Pelvic Tension/Pain - Pelvic Floor Pain Dysfunction

The pelvis connects the upper and lower body and supports the weight of the upper body on the legs. It also acts as a shock absorber for the spine, protecting the spine and upper body from the impact of the body weight, especially during walking and running.

The pelvic floor muscles are positioned like a hammock from the sacrum and coccyx to the pubic bone. Dysfunction of the pelvic floor muscles can mean weakness, disuse, incoordination, pain or holding too much tension. Symptoms can occur in both males and females and can present as urinary frequency, urgency, and incontinence of urine or bowel, pain with intercourse, and bowel movements, urination. Pelvic floor dysfunction can be present in diagnoses such as Interstitial Cystitis, Endometriosus, Vaginismus or Vulvadynia in women or Prostatitis in men.

Physical therapy will assess for postural, flexibility, strength of the pelvic floor and the core muscles of the abdomen as well as biomechanical defects of the lumbar and sacral-pelvic components as possible causes to the dysfunction of the pelvic floor.

Pelvic tension/pain typically involves a musculoskeletal component such as poor posture, lack of flexibility or strength, core muscle weakness, pelvic floor muscle weakness, sacroiliac joint (SIJ) pain, past trauma or an injury below the waist or possibly the spine. Symptoms may include but are not exclusive to non-relaxing pelvic floor muscles, tension syndrome, Dyspareunia, Levator Ani Syndrome and Vaginismus, Interstital Cystitis, Vulvadynia and non-bacterial prostatitis. These symptoms are seen in both males and females.

Treatment Options

• Education in Home Programs and Self-management
• EMG Training to Reduce Muscle Tension
• Myofascial Release, Strain and Counterstrain, Trigger Point Release
• Visceral Manipulation
• Electrical Stimulation to Reduce Muscle Spasm
• Ultrasound to Scar Tissue
• Therapeutic Exercise to Restore Contract/Relax Sequence and Facilitate Relaxation, and to Increase Mobility and Awareness of Pelvic and Abdominal Muscles
• Postural Re-education
• Heat and Ice Modalities