Healing Pelvic Pain
Work with a pelvic pain specialist in Oakland, CA
What can cause dysmenorrhea or a painful period and menstrual cramps?
Limited mobility of the uterus can contribute to symptoms.
The uterus needs to descend about 3 cm in preparation for menses. Limited mobility of the uterus can be caused by surrounding muscle and fascia tightness
The ligaments that support the uterus must be able to move freely to allow for ease of spine, hip, and abdominal movement during activities and exercise. These ligaments can be tight or lengthened, and contribute to the limited mobility and pain. (Barral 1993, Stone)
How is it treated?
Pelvic manual therapy techniques to encourage mobility of the soft tissues around the uterus, and your brain’s understanding about how to move more freely around your uterus, can help with painful periods. It may be recommended to visit your pelvic PT during menses so that they can assess and treat you when you are most symptomatic.
How long will treatment take?
If your period pain is primarily caused by neuromusculoskeletal findings, then expect relief with PT interventions and a home practice within 3 months.
What about symptoms primarily caused by uterine fibroids, endometriosis, adenomyosis, pelvic inflammatory disease, interstitial cystitis, and other pelvic pain during period?
Pelvic PT cannot cure these conditions, but we use manual therapy techniques to mobilize fascial restrictions from endometriosis lesions, scar tissues, and chronic inflammation.
If your period cramps are so bad you cannot move, we are expert movement therapists and can teach you how to move in ways to reduce your symptoms.
We may be able to significantly help you with your associated low back pain, neck pain, hip pain, urinary urgency, pain with penetrative sex, and constipation.
We would be thrilled to be part of your interdisciplinary team and are happy to meet with your other providers, such as endocrinological gynecologists, OBGYNs, urogynecologists, acupuncturists, mental health providers, etc. We can also guide you to the appropriate specialists to support your comprehensive and integrated care.
Do you experience pudendal neuralgia and other pelvic nerve pain?
If your peripheral nerves are symptomatic due to tension, we can treat you with mobilizations, such as pudendal neuralgia exercises.
If your nerves are symptomatic due to compression, we can find which muscles are tightening around the nerve pathways, and offer treatments to address it.
Nerve-like symptoms often present as burning pain along a stereotypical anatomical pathway. They commonly take longer to calm down after flare ups, but that does not mean they are damaged.
If you experience tailbone pain, it could be caused by postural habits and tension patterns in your pelvic floor muscles and hips.
If you have a history of falling on your tailbone, this can cause the pelvic floor muscles to continue to stay recruited in an effort to protect.
The tailbone often does not respond to pure “manipulation” treatment as it is a joint that is uniquely held by mostly pelvic floor muscles. The coordination of the pelvic floor muscles must be addressed for sustainable results.
Rectal pain and pressure
Rectal pain can be caused by referred pain from tense pelvic floor muscles, such as the puborectalis. It can also be caused by an irritated inferior rectal branch of the pudendal nerve.
If you are experiencing rectal pressure, and you are not constipated, your pelvic floor muscles may be tight and perceived as pressure. You may benefit from consistent relaxation practices like cyclic sighing, box breathing, and knee to chest stretches.
Sharp pain in cervix?
If you have had endometriosis, if you also have cervix pain during penetrative sex, and you experience rectal or sacral pain, the uterosacral ligament may be involved.
If you also get bladder, cervical, and pubic symptoms, it may be caused by the ligaments from your cervix to your pubic bone. If you do not have an IUD, you may benefit from gentle visceral fascia mobility for your uterus and its relationship to the sacrum, bowel, cervix, bladder, and pubic bone. Movement training to change the patterns and improve carryover from the manual work may be recommended.
Expect significant progress within 3 months of treatment.
“How to relieve sit bone pain?”
Sit bone pain can be caused by a tense and tender obturator internus muscle, gluteal muscles, hamstrings, or pelvic floor muscles. There are many nerves that travel near the sit bone that can be irritated. You may benefit from movement training and manual therapy to reduce the tightness and improve how the muscles and nerves at your sit bone move with you.
“How I cured my prostatitis.”
Persistent “prostatitis” that is non-bacterial is likely caused by pelvic floor dysfunction, irritated nerves, tight hips, tense abdominal muscles, unsustainable postural habits, and breath holding patterns. All of these are treated with pelvic floor physical therapy!
Pelvic floor relaxation for anxiety
When your pelvic floor is relaxed and integrated with breath support, your body will calm your mind.
The autonomic nervous system has a lot of activity in the low back and sacrum and the nerve pathways travel through the endopelvic fascia and ligaments. Gentle manual therapy techniques to improve parasympathetic and calming feedback to your brain may be helpful.
For vulvar and vestibular pain, we will screen for dermatological, hormonal, and inflammatory causes and direct you to the appropriate outside referrals as necessary.
Do you experience sharp stabbing pain in vulva?
The superficial pelvic floor muscles, bulbocavernosus, ischiocavernosus, and deep transverse perineum are likely to cause sharp stabbing vulvar pain. Relaxation practices to specifically support these muscles may be helpful.
“Why does my tampon hurt when I take it out?”
If you are experiencing this symptom, you may be tensing your muscles reflexively and causing pain. You may also be experiencing fear of the pain that contributes to the reflexive tension.
Do you experience pain with sex?
We offer internal pelvic floor therapy.
Round Ligament Pain
Labial pain can also be caused by tightness at the round ligament. The ilioinguinal nerve and genitofemoral nerve innervate the labia, and they need to move freely through the pathway at the round ligament. If they are irritated, you may be experiencing labial pain.
The pudendal nerve has branches that innervate the clitoris and can be irritated if you experience clitoral pain. The superficial pelvic floor muscles may also be involved and painful. You may have a dermatological or inflammatory cause to your symptoms. Mobility training, relaxation, and topicals if needed may be offered.