External Massage for Pelvic Floor Pain - Trigger Point Myofascial Release

Massage and myofascial release can be one of the most useful tools for fighting chronically tight and painful pelvic floor muscles. When the muscles of the pelvis are chronically tight or spasm'ing non stop throughout the day this can leave the muscles tightly bound and full of painful trigger points.

External massage can be especially useful for people who are a bit squeamish about doing an internal massage on themselves. Its a great place to start exploring your pelvic floor , finding your trigger points and bringing you some relief. Finally time to start healing the pelvic floor.

When performing a external massage to pelvic floor I concentrate on the Glutes Piriformis, Pubococcygeus and Levator Ani muscles which make up the bulk of the pelvic floor muscles. The levator Ani muscle is especially prone to holding painful trigger points as this is the muscle responsible for the upwards pelvic floor contraction, and is responsible for holding painful tension in your pelvic floor muscles.

 Method

Before you being make sure to find a quiet place where you will have 10-15 minutes free without being disturbed. So you can fully relax and get the most out of the massage session. I find it best to do 5-10 minutes before a morning or evening shower.

1. You will be massaging your pelvic floor with your hands so it is important to maintain proper hygiene practices. You can get some examination gloves from your local chemist or online , I usually go for the vinyl powder free examination gloves as they are fairly cheap and have close no chance of causing skin irritations or allergic reactions.

2.  Put on the examination gloves, and either lie on your back or stand up with one foot propped up on a low stool. The standing position may be the best for easy access as you will be going for some hard to reach places :).

3. You can begin the massage by exploring the muscles the wind around your anus, and searching with your fingers for any painful area's or parts that may feel gristly. Take it gently, relax and listen to your body. There is no right way to massage at this point its really going to be about finding trigger points. A trigger point will be any area that responds with pain to the touch, A happy supple muscles will not be painful when manipulated.

4. When you find a painful area , you can push the pads of your fingers into that area with a circular pushing motion or by simply holding constant pressure until the pain lessens.You will eventually increase blood flow to these muscles and breath new life into them and it can be quite a pleasant experience.

5. Go around every nook and cranny and find trigger points, knead them out and continue. Remember to take it easy as these muscles will take some time to get used to being massaged. After a massage give body time to heal and process the new oxygenated blood coming through.

6. Repeat the massage 3-4 times a week or as often as required.

Theracane

I recently purchased a theracane to knead out some trigger points in my hips and lower back and found it very useful for performing discrete pelvic floor massages as well. You use the handles on the theracane to get a nice Glutes Piriformis release.

It is great for targeting larger groups of muscles and definitely has its place in my arsenal of massage equipment but will never be quite as precise as using a gloved hand to find trigger points which can sometimes be like searching for a needle in hay stack.

Internal Massage

After all that here I am talking about internal massage again, I wish I could just ignore it but to be honest internal massage can be extremely valuable and its probably the most common procedure that a pelvic floor specialist will perform on you to examine your pelvic floor health.

An Internal massage gives you the ability to manipulate muscles from a totally different angle and also allows for a great number of stretching exercises. I know many people turn there nose up to get anywhere near their rear ends but that's exactly the problem right there, We are so disconnected its like we ignore that poor little peep hole because of its dirty history. He/She is part of us and deserves to be treated as such and only then will it heal.

Well enough of my blabbing , I shall publish a post on internal massage shortly or perhaps a different topic first. Stay Tuned if anyone is reading :P

Biofeedback Devices for Pelvic Floor Pain - Using Electromyography and Biofeedback for Pelvic Floor Dysfunction

Biofeedback devices are very popular for retraining the pelvic floor for suffers of pelvic floor pain and pelvic floor dysfunction. There are a few types of Biofeedback machines these are

-> Pressure Based Biofeedback Machines - These work by inserting a balloon type probe into the anus and measuring the built up air pressure around the probe. Usually a lot cheaper then the next type of device.

-> EMG biofeedback device -> An EMG or Electromyography biofeedback device is more high tech than a simple pressure biofeedback device as it will pick up electrical signals from your muscle contractions to determine your pelvic floor tension or relaxation.

-> Pressure or EMG device with inbuilt electrical stimulation - mostly used for training the pelvic floor much like a kegel without any effort but can be useful in some cases , explanation below. (note * kegels are never recommended for people suffering pelvic floor dysfunction.)

There are basically two main ways in which a biofeedback device will help bring relief to your pelvic floor.

1. Retrain the Pelvic Floor

The first is to retrain the pelvic floor so that you can develop a stronger body mind connection. The aim is to be able to determine exactly from the biofeedback device when you are contracting your pelvic floor and when you are relaxing.

This is particularly useful for people who find that when they are in the bathroom and trying to defecate that not matter how hard they push nothing comes out. Pelvic floor dysfunction often causes constipation as people unconsciously tighten and contract their pelvic floor instead of relaxing it which makes it almost impossible to have a happy bowel movement.

In my experience a biofeedback device is somewhat useful in helping you consciously feel a relaxed pelvic floor, and the difference between a contracted pelvic floor and a neutral/relaxed one.

Important:  Some people with pelvic floor dysfunction can experience excruciating pain when anything is entered inside the anal canal. I too have felt this before and I would describe it as a strong kind of ballooning pain where the pain slowly increases and then dissipates in a matter of about 15 seconds. For those people it is highly recommended to avoid the use of biofeedback devices. Experiment with a gloved finger first to determine your level of sensitivity.

I know this is not always possible but it is highly recommended you use a pelvic floor biofeedback device with the assistance of a trained pelvic floor specialist.

The Method

The method for using a biofeedback is quite simple. First of all make sure that your hands are clean and you have used a water syringe in your anus for hygiene purposes.  This is not strictly neccessary but can make the experience much cleaner and less off putting.

Once you are all cleaned up and ready to go , Lubricate the anal probe and while lying on your back with your knees bend and feet flat on the floor, gently insert the probe in your anus. Once the probe is inserted as comfortably as possible you can pick up the biofeedback device and establish a baseline level for your resting pelvic floor tension.

Once you have established your baseline, you then bring the machine back to zero and perform kegel contractions to determine the strength of your pelvic floor or maintain a relaxed state to see if you are able to relax the pelvic floor consciously. This can also be useful for finding trigger points for example you could massage your upper thighs or legs and see if this is causing you to perform involuntary kegels.

The EMG device will have much the same procedure but will give you more accurate/complicated readings.

2. Break the Muscle Spasm Cycle

Normally an electrical stimulation that forces you to contract your pelvic floor is not a good thing but it can sometimes be used to break a muscle spasm cycle. Say for example you find you have very twitchy pelvic floor muscles which spasm painfully you can use an electrical stimulation device to force contractions for desired duration or intervals in order to break a pattern.

Conclusion

Many of you with pelvic floor dysfunction may be interested in buying a biofeedback device and to some extent I believe they can be helpful especially to monitor involuntary muscle contractions and bring them under control.

The only issue is that when establishing baseline pelvic floor tension you may find that your relaxed state is not in fact a relaxed state so its not really an appropriate place to begin from. For people who have been holding tension for months or years even a relaxed pelvis can feel tight and painful.

I have tried all 3 types of devices Pressure, EMG and Electrical stimulation at great expense and could only really recommend the cheapest pressure biofeedback device to satisfy any curiosity you have in the effectiveness of these types of devices.

Not sure how interested people are but I will review the specific devices I have used , the PFX pressure biofeedback device, and the Neen Peritone electrical and biofeedback devices.

That's all folk's , hang in there and all the best :)