Pelvic Pain can affect your relationships: Heal with Pilates

Pelvic Pain

Pelvic pain is pain or discomfort, ranging from a sharp jab to a dull ache, in the internal region of the pelvis. The symptoms vary based on the cause of the pelvic pain. However, emotional stress can be a big contributing factor in pelvic pain.

For various evolutionary and anatomical reasons, the pelvic floor is a highly enervated and sensitive part of the body. The pelvic region is considered the emotional center too. Especially when it comes to romantic or sexual relations, a lot of psychological factors impact the sensations in this region.

Pain, though, is not always a sign of a tight pelvic floor. It can be due to tight muscles but also lax ones. When someone experiences pain, they clench the pelvic floor in tight. Although that is not evident outwardly, it is usually accompanied by clenching of the jaw, clenching of the fist or squeezing the inner thighs together. It might be accompanied by incontinence and painful intercourse.

Treating pelvic pain

Relaxation of the pelvic floor muscles is of utmost importance in the path towards reduction of pain. If muscles are extremely tight, they become weak due to constant contraction.

The first step in treating pelvic pain is to identify the triggers. This is followed by recruiting the right muscles and learning to relax and breath into the pelvic floor. Once the mind-body connect is established through the breath, we introduce a Pilates program to strengthen the inner core muscles, which includes the pelvic floor.

Case Study

Riya (name changed), a young girl came to Persis Elavia Therapies at Moushu’s Pilates, Mumbai with a case of pelvic pain. She had been studying in the US and had a boyfriend there. She started experiencing pain during sexual activity. The pain was on one side of her pelvic floor during initial penetration. A pelvic floor therapist in the US gave her dilators to practice but that was also painful.

An internal examination of her pelvic floor revealed tightness in the right side bottom quarter of the pelvic (vaginal) clock (explained in the video below). She had a painful burning sensation there. Any friction in that area made her uncomfortable as it was super sensitive. She also had a lower back issue which kept recurring.

There was irritation in some nerve in that region. So we first taught her to relax the pelvic floor. Then we started her on a rehab Pilates program. We helped her activate the Transversus Abdominus consciously. That reduced the irritation in the pelvic floor to some degree. We worked on strengthening her core further. We did a lot of lower body training along with hip abduction. Whether we did squats or clam, the concentration was on inhaling to expand the pelvic floor and exhaling to relax and shut the elevator doors.

There was a lot of tightness, so we worked on stretching the piriformis and adductor. We used active and passive stretching.

The dilators were stopped for some time as the overstimulation was taking her into pain. She had broken up before returning to India; the psychosomatic effect was increasing the pain. We also told her to do hot and cold fomentation to relax the muscles. All of this led to a gradual reduction in pain by almost 95%.

She comes for a check every 2-3 weeks. Now, she can use the dilator again till level 4, only if she goes to level 5 (the highest) it hurts.


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