Pelvic Floor pain comes in many guises – from excruciating Sciatica (shooting nerve pain down the side of leg from the hip to the toes) – to chronic Pudendal nerve pain (sharp pain and discomfort internally from the anal passage through to the vaginal wall/scrotum).
Pelvic floor pain is most common in women especially post natal and becomes more apparent after 2nd or 3rd children. However men that have had Bowel surgery or suffered from IBS etc – can also suffer from the same symptoms.
“30 million women – who have irritable Bowell Syndrome or one of 700,0000 with urinary frequency- urgency and pain – is known as painful bladder syndrome.”
“43% of women suffer from some source of sexual dysfunction – i.e.; pain during intercourse, sexual performance problems – or decline sexual response”
The “pelvic floor” refers to a group of muscles that attach to the front, back, and sides of the pelvic bone and sacrum (the large fused bone at the bottom of your spine, just above the tailbone). Like a sling or hammock, these muscles support the organs in the pelvis, including the bladder, uterus or prostate, and rectum. They also wrap around your urethra, rectum, and vagina (in women).
Coordinated contracting and relaxing of these muscles controls bowel and bladder functions—the pelvic floor must relax to allow for urination, bowel movements, and, in women, sexual intercourse.
Pelvic pain is relatively common among women, with a prevalence of at least 3.8%.
Symptoms of pelvic pain may require frequent use of medical resources and a significant number of surgical interventions.
It is estimated that 40% of diagnostic laparoscopies and 12% of hysterectomies are performed for pelvic pain.
Unfortunately, some of these patients have a diagnosis that is not surgically correctible or have a multifactorial etiology for their pain, which therefore persists despite surgery.
The pelvic floor musculature is well recognized as a potential cause of acute and chronic pelvic pain, but it is too often neglected during the evaluation of pelvic pain.
The pelvic floor consists of striated muscles, ligaments, and connective tissues that support the pelvic organs against gravity and intra abdominal pressure.
The pelvic diaphragm is composed of the coccygeus muscle posteriorly and the levator ani anterolaterally. Although they are not fully distinct, the components of the levator ani consist of the iliococcygeus, the pubococcygeus, and the puborectalis muscle group.
The pelvic floor must allow relaxation of this support at the urogenital hiatus during voiding and parturition while maintaining the anatomic position of pelvic structures.
The complex mechanics of its bimodal function and frequent insults to the integrity of the pelvic diaphragm from gravity, daily activities, and vaginal birth contribute to the pelvic musculature’s vulnerability to damage and injury.
Lying within the pelvic cavity are the piriformis, and obturator muscles, which are not elements of the pelvic diaphragm but may contribute to pelvic pain when injured.
Pelvic floor hypertonus may be the primary cause of pelvic pain in some patients; in others it may simply be a response to the underlying pelvic disorder.
Several mechanisms of injury may lead to spasm of the pelvic floor. These include, but are not limited to, traumatic vaginal delivery, pelvic surgery, positional insults such as prolonged driving or occupations that require prolonged sitting, gait disturbances, traumatic injury to the back or pelvis, and sexual abuse.
Malalignment of the pelvis, especially in the sacroiliac joint, due to trauma, poor posture, pelvic floor deconditioning, muscular asymmetry, or excessive athletics also may contribute to muscular dysfunction of the pelvis.
Injury leading to myofascial pain begins with an acute phase, characterized by inflammatory and immune responses. The injury may perpetuate itself with spasm promoting further inflammation, neurotransmitter release, and central nervous system sensitization.
Pelvic floor dysfunction can also arise in response to other common chronic pain syndromes, such as endometriosis, irritable bowel disease, vulvodynia, and interstitial cystitis.
A prospective evaluation of patients with chronic pelvic pain of various etiologies found abnormal musculoskeletal findings in 37%, versus 5% of controls.
For this reason, the pelvic floor should be included in any evaluation regardless of the suspected source of pelvic pain.
CIONE MYO-FASCIAL RELEASE: Releases the tensions within the Pelvic floor
6 dynamic muscles with a Myo-fascial connection
- Glut Medius (3 segments Minimus, Medius and Lateralus)
- Gemellus Superior
- Gemellus Inferior
The more complex the patient the more likely a ‘deep spasm’
A spasm is a tightening of the Adductors, Groin, Hip flexors, Quadraceps and Hamstrings – potentially impinging the Sciatic, Posterioral femoral cutaneous nerve, cluneal nerves and Pudenal Nerve branches.
Understanding the mechanisms behind some of the most difficult medical conditions:
- chronic pain syndromes
- chronic fatigue syndromes
- chronic visceral dysfunction
- anxiety and depression disorders
CiONE Postural Rejuvenation is all about realignment – releasing deep spasms and stabilising the pelvis and skeletal structure.
CiONE Postural Rejuvenation in the Harley Street clinic – is now seen as one of the leading centres of Biomechanical intervention within Pelvic Pain and the lead Consultant is working daily with Consultant Neurologists, Physiotherapists who specialise in this area of pain management. And talking at International and National seminars to this effect.