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Wondering what you can do besides pelvic floor physical therapy for your pelvic pain? This week we compiled the yoga sessions our PT, Melissa Patrick, has been hosting on our Instagram. Find the best yoga session for you based on the pelvic pain you are experiencing directly below its description.
Working with neuropathic symptoms around the genitals, anus or perineum? Allow Melissa Patrick, PT, DPT, RYT to guide you through an exploration of movements to find relief and ease in the entire body.
Three Poses, three Way for Pudendal Neuralgia
Find the stretch that suits you best! Melissa covers three poses, using props for variations, to help you design a practice that meets your body where it is today. These pose variations are designed to relieve tension in the posterior chain and may provide relief for those working with symptoms of pudendal neuralgia.
Therapeutic Backbends for Pudendal Neuralgia
Let’s open through the front line of the body to reduce tension along the posterior chain. These supportive and gentle backbends can be a great way to reduce strain & stretch along the pathway of the pudendal nerve. Backbends have other benefits, too! They help us to breathe more deeply by improving recruitment of the diaphragm. The better belly breaths we can get, the more our pelvic floor can lengthen and relax. Not to mention, deep breathing helps to calm our nervous system and induce physiological quieting. Finally, backbends have a natural antidepressant effect! Because backbends activate the heart, they invigorate and uplift the mood. Happy heart opening!
3 poses, 3 ways for pelvic floor release
Explore three different poses to relieve tension in the muscles around the pelvic girdle. We will explore variations of butterfly pose, wind relieving pose & wide leg fold to facilitate lengthening and opening in and around the pelvic floor.
3 Poses to Alleviate Tailbone Pain
The tailbone is a connecting point for a number of pelvic floor muscles. In today’s practice, we will focus on increasing spinal mobility and elongating the myofascial planes of the posterior chain to alleviate strain on the tailbone and relax the pelvic floor. Props needed: Wall, chair or table, blocks, blanket
Pose Lineup:
Standing cat/cow
Standing goddess with spinal twist
Downward dog
Those working with Coccydynia, or tailbone pain, often complain of pain when sitting or standing for long periods of time, rising to stand, or leaning back while seated. If you have tailbone pain during activity, it may be related to trigger points in your pelvic floor muscles or even glutes. Seek a pelvic floor physical therapist to learn more about why you may be experiencing tailbone pain.
Explore movements to support the hips and pelvic girdle with Melissa Patrick, PT, DPT, RYT. Develop awareness of how to coordinate your breathing with pelvic floor relaxation, learn about the vulva, and take a moment to get curious about what feels good in your body!
Prenatal Yoga – Floor Based Flow
20 minute floor based prenatal practice to open through the hips and lower back.
Postnatal Yoga for Pelvic Floor & Core
20 minute postnatal practice to engage the core and the pelvic floor. Learn how to assess for diastasis recti, too!
Extended Exhales = Relaxation Response
Simply prolonging your exhales during breathing relaxes the body. We will work with an inhale:exhale ratio close to 1:2 to slow the breathing rate and calm the nervous system.
Practice Tips:
- Breathe in through the nose
- Breath size should not increase substantially
- Breathe out thru pursed lips to facilitate longer exhale
Voluntarily decreasing breathing rate shifts us out of the sympathetic, or ‘fight or flight’, response that tends to dominate our body when we are in states of pain. The fight or flight response involuntarily increases breathing rate and volume. When we exhale blood moves out of the lungs which causes a small increase in blood pressure. In response, the nervous system reflexively decreases the heart rate and dilates blood vessels. This is known as the parasympathetic response, also commonly referred to as the ‘rest and digest’, or relaxation response.
Indications of parasympathetic activity:
- Decreased muscular tension
- Decreased heart rate
- Salivation
- Sensations of calm and ease
Meditation for Expansion & Energy
Charge your batteries for an energized and expansive day! Breath and body awareness melt tension and allow you to connect with your pelvic floor.
Body scan practices allow us to increase our internal awareness and consciously relax all areas of our body. This is a great practice for those new to meditation because it gives the mind something to focus on. For those working with pelvic pain, a body scan can help to bring your attention away from the painful parts of your body to areas that don’t cause discomfort. This allows you to consciously increase positive feedback to your nervous system and help you shift into a state of relaxation and rest. For today’s practice, we will be lying down so bring pillows, blankets and bolsters to set your body up for rest and relaxation. This practice is very beneficial at the end of the day and can even improve sleep quality. Enjoy!
Body Scan & Healing Meditation
Join Melissa as she guides you through a body scan and offers a healing visualization to bring stability and calm to your inner and outer worlds.
3 poses, 3 ways to develop hip mobility for forward folds, with extra care
Forward folds are a great way to stretch your posterior chain and can help alleviate tension in the pelvic floor. Did you know that when you bend forward, just 1/3 of the motion comes from your lower back? The other 2/3 should come from the hip joint. Improving your lumbo-pelvic rhythm, or hip-spine coordination, will pay off not only in your yoga practice but in the rest of your movement practices! Let’s take a look at three poses that will help you build into a forward fold practice with awareness of the mobility in your pelvis versus your lower back. Grab a block, strap, bolster and chair for today’s practice.
Fold Lineup:
Supine hamstring stretch
Half happy baby
Seated wide leg fold
Caution: If you have Pudendal Neuralgia, forward folds may not be indicated for you. Move slowly to test the waters or reach out to our PT Melissa Patrick, to schedule an individualized guided movement session where she can help you design a practice that fits your body’s unique needs.
Try these variations of bridge, supported shoulder stand, and legs up the wall to reduce symptoms of heaviness in the pelvis caused by pelvic organ prolapse.
Yoga for Digestion & Constipation
Join Melissa to explore variations of child’s pose, supine twist & forward fold to facilitate digestion and ease symptoms of constipation. Bring a bolster, blocks and a chair/bed. Pro tip: twist to the right first. Watch to find out why!
Standing Meditation & Embodiment Technique
Join Melissa in this standing mindfulness practice to relax the pelvic floor and release tension in the body with hands on techniques. Great for sitting pain, nerve symptoms, and anxiety!
Explore the senses as you find a comfortable seat and welcome in the sensation of breath.
Mindful Monday: Cultivating Clarity
Find pain relief and cultivate clarity in today’s Mindful Monday practice. Melissa will guide you through a body scan, using the visualization of the water element, to welcome ease and relaxation into the body.
Guided imagery and visualization are mind-body techniques that use the power of the mind to calm your sympathetic nervous system and reduce the stress hormones coursing through your body. Reducing the ‘fight or flight’ response in the body allows for a reduction in inflammation and activates the healing process.
Working with chronic pain? Guided imagery offers many benefits, without side effects, including increased relaxation, reduced systemic cortisol (stress hormone), improved sleep and potentially a reduced need for pain medication.
Observe the Sensations of Nature to Calm the Mind
Tune into the sensations of nature with this Mindful Monday practice. Melissa guides you in engaging the five senses to enhance the calming effects of nature in the body. Give yourself permission to slow down, get comfortable for ten minutes, and let the sounds of nature wash away your worries. We learn to embody the practice of mindfulness by truly becoming ‘the observer’. Simply engaging the five senses, to receive our environment or what we are visualizing, allows us to become present instead of focusing on worries from the past or anticipations from the future. Becoming aware of and emphasizing positive sensations in the moment has a positive effect on anxiety and depression and has the potential to reduce pain by activating the relaxation response.
Decrease Reactivity by Practicing Visualization
Cultivate stability and steadiness in your body in this Mindful Monday practice. Using the visualization of the lake, Melissa reminds us that we have a choice in how we respond to disruptions in our lives. Allow yourself to find balance in your breath and ease in your body during this ten minute practice. Guided imagery (a mind-body technique also known as visualization) is a well recognized and scientifically validated way to relieve pain, stress, anxiety & depression. Visualizations have the power to affect endocrine, immune and autonomic functioning in the body, reducing heart and breathing rates as well as blood pressure
Special episode: Self Myofascial Release (MFR). Props needed: Ball & Foam Roller
Let’s give some attention to a few of the 36 muscles that attach to the pelvis. As we work with muscle release using a foam roller and ball, we’re also impacting our fascia. Fascia is the connective tissue that encases our muscles, nerves, blood vessels organs and bones. It acts like a web, all over our body, to keep everything in place.
Restrictions in the fascia can occur as a result of poor posture, frequent sitting, scarring from injuries or surgery, inflammation and even general stress. When fascia isn’t sliding and gliding well, it can limit our range of motion, cause trigger points to develop, irritate our nerves, and cause pain locally or even in other parts of the body.
MFR focuses on compression of these web-like tissues to increase their pliability and moisture content. Think about a sponge, when you compress the fluid out of it, it is ready to be hydrated again. Fascia functions in a similar way.
Using diaphragmatic breathing during MFR is important. When first starting out, these techniques can feel intense and the body can react by tensing up. Using long, slow deep exhales helps to relax our muscles and calm our body to maximize the effects of the MFR.
Bridge the Gap & Bring your Mind into the Present Moment
Join Melissa for this Mindful Monday practice where we learn to navigate transitions and challenges. We tune into the breath and utilize the metaphor of the bridge to bring us out of the past or future and into the present moment. Melissa offers the reminder that your healing journey is your own. You have the capacity to go at your own pace, heal in your own time, and design your own transitions with self-compassion. Meditation is a studied and effective way to reduce stress in the body & we know that stress can exacerbate pain by causing more inflammation. Meditation wakes up our PARAsympathetic nervous system, the ‘rest and digest’ system, that helps our body heal + renew. PARAsympathetic activation moves the body out of the ‘fight or flight’ response (of the sympathetic nervous system) which causes stress hormones like cortisol & epinephrine to flood our body & can slow healing down.
Restorative Yoga for Pelvic Health
Join Melissa Patrick, PT, DPT, RYT for this 15 minute restorative yoga practice to help relax the pelvic floor muscles, improve the mobility of your respiratory diaphragm and relieve full body stress. See below to learn more about the benefits of each pose. Recommended props: 2 blocks/pillows; 1 strap, leash, tie or belt.
Reclined butterfly : stimulates the abdominal organs like the ovaries, prostate gland, bladder & kidneys, improves circulation, relieves stress, depression & improves symptoms of menstruation & menopause
Half happy baby : stretches the inner thigh muscles & helps reduce tension in the lower back which can improve the movement in your respiratory diaphragm
Constructive rest : balances the hip rotator muscles, alleviates compression in the lumbar spine & sacroiliac joint, puts the body in an optimal position to release the psoas, a muscle that for some, is a primary driver of pelvic pain
Spinal twist : directing the breath into the lower belly in this pose will release tone in the abdominal wall & pelvic floor
Savasana : practice being fully aware of the breath’s natural movement and rhythm here & allow the benefits of the practice to sink in
If you would like to work with Melissa one-on-one to develop an individualized yoga program to meet your body’s unique needs during your pelvic healing journey, please visit our website to request a session with her!
Interested in more yoga, meditation and general relaxation videos? Find the rest of our archived videos + informative blogs below:
Videos
Restorative Yoga for the Pelvic Floor
Using Mindful Somatic Movement for Pelvic Pain Relief
A Guided Meditation for Pelvic Pain Relief
Blogs
Pelvic Floor Muscle Function: Breathing Into Sexual Pleasure
5 Ways to Relax Your Pelvic Floor
Pelvic Pain Through the Lens of Curiosity: What Can You Learn?
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Are you unable to come see us in person? We offer virtual physical therapy appointments too!
Due to COVID-19, we understand people may prefer to utilize our services from their homes. We also understand that many people do not have access to pelvic floor physical therapy and we are here to help! The Pelvic Health and Rehabilitation Center is a multi-city company of highly trained and specialized pelvic floor physical therapists committed to helping people optimize their pelvic health and eliminate pelvic pain and dysfunction. We are here for you and ready to help, whether it is in-person or online.
Virtual sessions are available with PHRC pelvic floor physical therapists via our video platform, Zoom, or via phone. For more information and to schedule, please visit our digital healthcare page.
In addition to virtual consultation with our physical therapists, we also offer integrative health services with Jandra Mueller, DPT, MS. Jandra is a pelvic floor physical therapist who also has her Master’s degree in Integrative Health and Nutrition. She offers services such as hormone testing via the DUTCH test, comprehensive stool testing for gastrointestinal health concerns, and integrative health coaching and meal planning. For more information about her services and to schedule, please visit our Integrative Health website page.
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FAQ
What are pelvic floor muscles?
The pelvic floor muscles are a group of muscles that run from the coccyx to the pubic bone. They are part of the core, helping to support our entire body as well as providing support for the bowel, bladder and uterus. These muscles help us maintain bowel and bladder control and are involved in sexual pleasure and orgasm. The technical name of the pelvic floor muscles is the Levator Ani muscle group. The pudendal nerve, the levator ani nerve, and branches from the S2 – S4 nerve roots innervate the pelvic floor muscles. They are under voluntary and autonomic control, which is a unique feature only they possess compared to other muscle groups.
What is pelvic floor physical therapy?
Pelvic floor physical therapy is a specialized area of physical therapy. Currently, physical therapists need advanced post-graduate education to be able to help people with pelvic floor dysfunction because pelvic floor disorders are not yet being taught in standard physical therapy curricula. The Pelvic Health and Rehabilitation Center provides extensive training for our staff because we recognize the limitations of physical therapy education in this unique area.
What happens at pelvic floor therapy?
During an evaluation for pelvic floor dysfunction the physical therapist will take a detailed history. Following the history the physical therapist will leave the room to allow the patient to change and drape themselves. The physical therapist will return to the room and using gloved hands will perform an external and internal manual assessment of the pelvic floor and girdle muscles. The physical therapist will once again leave the room and allow the patient to dress. Following the manual examination there may also be an examination of strength, motor control, and overall biomechanics and neuromuscular control. The physical therapist will then communicate the findings to the patient and together with their patient they establish an assessment, short term and long term goals and a treatment plan. Typically people with pelvic floor dysfunction are seen one time per week for one hour for varying amounts of time based on the severity and chronicity of the disease. A home exercise program will be established and the physical therapist will help coordinate other providers on the treatment team. Typically patients are seen for 3 months to a year.
What is pudendal neuralgia and how is it treated?
Pudendal Neuralgia is a clinical diagnosis that means pain in the sensory distribution of the pudendal nerve. The pudendal nerve is a mixed nerve that exits the S2 – S4 sacral nerve roots, we have a right and left pudendal nerve and each side has three main trunks: the dorsal branch, the perineal branch, and the inferior rectal branch. The branches supply sensation to the clitoris/penis, labia/scrotum, perineum, anus, the distal ⅓ of the urethra and rectum, and the vulva and vestibule. The nerve branches also control the pelvic floor muscles. The pudendal nerve follows a tortuous path through the pelvic floor and girdle, leaving it vulnerable to compression and tension injuries at various points along its path.
Pudendal Neuralgia occurs when the nerve is unable to slide, glide and move normally and as a result, people experience pain in some or all of the above-mentioned areas. Pelvic floor physical therapy plays a crucial role in identifying the mechanical impairments that are affecting the nerve. The physical therapy treatment plan is designed to restore normal neural function. Patients with pudendal neuralgia require pelvic floor physical therapy and may also benefit from medical management that includes pharmaceuticals and procedures such as pudendal nerve blocks or botox injections.
What is interstitial cystitis and how is it treated?
Interstitial Cystitis is a clinical diagnosis characterized by irritative bladder symptoms such as urinary urgency, frequency, and hesitancy in the absence of infection. Research has shown the majority of patients who meet the clinical definition have pelvic floor dysfunction and myalgia. Therefore, the American Urologic Association recommends pelvic floor physical therapy as first-line treatment for Interstitial Cystitis. Patients will benefit from pelvic floor physical therapy and may also benefit from pharmacologic management or medical procedures such as bladder instillations.
Who is the Pelvic Health and Rehabilitation Team?
The Pelvic Health and Rehabilitation Center was founded by Elizabeth Akincilar and Stephanie Prendergast in 2006, they have been treating people with pelvic floor disorders since 2001. They were trained and mentored by a medical doctor and quickly became experts in treating pelvic floor disorders. They began creating courses and sharing their knowledge around the world. They expanded to 11 locations in the United States and developed a residency style training program for their employees with ongoing weekly mentoring. The physical therapists who work at PHRC have undergone more training than the majority of pelvic floor physical therapists and as a result offer efficient and high quality care.
How many years of experience do we have?
Stephanie and Liz have 24 years of experience and help each and every team member become an expert in the field through their training and mentoring program.
Why PHRC versus anyone else?
PHRC is unique because of the specific focus on pelvic floor disorders and the leadership at our company. We are constantly lecturing, teaching, and staying ahead of the curve with our connections to medical experts and emerging experts. As a result, we are able to efficiently and effectively help our patients restore their pelvic health.
Do we treat men for pelvic floor therapy?
The Pelvic Health and Rehabilitation Center is unique in that the Cofounders have always treated people of all genders and therefore have trained the team members and staff the same way. Many pelvic floor physical therapists focus solely on people with vulvas, this is not the case here.
Do I need pelvic floor therapy forever?
The majority of people with pelvic floor dysfunction will undergo pelvic floor physical therapy for a set amount of time based on their goals. Every 6 -8 weeks goals will be re-established based on the physical improvements and remaining physical impairments. Most patients will achieve their goals in 3 – 6 months. If there are complicating medical or untreated comorbidities some patients will be in therapy longer.