Pelvic Pain: What Is It and What Strategies Can I Use To Help?

Here are some common descriptions of pelvic pain I hear… 

• “It just feels like there is a migraine in my vagina.”
• “It feels like I am sitting on a ball.”
• “It's like I have a deep ache in my uterus… even when I am not on my period.”
• “My vagina feels raw...”
• “It feels like there is a spot/space that feels like sandpaper, somewhere in there.”
• “I feel the pain deep in my abdomen and into my hips and my groin.”
• “I don’t know how to explain it, it is just here (hands gesture around torso and saddle region) and I want to curl into a ball”

Let’s talk about pain. The International Association on the Study of Pain (IASP) defines pain as an “unpleasant sensory and emotional experience.” Pain is a normal human experience, but living in pain is not normal. There can be a lot of negative emotions around pain such as fear, hesitation and frustration. Pelvic pain, especially, can be very isolating as talking about anything “below the belt” can be considered taboo and off limits. It’s not always as simple as saying to your coworker, “I have a headache” or “my shoulder hurts.” 

So let’s take a dive into pain to understand it more. 

Let’s break down the key players in this pain mystery. The brain, the nerves, and the tissue all make up an alarm system. The tissue stimulates the nerves, the nerves carry the message to the brain, the brain decides what to experience based on the information received. When your brain is getting negative messages from the body, it calls it pain. When we start to experience chronic pain, pain that has been experienced greater than three months, our alarm system becomes more sensitive. So now you have an alarm system that should only go off when there is fire or a sharp nail that you stepped on… but now it is going off when you put toast in the toaster!

What feeds into pain?

Pain can be influenced by many things, these include and are not limited to injury, postural habits, stiffness of muscles/joints, scar tissue, bowel and bladder habits, sleep disturbances, and stress. At Athletes’ Potential we aim to look not just at the tissue and give you cookie cutter responses - we want to get to know you and understand the factors that are influencing your pain experience. 

What are some strategies I can use for home? 

Check out these videos and tips:

• Alternate nostril breathing: Shallow restrictive breathing patterns are common with pain. This can tell our nervous system we are not safe and our body goes into fight, flight, or freeze. Slowing down and focusing on your breath is a great way to decrease the flight, fight and freeze response that occurs with stress. If you are more stressed your nervous system is more easily irritated and therefore so is your pain. Breath can also help pump more oxygen into the body which also helps to calm down an overactive and over responsive nervous system. 
• Offset Quadruped Rock: This exercise is great to take your pelvic floor muscles through some nice passive range of motion. Just like we roll our shoulders or tilt our heads to stretch our neck to relieve tension, it’s nice, safe and soothing to take our pelvic floor through some gentle repetitive motion. Movement allows blood and oxygen to flow, and by producing small, gentle and pain free motion we can begin to educate our nervous system and brains that we are safe and decrease the negative messages. 
• Graded Motor Imagery: When in pain your brain is VERY concerned for you and is trying to keep you safe. This strategy is great if you are actually in danger, but when the activities you are doing are not actually harmful… like trying to have pain free intimacy, peeing, pooping, sitting, standing, walking, holding your baby or grandkid, it can be super frustrating. Visualization can help train the brain and rewire the circuitry to help your brain understand you are NOT in danger. 
• Close your eyes and visualize your pelvic bowl what colors and textures you see. Do not judge yourself on being anatomically correct, just be a witness to your experience. 
• Consider an activity that you want to do and see how this activity changes the color or texture of your pelvic bowl. 
• If negative thoughts, feelings, emotions, colors, experiences, or textures arise, consider visualizing water being poured into your pelvic bowl. The water will circle around the bowl and wash down onto the floor. Removing that which does not serve you. 
• Continue this process 3-4 times and attempt to practice it regularly. 
• Notice through consistent practice if what you originally visualize changes. 

By exposing your brain to enjoyable and healthy experiences, your brain will be less concerned about you, which will make your nervous system less fearful and hesitant to attempt the movements and activities that should bring you joy. 

As a pelvic health physical therapist, I am uniquely trained to be able to connect you to your pelvic floor, understand your experience, and guide you. If you are in the Columbus area, our office is located in Worthington off of Busch Blvd.

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Thanks for reading!