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Author: Dr. Cynthia Neville, PT, DPT, WCS
A few months ago, we discussed pregnancy and pelvic floor PT. Here, we will go in more detail on sources of pain related to the pelvic floor. Sometimes pain in the lower back is coming from the pelvis: the pelvic girdle and sacroiliac joints. The pelvic girdle consists of the bones, joints, ligaments, and muscles of the lower lumbar spine, the pelvis, and the hips. The pelvic girdle’s primary job is “load transfer” which is the distribution of weight, load, or biomechanical forces between the upper and lower body during movement and at rest. We all rely on our ligaments, muscles, and connective tissue to support the pelvic girdle in the function of transferring load.
People with EDS/HSD may have problems and pain in the pelvic girdle when connective tissue laxity contributes to ineffective load transfer across the pelvic girdle joints. The pelvic floor muscles inside the pelvis may develop increased tension to improve stability and load transfer in the pelvic girdle. Increased pelvic floor muscle tension can further contribute to pelvic girdle pain, as well as to problems with bowel, bladder, and sexual function. The pelvic floor muscles and the pelvic girdle work together and directly affect each other. Some diagrams can be seen below.
The first line treatment for pelvic girdle pain and pelvic floor dysfunction is pelvic physical therapy. You can find a pelvic physical therapist at Pelvic Health PT Locator or at Pelvic Rehab.com. Be sure to ask if the pelvic physical therapist is familiar with treating patients with EDS/HSD or is willing to learn more.
Have you ever had experience with pelvic floor pain, or pelvic floor therapy?
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I’ve had my pelvic floor reconstructed; after a R&V prolapse in about 2017; and it appears to have returned again in 2021. EDS is no joke. I believe the key is building and strengthening those muscles for stability.
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5 ReactionsI was receiving pelvic floor therapy 3 years ago when Covid came on the scene and I stopped. But I got the treatment for about 6 weeks. (I sought out pelvic floor therapy because my gynecologist referred me to one when I experienced pain during his exam.)
The Physical Therapist worked to loosen tension in my pelvis by inserting her fingers into my vagina and putting pressure on the vaginal walls to relax them. She said she could feel a lot of tightness at first. She gave me leg exercises to do and encouraged my husband to continue to massage the vaginal walls with his fingers at home. We purchased some vaginal stretching apparatus and worked daily to support what she was doing once a week. Just before stopping the therapy I got the dreaded UTI. I ceased all exercises and never went back. I continue to have pelvic floor issues but they come and go. I am now seeing a chiropractor for spinal adjustments once a month.
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1 ReactionYou could try a Regenerative Medicine doctor. You might have some hypermobile joint issues
Yes, I have had pain in and around the pelvis for several years now, while going through perimenopause. I’ve also had incontinence, which started in earnest just after going off birth control, so I knew it is hormone related.
Now that I have been diagnosed with hEDS, and know that hormone changes/imbalances play a huge part in worsening symptoms, this makes a lot of sense. I hope that the following things will help:
** The Integrative Movement Method (IMM) by Jeannie di Bon (The Zebra Club app)
** Working with my physical therapist to stabilize and strengthen the muscles that are doing all the work of my ligaments and tendons
** Nutritional and immune boosting supplements
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6 ReactionsI suspect I'm going through perimenopause, and I'm current dealing with pelvic instability akin to when I was actually pregnant! I have seen my doctor about this, and I am awaiting an initial PT appointment, and I have started water therapy classes. I'm beginning to wonder if I should talk to my ob/gyn about checking my hormone levels, and eventually, whether estrogen would help. I can't do a combined pill; I tried that and it make the joint laxity and dysautonomia/digestive issues worse for me,
Thank you for sharing what you feel may be helpful! 🙂
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3 ReactionsHi @flexiblemomma247, given your username I assume you have EDS. Is that correct?
Great idea about the water therapy class. Have you had a chance to make an appointment with your ob/gyn?