Chronic Pelvic Pain. This term encompasses conditions ranging from endometriosis to painful sex (dysperonia), incontinence to constipation, pelvic floor inhibition to over activation. These are complex conditions with a multitude of contributing factors. As such, it can a be frustrating nightmare when looking for answers. But complexity in this instance also offers those with these conditions several avenues to begin addressing the pain at home as well as gather information to help their health care provider faster make a diagnosis. Support Your Pelvis Supporting your pelvic structure and function is one of the first steps to a pain free pelvis. It is also an important step in preventing pain and maintaining re-established freedom. Use a Faja or Sacral (SI) belt during strenuous activity such as heavy lifting, running, or instances of excessive sitting. Limit sitting to 45 minute or less stretches at a time when possible, punctuating the time with periods of movement. Adopt healthier sitting postures (as described here), whenever possible. Increasing body awareness to correct postural and movement imbalances such as hunched shoulders or walking on the insides of your feet will also support your pelvic health and alignment.
Extremes often seem to be the goal in America's fitness crazes - extreme flexibility, extreme intensity, extreme weight. While pushing yourself is beautiful for growth, stretching until you injure yourself or straining to lift weight until you pee are instances of moving from challenging to deleterious. Intersperse your exercise routine with low impact exercises such as swimming and hypopressive abdominal work. If you feel super strained in your abdomen or hips at any point in any workout, modify the exercise to be more pelvic friendly. Start a Food Journal
Certain bladder and pelvic floor conditions can be exacerbated by what you eat. Tracking when your flare ups occur helps you make a correlation between your diet and your pain. Pay special attention to foods containing caffeine, artificial sweeteners, alcohol, and high acidity as these have been linked to pelvic agitation.
Change Your Diet
Should you find a link between what you are eating and your pelvic pain, eliminating possible irritants from your meals for at least 14 days - though 30 is better - can confirm your hunch and give you pain relief. If you have a strong suspicion that food is a big factor, you can skip the journaling part and go straight to elimination. Either way, make sure you are very strict about keeping the chosen food(s) out of your diet completely! Cheating here will mean you have to start the process over from day one. Adding foods high in Omega 3s, antioxidants, and other anti inflammatory properties (flax seeds, low caffeine herbal teas, and deep green vegetables are a good place to start) whether or not you choose to undergo an elimination experiment can also be helpful in decreasing pain. Balancing your diet might also help to balance your hormones, a big factor in pelvic pain conditions.
Our pelvic floors are highly reactive to stress, contracting when experiencing strong negative emotions. Being in constant states of tension can increase or even cause pelvic pain. Stress reduction can seem like a tall order in our constant go of life, so start small. Five minutes of meditation when you wake up and before bed can do wonders to set a calm mood. Taking mini breaks throughout the day to color, read, walk outside, or really be present with your cup of tea can also be a boon to your mental health.
Establish Boundaries Though this element is closely tied to stress management, I think it deserves its own segment. Often much of our stress comes from over extending ourselves. Learning to say “no” can be a powerful way to reclaim your energy. However, the flip-side is also true. Learning to say “yes” to the things that truly light you up, not just the things you feel obligated to do, is reinvigorating and clarifying. When you feel more balanced, tension and pain tend to greatly reduce.
While we know our diaphragm is the prime mover in respiration, it is important to remember the role our pelvic floor plays in breathing. As a synergyst, or a muscle that coordinates with the primary to create an action, the pelvic floor depresses with inhalation and elevates with exhalation maintaining intra abdominal pressure which in turn assists in digestive and reproductive health. (Check out this awesome video to see the extent of movement in our viscera with breath!) However, most people have developed poor breathing habits. This can stagnate movement in the pelvic floor, negatively affecting its adaptability. Establishing a regular breathe practice and breathing mindfully can retrain these habits and lead to an overall improvement in health.
By far my favorite self care (but perhaps I am biased) is self massage. Trigger points in your glutes, low back, abdomen, and thighs, especially the adductors, can refer pain deep into the pelvis and groin. These little buggers will not show up on medical imaging tests, but they can be palpated. How will you know that you have found a trigger point connected to your pelvic pain? Pressing on it will reproduce your symptoms. Rid yourself off trigger points by using your hands, tennis ball, Theracane, foam roller, whatever is easiest and most convenient for you to massage along the aforementioned muscle groups until you find a tender spot that radiates or produces traveling pain. Then - the fun part - push on that point to the level of progressive or good pain until the sensation dissipates. Do this once or twice a day, as often as feels necessary, or as your massage therapist recommends.
Pelvic pain can be a maddening experience, but as knowledge advances we are getting better and better at identifying and treating these conditions. Use these self care tools to start chipping away at your pain at home and tell your health care practitioner about the results. Your work could go a long way to finding a diagnosis if you do not already have one.
Which of these suggestions did you find most helpful? Are there any that you feel could use clarification? Let me know in the comments!