Physiotherapy can help with longstanding pain in the lower abdomen, bladder, vagina or in the perineum as well as with pain during intercourse. Before commencing physiotherapy treatment, the first step is to have a thorough medical examination (urologic or gynecologic, and gastrointestinal etc.). There can be a multitude of factors leading to these symptoms. Physiotherapy is safe to start once we know what diagnosis has been made or in some cases it is enough to have had an exclusion of certain diagnoses.
When should you start physiotherapy if you have long-standing pelvic pain?
Once you received your diagnosis from your doctor ( eg. interstitial cystitis/bladder pain syndrome, endometriosis, atrophic vaginitis, vaginismus etc.) or if your doctor excluded serious pathologies that would warrant medical attention, we can begin physiotherapy. Please bring your doctors’ notes with you to your first appointment.
What happens during the first assessment and what does treatment entail?
In cases where pain is the main complaint, the myofascial structures are checked. Assessment of the abdominal muscles and fascia, the structures surrounding the hips, the diaphragm is important, as well as looking for tightness in the low back or weakness which may be contributing to the experience of pain. When needed, we work on learning how to relax the pelvic floor muscles, practicing breathing techniques and stretches. If there is tightness around the pelvic area, foam roller is used to improve function in the myofascial system.
Novice movements are taught in order to train the nervous system that it can sense and interpret input other than danger and pain. The complex way our nervous system works is discussed, and your experiences and thoughts surrounding your symptoms are considered. Our nervous system is very good at protecting our bodies from danger, but sometimes these mechanisms also contribute to long-standing pain. Occasionally, treatment might involve working directly on the pelvic floor muscles, superficially from the outside or through the vagina or rectum. There is always a thorough explanation beforehand and we only use techniques that you are comfortable with and that you have consented to.
We never use forceful or painful techniques on the pelvic floor muscles!
Women’s Health Physiotherapy assists women through different cycles of life