How to Solve Your Pelvic Pain
How Can I Get Rid of My Pelvic Pain?
My Top 4 Secrets to Healing Your Pelvic Pain
Getting To Know Your Pelvic Floor
Healing your pelvic pain begins with understanding your body on an anatomical level. Your pelvic floor (PF) is a complex set of muscles, nerve and connective tissues. The PF is shaped like a basin and is the size of a small salad bowl.
Major nerves that innervate your entire lower extremity pass through the pelvic region and a complex web of muscles and fascia support your uterus, bladder, vagina, rectum and other abdominal organs. If the muscles in your pelvic floor are in spasm, weak or filled with trigger points or scar adhesions, your pelvic symptoms will be worse.
If your PF muscles are weak, you can experience sexual dysfunction and a slew of bladder issues, including incontinence, urgency and frequency of urination. Many times women will feel as if they cannot completely empty the bladder or bowels and they resort to straining. Straining is a big no-no as this action strains the PF muscles and contributes to spasms, trigger points and more weakness.
To understand this area of your body better we will take a look at the various constructs of your pelvic floor muscles. There is a lot to cover, but by getting to know your own anatomy it will open doors to your own healing and maintain long-term results.
The muscles of the pelvic floor can be a source of confusion for many people – even to the trained professional – because they have been given several different names. However, the main bulk of the PF ‘sling’ is made up of a group of muscles known as the levator ani.
The overall PF muscle ground has four primary functions.
Support – they help to hold your organs up and in place
Sphincteric – they help to prevent urinary and faecal incontinence
Sexual – they create and enhance orgasms
Stabilising – they help to stabilise the lumbar, sacral, pelvic and hip regions
The PF muscles are all highly innervated by nerves that come from the lower back and sacrum. That is why your back is so important when it comes to PF dysfunction.
The Trade Secrets List
At my clinic one of the first educational materials I give my patients is a comprehensive list of “trade secrets.” These encompass the basic rules and precautions all women need to know to stay healthy, strong and prevent injury. As you read through the list, make note of any changes you may need to make to your daily routines. The list is not comprehensive and there will be some activities that you may need to avoid more than someone else due to your particular condition but below I have shared the top four activities that you should avoid and what changes you need to make.
Implementing these changes will significantly reduce your pelvic symptoms and help you back on the way to feeling like your old self again.
1. Avoid Jackknifing Out of Bed
Jackknifing is the act of sitting up straight out of bed as if you were doing an abdominal crunch exercise. Jackknifing puts your abdominal muscles under a lot of stress and strain and aggravate problems such diastasis recti. The rectus abdominis muscles are joined at the middle by a connective tissue sheath called the linea alba. When you jackknife you put a lot of stress on the linea alba and, like a zip, it can open at the seam, creating a gap.
The abdominal muscles help in the support of the abdominal organs and so if they are not doing their job correctly more and more pressure is put on the PF itself, often resulting in very tight and reactive PF muscles. If you have every seen a bulge that pops out in the middle of your belly, especially during positional changes, this is a diastasis bulge and needs to be treated. Making changes such as this will help to reduce the strain on your abdominals.
The Secret: Using a Log Roll
To log roll, turn completely to the side first, and then sue your arms to hep you side up along the edge of the bed. Log rolling is less stressful for the abdominal muscles and will help to prevent any diastasis from getting any bigger and wider. If you are suffering from pubic bone or groin pain, squeeze a pillow between your knees while you roll to the side. This helps to stabilise the pelvis and hip bones and can significantly reduce pain during these difficult transitional movements
2. Avoid Holding Your Breath
A “Valsalva” manoeuvre or holding your breath places increased stress and strain on the abdomen, pelvic organs and PF muscles. Holding your breath when lifting objects or having a bowel movement can cause your pelvic organs to descend, placing increased pressure through the PF muscles.
When your organs descend, they can prolapse and lead to PF muscle dysfunction, incontinence or pelvic pressure. Holding the breath can even make your diastasis recti wider and contribute to abdominal weakness, disc herniations and back pain.
The Secret: Focus on the Exhale
Focus on the exhale with all of your activities to reduce stress and strain on your pelvic organs, abdominals and lumbo-pelvic region. It is often helpful to count out loud when you are performing your exercises and other daily activities as the focus on talking will help you to stop holding your breath.
If you are struggling when you are lifting then you can start to focus on creating voluntary contractions of the abdominal muscles to help support your back and PF. If you are suffering with a prolapse then you may also want to think about contracting the PF whilst performing the lifting exercise as well. I would only suggesting doing this however if you are sure that you have weakness in the PF itself. If you are unsure then it is always best to get an experienced opinion from a health professional.
3. Don’t Push With Urinating or Defecation
Do you feel like you need to push or strain when you have a bowel movement or defecate? This straining force can be detrimental to the PF muscles. When you push or strain when you go to the bathroom, the abdominal organs descend downwards resulting in a significant amount of stress through the muscles of the PF.
The cumulative effect of pushing and straining when going to the bathroom can make you susceptible to pelvic organ prolapse, weakened PF muscles, incontinence and pelvic pain. It is extremely important to limit the amount of stress through the PF and limit pushing as much as possible
The Secret: Use Correct Posture on the Toilet
Toilet posture is the ultimate position for better bowel and bladder function. This posture puts your body, PF muscles, bladder, colon and internal organs in the best position for emptying. Most importantly it helps to relax your PF muscles, facilitating the best possible bowel and bladder function. The main theory is that when in a conventional sitting position on the toilet a small muscle known as puborectalis creates a kink in the colon. This is an important continence mechanism in the body, but does not help us if we are trying to defecate. When you raise the knees up to a position higher than the hips the puborectalis muscle relaxes and allows for easier, healthier elimination.
Constipation is a nightmare for women who suffer with PF disorders. Constipation, straining and pushing with defecation or urination creates havoc on your PF muscles and you should avoid it at all costs. To manage constipation make sure you are getting the right amount of fibre, drinking plenty of water and always using the correct toilet posture. Don’t forget to discuss this with your GP is you are struggling to control your constipation, especially if you are suffering with a prolapse.
4. Avoid Just in Case (JIC) Urination
We are all guilt when it comes to JIC urination. JIC can adversely affect the way your bladder functions causing you to have to use the bathroom frequently. JIC can also lead to you having to wake up during the night to urinate. When your bladder fills to its volume, a signal gets sent to your brain which then stimulates your body to urinate by getting an urge. Many women go to the bathroom before they get a proper urge, leading to “shrinkage” of the bladder, hence the expression “I suffer from a small bladder.”
Going to the bathroom before the bladder fills and before you get the proper signal to urinate can lead to urgency, urge incontinence and frequent trips to the bathroom. Normal bladder function is 6-8 voids per day, every 3-4 hours with no leaking. A normal void lasts for approximately 8-10 seconds.
The Secret: Use Time Voiding, Bladder Diary and Waiting for Proper Urge
A picture paints a thousand words – to see the truth about your bladder habits you need to keep a voiding log and take note of what is going on with your bladder. Record each time you go to the bathroom and how long it lasts as well as if there was an urge or if there was any leaking. This will allow you to see what is going on.
Tips for a successful bladder:
Avoid bladder irritants such as caffeine and carbonated drinks
Stay hydrated – do not limit your water intake
Fill out a bladder diary
Listen to a proper urge and avoid all JIC urination
Don’t strain to get the urine out – it will do more harm
Next Steps
Do not underestimate the power of making these simple changes. Stopping habits that may be causing you harm will put you on the fast track to healing your PF. Making all the above changes will make a difference to your pain.
There are times where you need extra support and it is in those situations that many women find themselves in my clinic seeking more specific advice.
Pelvic Pain Treatment in Guildford
Sally is our specialist Women’s Health Osteopath at Surrey Osteopathic Care. Having suffered with endometriosis herself she didn’t find any relief in the medical system (despite 2 laparoscopies!) and so looked to osteopathy to help. With a combination of treatment and some dietary changes Sally has now mostly overcome the symptoms that she was suffering with and uses her experience as well as her expert knowledge to help other women with the symptoms that they are suffering with from the endometriosis.
To find out more about how we can help you click here