pelvic floor
myofascial release therapy
for women's pelvic health
What is pelvic floor myofascial release therapy?
Pelvic health myofascial release therapy is a specialised form of physical therapy that treats pain and dysfunction in the pelvic region. This therapy focuses on the muscles and connective tissues, known as fascia, surrounding and supporting the pelvic organs.
Through gentle, hands-on manipulation, myofascial release helps to reduce tension, improve mobility, and promote healing in the pelvic area.
This therapy can be particularly beneficial for individuals suffering from conditions such as pelvic pain, bladder and bowel dysfunction, painful intercourse, and postpartum recovery issues.
By addressing the root cause of pain and tension, pelvic health myofascial release therapy provides a holistic and effective approach to improving overall pelvic function and well-being. Alex uses tailored techniques to ensure each session is both therapeutic and restorative, helping clients achieve a better quality of life.
The Benefits
External and internal pelvic floor treatment, combined with a home program, helps to soften, stretch, stimulate, and strengthen the pelvic floor soft tissues. This can:
Support bladder and bowel control
Prevent, improve, or even reverse the symptoms of prolapse
Alleviate pelvic pain
Reduce or reverse the narrowing of the vagina and the pelvic floor soft tissues.
Relieve vaginal discomfort from painful sex
Enhance blood flow to the pelvic region
Promote muscle relaxation
Improve sexual function for a more fulfilling and enjoyable sex life
Aid in postpartum recovery, helping new mothers regain strength and function in their pelvic floor muscles
Enhance emotional well-being and self-confidence
Improve core strength, supporting better balance and posture
Understanding the Pelvic Floor
The female pelvic floor is made of muscles and connective tissue that form a 'sling' or 'hammock' across the base of the pelvis from the symphysis pubis at the front of the pelvis to the coccyx at the spine's base.
The pelvic floor is responsible for supporting the bladder, uterus, and rectum to maintain their proper function and provide stability for the spine and pelvis. When the pelvic floor functions well, the muscles can be tightened and relaxed voluntarily.
However, various factors can cause the pelvic floor muscles to become either too weak or too tight. A weak muscle can be both too long and too short, while a tight muscle has difficulty relaxing and is constantly contracting. When a muscle is too tight, it can't function properly because it's already contracted to its fullest extent.
The pelvic floor muscles are essential for:
Bladder and bowel control
Urination
Bowel movements
Childbirth
Sexual intercourse
Walking and moving in general
Pelvic health symptoms:
A weak pelvic floor can lead to urinary or bowel incontinence and pelvic organ prolapse.
Conversely, overly tight pelvic floor muscles can cause symptoms like:
A weak pelvic floor can lead to urinary or bowel incontinence and pelvic organ prolapse.
Conversely, overly tight pelvic floor muscles can cause symptoms like:
Urinary frequency
Urgency
Difficulty emptying bladder/bowel
Painful urination
Constipation
Vaginal pain
Pain during intercourse
Causes:
Pelvic floor issues can stem from factors such as:
Childbirth
Gynaecological interventions
Infections
Lifestyle factors like diet and exercise
Menopause
Trauma (physical and emotional)
Do you think you have a hypertonic (tight) pelvic floor?
If you have any of the signs or symptoms of a hypertonic pelvic floor, seeing a specialist pelvic floor therapist is essential. The therapist will be able to identify the root cause of the hypertonicity and provide tools to help overcome this.
Do you think you have a weak pelvic floor?
Weak muscles lose proper contractile function and do not provide enough support for the pelvic floor. Fascial restrictions can also cause weakness and lack of support for the organ due to tissue shortening. Consequently, a dropping of the organ (prolapse) and/or tilted organs (amongst other problems) may occur.
Assessment and Treatment:
Like all fasciae and muscles in the body, the pelvic floor can spasm or be overly tight. This can cause a persistent pelvic floor contraction, making it difficult to contract further when needed, like when you stand up, sneeze, or want to empty your full bladder. The muscles need to learn to relax before they can regain their strength.
Restoring the health of the pelvic floor is a step-by-step process. First, we manually treat any tight or unbalanced pelvic floor tissues, allowing them to regain function and become soft and relaxed. This may well include other areas, like the abdominals or buttocks, that also influence pelvic floor function. Depending on your situation, this may take anywhere between a few weeks or longer.
Once the tightness is restored, we can start to address any weaknesses through strengthening exercises. This systematic approach helps restore the healthy function of the fascia and muscular structures of the pelvic floor.
What can a treatment session look like?
An assessment may include internal and external examination and treatment
External release of abdominal and pelvic fasciae and muscles
Internal manual release techniques can be used to relax the tight pelvic floor
Pelvic floor muscle relaxation techniques
Regulating the nervous system as stress often affects the pelvic area
Breathing techniques
Pelvic and hip stretches
Treatment of scar tissues
Abdominal massage techniques
Toileting advice
Suggestions on lifestyle changes and implementation
Education on vaginal dilators to stretch the pelvic floor muscles
Education about persistent pain
Pelvic Floor Rehabilitation
Techniques and exercises will help retrain appropriate motor control of the pelvic floor muscles to regain function. Rehabilitation techniques are an essential part of your pelvic health treatment and self-care. They help you progress and maintain the results of your treatment session. It also gives you back a sense of control and confidence.
How many treatments will I need?
The number of visits you need will vary based on your specific pelvic floor problems, how long you've had these problems, your overall health, consistency with your home programme, and what you want to return to doing!
Women with, e.g. incontinence due to childbirth, menopause or injury tend to be something that can be resolved relatively quickly over a few weeks. Some other existing issues can take a little longer to unravel. It is a different journey for everyone.
The average person will start to notice an improvement in just 3-4 visits. You may already start to feel the difference after your first session.
Don’t let embarrassment prevent you from seeking help.
Contact Alex today to start your journey towards better pelvic health and regain confidence in your body.
Overactive/tight Pelvic Floor
What is an overactive/hypertonic pelvic floor?
An overactive or hypertonic pelvic floor is characterized by muscles in the pelvic region that are excessively tense and unable to relax properly. Individuals with a hypertonic pelvic floor often experience issues such as constipation, painful intercourse, urgency, and pelvic pain. This condition may also involve tension in adjacent muscles, including the piriformis, obturator internus, coccygeus, and hamstrings.
What causes a hypertonic pelvic floor?
A hypertonic pelvic floor can result from various factors without a single definitive cause. Engaging in activities that continuously activate the core muscles, like intense workouts, can lead to persistent pelvic floor tension due to the lack of relaxation periods. Additionally, habitual behaviours such as frequently delaying urination or bowel movements can contribute to muscle tightness. Stress, fear, and anxiety are also significant contributors, as these emotional states can cause a physical response where the pelvic floor muscles contract, similar to how a stressed dog tucks its tail between its legs.
Certain health conditions can exacerbate or lead to hypertonicity in the pelvic floor. For example, endometriosis, with its chronic pain and inflammation, can cause the pelvic floor muscles to become tense. Irritable bowel syndrome (IBS) may lead to pelvic muscle cramping and pain due to abdominal discomfort. Other related conditions include interstitial cystitis, pudendal neuralgia, and vulvodynia.
Birth trauma and scar tissue are additional factors. Women who have experienced perineal or vaginal tears during childbirth may develop hypertonic pelvic floor muscles due to pain and protective muscle tightening. Identifying the specific cause of hypertonicity in each person is crucial, and a pelvic health physiotherapist is ideally suited to make this determination.
Thanks to the Continence Foundation of Australia for much of the information provided above.
How to Know if Your Pelvic Floor is
Weak or Tight?
Weak or Tight?
Recognising the signs of a tight or weak pelvic floor can help you find the right treatment.
Signs of a Tight Pelvic Floor:
Pelvic pain or pressure
Vaginismus (an uncontrolled, involuntary spasm of the vagina muscles)
Pain when you have bowel movements or urinate
Urinary incontinence
Incomplete bladder or bowel emptying
Slow urine flow
Hesitancy or delayed urine stream
Urinary urgency
Frequent urination
Painful urination
A forward urine stream (rather than down into the toilet)
Painful sex
Inability or difficulty in achieving orgasm
Constipation
Straining during bowel movements
Lower back pain
Hip pain
Coccyx (tailbone) pain
Signs of a Weak Pelvic Floor:
Urinary Incontinence
Pelvic Organ Prolapse
Difficulty Controlling Gas or Stools
Reduced Sensation
Back Pain
What to do if you notice any of these signs?
It is common to have signs of both a weak and tight pelvic floor. A myofascial release pelvic floor specialist can assess and evaluate your symptoms and provide a personalised treatment plan.
Myofascial Release for the pelvic floor is a specialised manual therapy using sustained and gentle stretching to help alleviate symptoms related to the pelvic floor, like pelvic floor dysfunction and persistent pain.
External pelvic floor techniques are applied to the outside of the body and can help soften and lengthen the external fascia and soft tissues. These areas can, amongst others, include the abdomen, the lower back, the thighs, and the gluteal area.
Internal pelvic floor treatment involves techniques that are applied inside the body, specifically within the vagina or rectum. This enables access to the pelvic floor tissue that cannot be reached externally. These techniques help soften and stretch tight internal muscles and fascia to return to their normal functional resting length. More information on internal techniques can be found below.
Monitor Symptoms: Keep track of your symptoms and any triggers to discuss with your practitioner.
Strengthening Exercises: If the pelvic floor shows weakness, a structured exercise program tailored to your needs can help improve healthy muscle tone, relaxation and strength. Strengthening exercises should only start when hypertension in the pelvic floor region has been addressed.
Practice Relaxation Techniques: Techniques like deep breathing and gentle stretching can help relax tight pelvic floor muscles.
Start using a squatty potty (poop stool) to prevent straining and promote a more complete emptying of the bowels and bladder.
Note: It’s essential to address pelvic floor concerns with a healthcare professional to ensure accurate diagnosis and appropriate treatment.
Urinary incontinence is often (but not always) associated with a weak pelvic floor.
The pelvic floor muscles support the bladder and help control the release of urine. When these muscles are weak, they are less able to perform these functions effectively, leading to various types of urinary incontinence, such as:
Stress Incontinence: Leakage of urine during activities that increase abdominal pressure, such as coughing, sneezing, or exercising.
Urge Incontinence: A sudden, intense urge to urinate followed by involuntary loss of urine.
Mixed Incontinence: A combination of stress and urge incontinence.
Weak pelvic floor muscles can result from several factors, including childbirth, surgery, chronic coughing, and excess weight. Strengthening the pelvic floor muscles through exercises like Kegels can often help improve symptoms of urinary incontinence. Make sure to see a pelvic floor specialist to assess your pelvic floor muscles for weakness or tightness. If you strengthen weak pelvic floor muscles before attending to the tight ones, your symptoms may worsen.
You can read more here about MFR for incontinence.
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