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Pelvic Pain and Manual Therapy

Pelvic Pain and Manual Therapy

Do you suffer from pelvic pain? Is it chronic or does it just present when you are performing certain activities, such as riding a bicycle or having sex? Is it difficult to sit for long periods of time, like at a movie or at work?

Pelvic pain can be debilitating. Imagine not being able to perform the most basic and mundane activities, such as sitting, and how that would affect your life.

Experienced by 25% of Women in the US
The incidence of pelvic pain and pelvic floor disorders is rising. According to the National Institutes of Health, roughly one quarter of US women are affected by pelvic floor disorders. One study, published in the Journal of the American Medical Association in 2008, showed that the frequency of pelvic floor disorders increases with age, affecting more than 40 percent of women between 60 and 79 years of age, and about 50 percent of women 80 years and older.

Injuries Must be Considered
In traditional physical therapy settings, pelvic pain is generally regarded as a muscle problem, where pelvic muscles are in a state of spasm and tension, leading to pain. What often is not considered is the person’s potential trauma history, such as a car accident or sports injury. Imagine being in a car accident. The impact can contribute to our spine and pelvis being out of alignment. It is important to note that our pelvic muscles attach to our pelvis and skeleton. The result of the pelvis and spine being moved out of alignment (because of the force of the collision) can be strain in the pelvic muscles.

The muscles cannot relax until the spine is back in alignment. Manual Therapy is a tool that can successfully restore pelvic and spinal alignment, thereby reducing pelvic pain.

Gentle Therapy that Corrects the Cause
Manual Therapy is a hands-on approach that is practiced by many physical therapists and massage therapists. A particular advanced form of Manual Therapy is Integrative Manual Therapy (IMT). Integrative Manual Therapy is a gentle type of treatment that can identify underlying reasons for pain. IMT practitioners look at the ability of the joints to move, for example, the low back and pelvis. They also assess the alignment of the joints. Gentle techniques are used to improve mobility and alignment. IMT therapists assess the tension of the fascia in the low back and pelvis to determine areas of compression. Assessment goes beyond the joints and includes soft tissue, to find possible underlying contributors to pain. IMT is beneficial in creating a more neutral alignment in the low back and pelvis, to support reduction and elimination of pain.

Keep in mind that even minor falls can cause the pelvis to shift out of alignment. Some of the pelvic muscles are positioned in a sling-like arrangement in the pelvis from one side to the other. Let’s say you slip on the ice and fall on your butt; it is unlikely that you land perfectly in the middle. Very likely, one side hits the ground first. This force can cause the pelvis to shift, creating pelvic and low back pain. By using IMT, we can create healthier balance between the two sides of the pelvis and restore alignment, thereby reducing pelvic pain.

Sneezing and Stress Incontinence
Some women suffer from stress incontinence when they sneeze. The pelvic muscles in this sling-like formation have a distinct right side and left side. One side can go into spasm secondary to a fall or other physical trauma, while the opposite side is not in spasm. In the center of these two muscles is the sphincter that allows urine out of the bladder. When there is an imbalance between the two sides of the pelvic muscles, the sphincter can be affected, contributing to stress incontinence. By restoring alignment of the pelvis, and by focusing IMT on the pelvic muscles to reduce the spasm, pressure is taken off of the sphincter and urinary function is improved.

Strengthening the Immune System
In addition to a physical trauma, some people have histories of women’s or men’s health issues in the pelvis. Many of these types of issues, such as bladder and bowel dysfunction, can be inflammatory and are often accompanied by pelvic pain. The inflammation and toxicity in the pelvis can affect the strength of the pelvic bones, especially the sitting bones, which can lead to pain. In addition to correcting the alignment of the pelvis and low back, it is often beneficial to focus IMT on strengthening the immune system and promoting circulation and drainage to and from the pelvis. This can create more strength in the pelvic bones and help to relieve symptoms brought on with different activities.

Dietary Changes are Another Option
In addition to IMT as a tool to restore pelvic alignment and reduce pelvic pain, making some basic dietary changes is another option that may help to improve pelvic pain. When pelvic pain is an issue, there is the possibility that it is caused by inflammation throughout the pelvic region, creating difficulty for the individual organs to function optimally. Pelvic inflammation can lead to multiple challenges, including suboptimal bowel and bladder function, PMS and menstrual irregularities, and more. By switching to a diet that avoids inflammatory foods, the pelvic inflammation can be reduced. One inflammatory food is gluten, which is a protein found in wheat, rye, barley and often, oat. When gluten is ingested, it can increase inflammation in the body. Eliminating gluten completely from the diet can promote overall health for many people and help to restore normal pelvic function and reduce chronic pain.

Ayelet Connell-Giammatteo, PhD, PT, IMT,C is the President and Owner of Integrative Wellness and Physical Therapy in Bloomfield, CT, a wellness center specializing in holistic Physical Therapy, Integrative Manual Therapy (IMT), and nutritional wellness. Dr. Connell-Giammatteo is a Physical Therapist and Certified Integrative Manual Therapist. She has been practicing in the field of IMT for over 15 years. Dr. Connell-Giammatteo is a graduate of the Institute of Functional Medicine’s program “Applying Functional Medicine into Clinical Practice” focusing on nutritional wellness. She has written many articles on the subjects of IMT, healthy living, natural parenting, and nutritional wellness. She has been living in the Greater Hartford area for many years, where she integrates a healthy lifestyle at home with her wonderful family.