Do you have Chronic Pelvic Pain? Have you been referred to a Physical Therapist?

Often a woman is aware of the role the Physical Therapist plays in returning her injured child back to sporting activities or the role of the Physical Therapist helping to teach her mother to walk after her Total Hip Replacement surgery. However, when she has been referred to Physical Therapy for chronic pelvic pain she is often unfamiliar with the role of the Physical Therapist in the treatment of CPP.

Physical Therapist's are trained to evaluate and treat musculoskeketal problems . Physical Therapist' working in the field of Women's Health and who treat women with Chronic Pelvic Pain have additional specialized training in the evaluation and treatment of pelvic floor muscles. Your doctor may refer you to a PT she/he has worked with before. If you need to find a PT in your area who specializes in the field of Women's Health, you can contact the American Physical Therapy Association, Women's Health section. The phone number is 703-706-3237 ext. 8516 or http://www.apta.org/. Insurance coverage varies from company to company.

If you are suffering from pelvic pain, you may be experiencing a variety of discomforts related to your musculoskeletal system. The changes you are experiencing may be affecting your activities of daily living. Some women report increased pelvic pressure and a sensation of heaviness of the perineum when they are exercising, They may also experience pelvic achiness, pressure and or pain during prolonged periods of sitting or standing, with intercourse or during urination.. Women also experience Low Back Pain, abdominal pain, inner thigh pain and hip pain. She may also experience numbness of the thigh or skin of the groin.

Surgical scars from childbirth or previous abdominal surgeries can contribute to pelvic pain. As a result of your pain, you can develop a protective posture. This means you may be unconsciously holding the muscles of your pelvic floor, low back , hips and or abdomen in a rigid position so as to protect yourself from more pain. These unnatural holding patterns of your muscles can lead to soreness, weakness and possible compression of your nerves.

A Physical Therapist (PT) will perform an initial evaluation. This will include a musculoskeletal screening. They will carefully observe for postural changes and evaluate for muscle spasms and weakness. A PT working in the area of Gynecologic Physical Therapy is also trained to do an internal evaluation of the muscles of the pelvic floor. Following the evaluation, you will determine with the PT the goals you would like to achieve together.

Physical Therapy treatment may include addressing the postural changes by helping you to change poor postural habits and activate the correct muscles while you are sitting and or standing. Education of proper posture, rest positions and relaxation techniques will be part of your PT treatment. PT will instruct you in symptom management strategies to help control your pain on a daily basis.

PT will also implement techniques to reduce the spasms present of your muscles such as soft tissue mobilization techniques or trigger point techniques. The PT will instruct you in stretches and exercises to maintain what has been accomplished with these techniques. These exercises may be for the muscles of your pelvic floor, low back, hips and abdomen. Modalities such as ultrasound, heat, cold, electrical stimulation can also be used to improve your condition. Biofeedback is a tool used to help increase your awareness of how your muscles are working. It may be used to help you learn how to relax the muscles of your pelvic floor and/or how to strengthen the muscles of your pelvic floor.

Physical Therapy can offer many options in assisting you to optimal recovery.

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©Susan Parker, PT

OBGYN.net Chronic Pelvic Pain