me sad because I end up being the first practitioner to tell them that there is another option.
That option is pelvic floor physical therapy in conjunction with a new way of thinking about your body. One of the biggest points I drive home to my patients is that I cannot change their medical diagnosis, but I can help change the way their body responds to that diagnosis. You see, when we have a medical condition like endometriosis or irritable bowel syndrome, it is very common for our abdominal and pelvic floor muscles to go into “protective mode.” To put it simply, when you have an IBS or endometriosis flare, your muscles are like “What the heck is going on? Maybe if I start to clench all of the time, I can help protect whatever is going on inside of me.” Basically, your muscles turn into this protective blanket, contracting tighter and tighter in an effort to protect your body. In the end, you get painful, sore, non-relaxing muscles that only makes the situation worse.
In previous posts, I touch based on the function of the pelvic floor. I will touch base on it again. Our pelvic floor muscles attach from the pubic bone and expand all the way back to our tailbone. These muscles form a bowl shape, enveloping our rectum, urethra and vagina. If these muscles are in “protective blanket mode,” they are restricting our urethra, vagina and rectum. This leads to urinary hesitancy, urinary frequency, constipation and painful sex, to name a few. Furthermore, these muscles can also begin to irritate the nerves that pass through them. Nerves are not a big fan of the protective blanket.
SO, back to our endometriosis or IBS examples. Now, not only do you have this diagnosis to deal with, but you also have accompanying issues specifically caused by the pelvic floor muscles being over-protective. This is where I come in. As a doctor of physical therapy who has taken the appropriate continuing education, I can perform internal pelvic floor releases which helps these muscles calm down and chill the ef out. Through a very specific treatment plan, I can help facilitate the first steps to taking off that restrictive “protective blanket” and help you get back to the life you deserve.
-Dr. Betsey Stec PT, DPT
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