PT CORNER - by Lyne Ezenwa P.T.
True or false? You should keep your pelvic floor muscles tight at all time to prevent leakage and/or pain.
Bravo, I know your answer is false, because you read last month’s tip! I would like to address pelvic floor muscle relaxation in more detail since it plays an important role in pelvic pain and leakage.
As a normal reaction, when we experience pain, we tend to tighten our muscles. If you work on your computer all day, at the end of the day you will probably feel ache and soreness in your neck muscles. When you palpate those muscles they are tight and in spasm. The same principle applies to your pelvic floor muscles. When you experience pain, the muscles tighten and remain in spasm. This then becomes your “too tight” resting state. Often time, because you have kept your pelvic floor tight for so long, relaxing the muscles almost feels like you are bearing down (motion that you experience during a bowel movement).
I will repeat myself over and over; getting in touch with the muscles of your pelvic floor and learn its function will guide you to greater pelvic health and less pain. What we do in physical therapy is to gently massage and stretch the muscles of the pelvic floor to help them relax and learn the “new and improved” resting state. Pelvic floor muscle reeducation using biofeedback is also very helpful in “down training” the muscles (which means relaxing). Also, electrical stimulation has shown to be effective in some cases to help break down the cycle of muscle spasm.
Another myth that I hear frequently is that “if I relax my pelvic floor too much, I will leak”. If you hold your pelvic floor tight all day long, and you suddenly sneeze, your muscles are so overworked that they do not have the energy to contract further and prevent the urine from leaking out. So remember, a tight muscle can often time be a weak muscle.
On a daily basis, I tell my patients to bring their awareness to their pelvic floor muscles many times throughout the day and remind themselves to relax. Also, breathing exercises and visualization using the images of a relaxed pelvic floor will help calm the sympathetic nervous system and aid in greater relaxation.
Take a few minutes every day to relax and practice your breathing exercises, you may find that more than just your pelvic floor will benefit from it!!!
Lyne Ezenwa P.T.
The Pelvic Health and Physical Therapy Center
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