“Oh, wow,” my physical therapist said, with her finger inside of me. My hands were gripping the sides of the table as I lay on my back, knees bent. I was sweating profusely as the nerves in my pelvis sent angry shocks of pain toward my abdomen. The parchment paper underneath me started to stick to the small of my back.
What was my physical therapist — and not my OB-GYN — doing with her finger inside of me? Believe it or not, it’s part of the deal when being examined for a pelvic injury.
“You have what I would call a high-tone pelvis,” she finally said. She went on to explain that my pelvis was too tight. I was shocked when my physical therapist suggested rehabilitative movements to “un-Kegel” my way out of this situation. Throughout my pregnancy, I read books and attended workshops and classes that placed a lot of emphasis on toning the pelvic floor. And yet, these strengthening exercises, combined with stress, childbirth, and my struggle with anxiety for much of my adult life, were what got me here, in her office, with her finger inside me.
“For some crazy reason, no one talks about these issues,” said Dr. Shannon Young, a pelvic floor physical therapist at Orthopedic & Sports Physical Therapy Associates, Inc. (OSPTA). “This is a problem not only with patients but also in the medical community.”
Nobody talks about it, but pelvic dysfunction is more common than we think
According to one study, 67.5 percent of women have experienced one or more of these problems:
- pelvic floor dysfunction of at least one major type, including a high-tone pelvis
- issues related to incontinence
- uterine prolapse
A lot of times, Young said, the information just isn’t available to women who need it.
“People are often searching for answers for years before anyone really addresses the problem,” Young explains. “And when it is addressed, it's often through unnecessary medication or even surgery, when the problem was a muscular issue all along.”
For me, learning about my pelvic floor dysfunction meant I had found the root cause for the seven months of chronic pain I’d experienced following my daughter’s birth. It was a relief having an answer to why I was experiencing frequent urges to urinate, painful sexual intercourse, and agonizing pain radiating from my groin to my abdomen, back, and legs.
Childbirth had been the last straw after the years of piled-up stress and anxiety that caused me to tense not only my shoulders and jaw but also my pelvis. I basically had a tension headache in my pelvis.
“What I’ve realized, as a women’s health advocate, is that mental and emotional health factors a lot into the disorders that we see in women, whether it’s with a high-tone or low-tone pelvis,” said Dr. Jessica Shepherd, an OB-GYN and associate professor at the University of Illinois at Chicago. “Stress is a big factor in a lot of the diseases that affect the body, and it can wreak havoc on muscles, including those of the pelvis.”
Young said that while medication or surgery is sometimes necessary, most cases of pelvic dysfunction can be solved with a combination of physical therapy and diaphragmatic breathing. Both have been shown to help reduce stress as well as lower blood pressure and heart rate.
Active relaxation is just as important as muscle strengthening
In the months that followed my diagnosis, I adhered to a regimen that included internal trigger point massage. The discomfort that I had initially experienced so clearly eventually subsided as I continued to work with my physical therapist on rehabilitative movements through stretching and breathing techniques.
“[Treatment] for this kind of pelvic pain is about learning how to take the tension out of your pelvis and distribute it throughout your body equally and evenly,” Shepherd said, noting that pelvic disorders aren’t just reserved for those who have given birth. High-impact exercise, menopause, trauma, and aging can all lead to pelvic-related issues.
What this means for me is daily diligence
While I might not always finish every physical therapy exercise or sit and breath quietly for ten minutes at a time like I did when I was originally diagnosed, I am sure to do small things. I pay attention to when I’m sitting at my desk for too long or to when my jaw and shoulders are tightening — these are sure signs that I’m also tensing my pelvis. Taking a few focused deep breaths helps relieve the tension.
Shepherd said these “internal cues,” or little reminders, are crucial to finding relief from stress-related pelvic pain.
“When you are relaxed and not stressed over your issues,” Shepherd said, “then everything falls into balance.”
I’m so glad to have found that balance.
Caroline Shannon-Karasik's writing has been featured in several publications, including Good Housekeeping, Redbook, Prevention, VegNews, and Kiwi magazines, as well as SheKnows.com and EatClean.com. She is currently writing a collection of essays. More can be found at carolineshannon.com. Caroline can also be reached on Instagram @thesincerelylife and Twitter @SincerelyCSK.