Pelvic pain is not something we easily talk about with friends or colleagues. Yet it can be a huge disruption in our lives. It can affect our ability to sit in the car, at the table to have dinner with friends or family, in an important meeting at the office or even to enjoy intimacy. The pain can be short lived or it can be chronic. There can be many causes of this pain including but not limited to a simple muscle spasm from over stressing the body during a workout or competition, an ill-fitting bicycle or bicycle seat, childhood or recent trauma, surgery, a fall, fracture or the progression of a back injury.
So what can you do about this?
First, know that you are not alone and that there are options. It would be prudent to check in with your physician to rule out any serious disease. Second, get to know your pelvis, hips and pelvic floor.
The pelvic floor muscles span the underside of the pelvis like a hammock. They connect from the pubic bone to the tailbone and between the sides of the pelvis and ischial tuberosities or sit bones. They have three main jobs: Support the internal organs, sphincter the bowel and bladder and enhance sexual function and pleasure. Also of note is that these muscles are a primary supporter and stabilizer of the sacroiliac joint. They interdigitate with the deep rotators of the hip, Adductors (inner thigh) and gluteus maximus through fascial connections and work with the deep stomach muscle, the transversus abdominus.
The muscles can irritate nerves to the pelvic floor and can affect the alignment of the pelvis contributing to sciatica. Common symptoms of dysfunction in the pelvic floor include: urinary urgency, urine leakage, pain with sitting, tailbone pain, pain with intercourse, erectile dysfunction, numbness to the upper inner thigh or lower back pain. As you might expect none of these symptoms are normal. Many are common, rarely discussed.
When the muscles are tight or in spasm, they cut off their own blood supply causing more pain and spasm. They are often too fatigued from the constant spasming to adequately contract to stop the flow of urine so leakage can occur as well. Spasm in the pelvic floor muscles may be due to (but not limited to) scar tissue from childbirth, past fractures to the pelvis or hip or post prostatectomy. The scar tissue can pull on the muscles preventing them from contracting smoothly or may cause the muscles to compress nerves and blood supply to the region creating a pain cycle.
In case you are curious Body in Tune would love to collaborate with you to find your perfect movement practice to address your pain.
But what if the pelvic floor muscles are the victim instead of the cause?
In a perfect world the muscles in and around the pelvis would work together like a series of ropes and pulleys to support our pelvis in the ideal position allowing for easy mobility and static positions. Sadly, this is often not the case. We are talking about all the more external muscles that attach to the boney pelvis, some of which have fascial connections to the pelvic floor muscles.
In addition to the reasons for pelvic pain listed above, we may repeatedly assume postures or perform repetitive activities such that the muscles get stronger moving into the posture or the repeated motion. Imagine the position we assume when we look at our cell phones and the position we sit in on a bicycle or in a kayak or at our desk. Then think about where the dishwasher is relative to the sink, the toilet paper relative to the toilet and which side of the bed your bedside table sits.
Over time we will repeatedly contract our muscles into these positions or directions. The result is that these movements will get stronger than its opposing muscles and it will get harder to move the opposite direction (but not impossible).
So what does all this have to do with the pelvic floor muscles?
As mentioned above the pelvic floor muscles are a sling of muscles between the sit bones. There is an outer sling of muscles that attach the leg bone to the pelvis. These 6 deep hip rotators have a fascial connection to the pelvic floor. So if there is tightness in one hip, it is likely that it will pull awkwardly on the pelvic floor all the way across to the other hip. The same is true when we examine the front of the hips or hip flexors and compare these to the gluts or back of the hip.
Or, if the front of the hips stiffen and shorten and we don’t use the muscles on the back of the hips, we may develop what practitioners call an imbalance. This alters the position of the pelvis which in turn will affect the ability of the pelvic floor muscles to contract and relax as needed and may result in spasm and pain.
The result is that the pelvic floor muscles may start trying to help the outer and bigger muscles of the hips. They get over worked. They get tired. And if we add an injury to the hip, pelvis or lower back, voila, they get pissed and may become painful.
Good news! Body in Tune would love to collaborate with you to teach and support you with a yoga practice so you can enjoy your life off the mat with confidence.
So what can we do?
Start with the breath. A breathing practice will not only quiet your nervous system allowing muscles to more easily and relax but also invite awareness to the sides and back of the diaphragm. When we focus the breath within a practice, we can improve the coordination of the pelvic floor muscles, diaphragm and core stabilizers which in turn will help balance and improve the mobility of the hips and pelvis and can have an amazing effect on pain in the hips, pelvic floor and lower and mid back.
At Body in Tune, LLC we weave together the techniques of pelvic floor physical therapy and guided yoga sequences. You will learn ways to manage and ease your symptoms so you can be active and keep up with friends and family.
Body in Tune, LLC was born from a belief that quality of life matters; both life and physical balance matters.
We would welcome the opportunity to be part of your support team with regards to your muscles, joints, bones and osteoporosis. The goal is, after all, to help you feel confident in your body so you can play with your grand children, take that long-dreamed of vacation and get outside and enjoy a walk with friends.