• Erin Zaranec

So, my pelvis has a therapist

My pelvis has a physical therapist, that is.

In November, I started pelvic floor physical therapy to strengthen my pelvic floor and relieve some of my muscle tension. When I thought about pelvic floor PT, the first thing I thought of was kegels... ya know the thing - breathe and squeeze, breathe and squeeze (all together now, gals!!).

Kegels are so simple that you can do them practically anywhere - at work, at the gym, during your Netflix binge. Pelvic floor PT... not that simple! There's both internal and external work involved. I can get away with doing my external work anywhere - well anywhere that I can lay down and do some stretches. My internal work, though, has to be guided by my PT and does A LOT more than a kegel can achieve.

Alright, so let's get this part of the way. When I refer to internal PT work I am, in fact, referring to physical therapy work that gets reallll physical. Currently, my PT manually manipulates my internal muscles. When I say manually, I mean she uses her hand. And when I say internal muscles, I mean everything a bit north of the vagina.

So, what exactly is my PT doing up there?

Honestly, I'm still not completely sure. We're in the early phases of pain diagnosis and treatment. My first PT session involved finding internal pressure and pain points and working to agitate the issue so that we could discover the exact areas of pain and muscle tightness.

Also, it's so interesting being a patient to an internal treatment. I can feel all the things happening, but can't really pinpoint what is going on. And, on top of that, I don't really ask a lot of questions (bad patient here!) because the more I ask, the more I focus on her specific internal movements and the more pain I feel. I prefer chatting my way through sessions to block out some of the discomfort.

I go to PT twice a week and my sessions vary a bit from session to session. Currently, we either start or end each session with what I call "massage time" and what my PT calls "tissue work". I split time between laying on my stomach and back and she works on my muscle and tissue in my lower back, belly, and pelvic region. She is working to increase blood flow to the area, to find and relieve any muscle knots or tightness, and to work the connective fascia throughout that region.

From there, we go into stretching or internal. My stretches are pretty simple - things I can do at home or the gym. A lot of my stretches revolve around realigning my poor little pelvis that is tilted to the left. Some are as simple as touching my toes, some mimic yoga poses, and others are a bit more involved and include resistance and pressure.

And then the internal starts. Internal PT, honestly, isn't that terrible. To me, it doesn't feel uncomfortable or invasive, but I'm one who has never really been bothered by those things and I'm lucky that my PT is a really cool woman around my age.

The only reason I dread internal PT is because that's typically the toughest time for me to get through.

With multiple internal muscle knots that still haven't started to untie themselves, my internal work involves working... and working... and working on these knots to relieve my pain longterm. In the short term, ouch. It hurts.

I'm two weeks into going to pelvic floor PT twice a week. Soon, we'll be incorporating some electronic assistance like TENS units and other small machines.

Pelvic floor PT isn't just for patients with endometriosis. It's not even exclusive to women.

Pelvic floor PT strengthens all of the pelvic floor - from the muscles involved in sitting and standing to using the bathroom to sitting comfortably during a long drive. My PT said that in a given day she sees a mix of men and women of various ages. Some women visit a pelvic floor PT after childbirth, some men visit after playing years of a contact sport.

It's truly an art that my therapist does with me twice a week. She works on a muscle group she can't physically see and helps in issues larger than just a muscle knot.

Again, I'm no doctor - but I would recommend looking into pelvic floor PT if you have any sort of pain in or around your pelvic region. In two weeks time, my PT has already given me some simple ways to ease my daily pains and work through pain flare ups. You're always going to need your pelvic floor, so you might as well make sure it's a solid floor to stand on!

The Invisible Illness series will be published on Mondays, detailing my journey with chronic pelvic pain and the various treatments I am prescribed.


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