I have been successfully treating pelvic pain with Myofascial Release in men and women for over 20 years now. This technique is effective for the common issues that most men and women are walking around with and just dealing with now, such as urinary frequency and incontinence, pelvic pain and sexual dysfunction. It still surprises me that Myofascial Release is a hidden secret when it is so effective. Why are doctors not sending all of their patients immediately as a first line of defense for common pain and pelvic floor issues instead of prescribing these less effective pharmaceutical agents which all have side effects? I truly have no answer for this except for the underlying knowledge of the need for profit and revenue producing procedures in our health care system which generally involves prescription drugs and surgical procedures. That being said, I find it important to educate as many men and women about pelvic floor dysfunction and how easily and effectively it can be treated and encourage them to spread the word. There truly is no reason for men and women, both young and old, to have their lives and activity levels affected by changes in the pelvic floor that come with our normal day to day activities and life changing events such as pregnancy and childbirth.
The following case is just one example of a very typical client referred to Physical Therapy for low back pain who also had urinary incontinence. Client A is a 55 year old female, post menopausal on bio-identical hormone replacement. She has an active life style with a regular exercise and stretching program. During her evaluation, it was noted that she had 2 pregnancies and 2 C-section deliveries. She also revealed that she had been dealing with urinary urge and incontinence since the second pregnancy. The evaluation showed a rotated pelvis with muscle imbalances involving the hip flexors and quadriceps as well as weakness in the abdominals. Client A did really well with external techniques to correct the rotated pelvis and bring more balance to the lower extremity muscles. Her chronic back pain was immediately reduced from a constant level 8/10 to 0-2/10. Since the low back muscles and pelvic floor muscles are so closely related, Client A agreed to an internal pelvic floor assessment to further progress her back pain issues as well as the urinary incontinence issues. The pelvic floor exam revealed moderate muscle imbalances of the pelvic floor with tightened scar tissue from the C-section deliveries. She also had a weakened pelvic floor muscle strength. Initial treatment included internal treatment to correct the pelvic floor muscle imbalances as well as external scar tissue releases. Client A was not given pelvic floor muscle strengthening initially due to the high muscle tone found in her pelvis. Client A received a series of treatments over 2 months to address the muscle imbalances as well as re-educate the pelvic floor muscles. By the end of her second month, urinary incontinence was decreased 50% and Client A was successfully maintaining her home exercise program to further progress the incontinence. She checked back once a month to make sure that she was maintaining the changes of her her pelvic floor muscles as well as using the myofascial release treatments to further open the scar tissue and increase mobility of her spine and pelvis. By 5 months, urinary incontinence was totally resolved and Client A was fully independent in her home exercise program. She chose to continue periodic Myofascial Release treatments as a wellness technique to maintain her progress and stay ahead of the rigors of her day to day life style.
Most recently, Client A had an acute exacerbation of pelvic pain. She denied any accident or injury. She described the pain as a slight burning around her bladder but noted that it did not feel like a bladder infection. She also noted some pain with intercourse. She thought that maybe her hormone balance was low and may need additional supplementation. She had decided to do more of the home techniques that she learned in her Physical Therapy sessions and was surprised to see that the symptoms were immediately decreased. She decided to come in for a treatment to assess her pelvis to see if a mechanical issue could be causing this new pain, even though it did not have a mechanical or muscular feel. She did note that she had been doing a lot more travel lately and there was an increase in stress levels. Her treatment showed a significant shift in her pelvis which corrected in one treatment. Client A noted an immediate change in the internal pelvic pain. Two days later, she called me to report that the pain had not recurred and she had resumed all of her normal activities including pain free intercourse.
I feel that this case is important to share for several reasons. First and foremost, many women and men that are healthy and active are walking around with urinary incontinence. Most of these people are reluctant to talk about it even with their doctors. When they do bring it up, the simplest and most effective technique, Myofascial Release, is not brought up as the first line of defense because it is not as profitable to the health care industry. The second important factor in this case is to show how Myofascial Release treatments not only can correct the problem, but teach and empower the client to understand their body and take care of the issues themselves. The acute onset of pelvic pain and dyspareunia (pain with intercourse), felt like a medical issue to the client initially. She suspected a dip in her hormones which would alter elasticity of the vaginal vault and mobility of those tissues. Many post menopausal women think that pain and decreased sensitivity of the vaginal vault, which results in a decrease in sensation and or pain during intercourse is normal. It’s unfortunate that their health care providers, who should know better, don’t.
If you or someone you know is dealing with pelvic floor muscle changes and are not getting the help that they need, let them know that a practitioner properly trained in pelvic floor treatment and especially Myofascial Release, may be able to help them. The therapists at Verde Valley Myofascial Release and Hands On-Austin have the skills necessary to successfully evaluate and treat acute and chronic pain patterns along with male and female health issues.
Do you have a story to share regarding pelvic pain?
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Jody Hendryx, PT