Myofascial release therapy for pelvic floor tightness 

 

Pelvic floor issues are completely normal. They can affect the old and frail and even the strongest among us, but that doesn’t mean it will stay that way forever.

We’ve been taking a look at a few different treatment options for pelvic floor dysfunction from biofeedback to pelvic floor exercises and next on our list is myofascial release therapy.

This treatment can very well be the change you need for the relief of your pelvic floor ailments and can help improve your quality of life significantly.

We know you have many questions so we won’t waste any time. Let’s get straight to the point. What is this myofascial release that we speak of?

Myofascial release therapy defined

Myofascial release therapy is a type of treatment that consists of applying gentle pressure to areas of tight fascial tissue in the pelvic region to ease pain and grant relief. It is performed by pelvic physical therapists in a series of consistent sessions over the course of a few weeks to a few months.

This type of therapy is done to:

Reduce pain and inflammation of pelvic floor muscles
Increase mobility and flexibility
Provide stability to the pelvic floor
Induce relaxation
Facilitate tissue repair and extensibility

What causes pelvic pain and tension?

The pelvic floor is a powerful set of muscles and with great power comes great responsibility.

The pelvic floor is responsible for maintaining the entire reproductive system and helps organs such as the bladder, uterus, vagina, cervix, bowel, and rectum to function properly. Because of this the pelvic floor is susceptible to a lot of wear and tear and tension and overtime it becomes weakened.  But scars from surgeries and childbirth can also cause your pelvic floor to become too tight.

Things such as poor posture, poor sitting habits, bowel disorders, urinary tract infections, childbirth, and surgery can speed up the natural timeline for pelvic floor dysfunction. This can cause expose you to a myriad of conditions such as urinary and fecal incontinence, prolapse and pelvic pain .

These issues can be picked up easily by doctors after tests and scans and can be solved or improved with different types of treatments and medication that help to strengthen the pelvic floor.

In other cases, however, the muscles aren’t necessarily weakened, they are tense and this can actually elude tests or cause misdiagnosis. The reason for this is that many gynaecologists focus on the organs, rather than the muscles themselves which can be the source of discomfort. If medication and treatments designed for strengthening pelvic floor muscles are prescribed, this can be ineffective or even worse, backfireand cause even more pain and tension.

The pain and tension caused by tense pelvic floor muscles is called myofascial pelvic pain (MFPP). Myofascial pain can affect women of all ages but is most common in menopausal women since hormonal changes make the pelvic muscles more sensitive. This type of pain can be described as “achy”, “heavy”, “deep” or even “sharp” and “piercing” if the pain is focused on the rectum or clitoris. Other women describe a burning when it is focused on the entrance of the vagina or inside the vaginal canal.

Often times doctors have to rule out a number of conditions before concluding that this is the problem since it can only be properly identified by a focused internal examination. When the doctor suspects this, he/she may prescribe medication and myofascial release therapy to relieve your pain.

How does myofascial release therapy work?

Myofascial release therapy works by addressing the source of the issue, the muscles. Sure, medication can help to dull the painbut the tension will still be there.

The pelvic floor muscles are like any other muscle. When you feel pain, you normally stretch the muscles or get massages to loosen any knots and release tension. By relaxing contracted and shortened pelvic muscles, you can help to relieve pain, discomfort, and cramping.

Myofascial release therapy can also help to treat or reduce the symptoms of :

Stress incontinence
Urge incontinence
Bowel disorders
Sexual disorders

Pelvic organ prolapse

What happens during myofascial release therapy and how to prepare

Myofascial release therapy is conducted by highly trained physical therapists. These therapists are typically women and are regulated through a number of bodies on a state by state basis.

When choosing a physical therapist to conduct your myofascial release therapy, there are some things you should check for.

The first should, of course, be the experience of the physical therapist along with success rate and patient satisfaction.

The next is credentials which are certified by the American Physical Therapy Association (APTA). Ask your potential physical therapist if he/she has:

The Certificate of Achievement in Pelvic Physical Therapy (CAPP) – this means that the therapist has undergone a comprehensive program that deals with the diagnosis, treatment, and management of pelvic floor dysfunctions.
The Women’s Health Clinical Specialist (WCS)- this means that the therapist is proficient in evaluating and treating women’s health conditions including pelvic pain.

While there is a shortage of pelvic pain therapists, your gynecologist should be able to refer you to one. Be sure to book your therapy sessions as soon as possible since they’re usually super busy.

During the session, the therapist will look for what is known as trigger points. Myofascial trigger points are painful lumps or nodules in the tissue that can either be active or latent.

Active trigger points produce constant pain while latent trigger points are not painful unless there is some added stress from compressing or stretching the muscles. These can be found in any part of the pelvic floor such as the perineum, urethra, vagina, and rectum. They can even be present in the buttocks, abdomen, and back. The therapist will apply pressure to the necessary areas to elongate contracted muscles. Your therapist may also recommend internal vaginal manipulation and massages to improve the efficacy of this treatment.

The average number of sessions required for myofascial release therapy is usually between six and eight and last for an hour. This is, of course, dependent on your situation and can take several months in the most severe cases.

When your sessions are over, you will have to come in for follow up sessions to maintain your progress. Your therapist will also teach you some stretches you can do at some along with point release techniques that can be done with your finger, a dilator or a trigger point one. Your partner may also be involved in the process.

You may be required to make dietary changes to deal with your bowel and bladder issues and given pain medication and management techniques.

How effective is myofascial release therapy?

Myofascial release therapy is effective to some extent, it all depends on your situation.

No treatment is 100% effective and what works for one person may not work for another.

Many women have felt a great improvement in their pelvic floor pain and have seen their issues fade away. Others have had minimal success.

What are the benefits and drawbacks?

Myofascial release therapy is beneficial in relieving pain along with the severity of other conditions related to the pelvic floor. It also comes with a set of drawbacks. Here are the most commonly experienced ones:

Benefits:

It can relieve pelvic floor pain
It doesn’t require surgery so there is no downtime
You don’t have to do anything special to prepare for it. All you have to do is show up

Drawbacks:

o It can cause initial discomfort
o It is a hands-on treatment and can be embarrassing for women who have a history of sexual abuse or are uncomfortable with vaginal examinations
o It takes a while before improvement is seen

Cost

Myofascial release therapy is covered by insurance, however, the amount of coverage you get may vary. The cost varies depending on your therapist but on average costs $200 per session.

Precautions/ safety concerns

Myofascial release therapy is safe and is suitable for most persons.

It is not suitable for persons with a history of sexual abuse who may be uncomfortable with a stranger massaging such an intimate area.

Pregnant women should consult their doctor before undergoing this treatment.

Substitution
Pelvic floor pain can be treated with other treatments such as biofeedback , electrical stimulation , tibial nerve stimulation, and manual therapy.

At-home treatment for pelvic pain can involve:

Using heat and ice in the pelvic region to soothe the areas
Yoga, including resting poses which promote muscle relaxation
Breathing exercises to calm the mind and body
Warm baths to relieve pain and tension
Using foam rollers and physioballs to stretch muscles

Light, guided exercise

Final word

You don’t have to live with pelvic floor pain for the rest of your life. There are many treatment options available. Myofascial release therapy is just one of them.

This treatment is not the most readily available but can help to relieve pain when basic Kegels and medication have failed. If this treatment option was not suggested by your doctor, be sure to mention it to him/her to get his/her take on whether it can be effective or not.

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