What is the pelvic floor?
The pelvic floor is a group of muscles which attaches at the front to your symphysis pubis and at the back to your sacrum. It acts like a hammock and holds all your pelvic organs in, and keeps you continent of urine and faeces.
When do pelvic floor problems start?
Pelvic floor symptoms can start if the pelvic floor muscles, often on only one side, are too tight or ‘overactive’. This can be due to holding your pelvic floor muscles too tightly (pelvic floor over-activity) and can be linked to previous pelvic floor trauma, for example, after a tear or episiotomy during birth.
- You may have PGP pain which is not getting completely better with manual therapy, or which keeps coming back after good treatment.
- You may also have leakage of urine or faeces.
- You may experience pain during sexual intercourse due to the tightness in your pelvic floor muscles.
- You may also have stomach pain low down in your stomach, or urgency or frequency going to the toilet (for urine or to open your bowels), constipation, or pain which feels as if it is in your bowel or back passage.
What can I do about it?
As with PGP, pelvic floor problems respond well to manual therapy treatment. The treatment for pelvic floor tightness is physiotherapy which is done by internal examination through the vagina, finding tight ‘trigger points’ and releasing them using pressure from the therapist’s fingers. This may be followed by exercises to retrain your muscles to get them working normally and avoid them tightening up again.
As with all manual therapy treatments, this treatment can be uncomfortable at the time, but the pain should get better straight away – you should walk out feeling better after each treatment, and should see continued improvement between treatments as well.
At the same time as treating the pelvic floor you will need to have treatment for the pelvic joints as well, so that the alignment can be improved.
Who can provide this treatment?
This treatment can be carried out by a physiotherapist specialising in trigger point therapy for the pelvic floor, usually a women’s health physiotherapist. The alignment of your pelvic joints may be checked and treated by the same therapist at the same time, or you may need to see a specialist manual therapist separately, depending on the experience of the therapist you are seeing.
There is more information about overactive pelvic floor symptoms and treatment available at www.pelvicphysiotherapy.com, which also has a list of practitioners who have undertaken extra training in this type of treatment.
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