Hello Lovelies,
My name is Kat, or sometimes known as Kryptkeeper Kat online. I was born and raised in Ottawa, Ontario. I’m currently 33 years old, I have a miracle 7 year old daughter, and I have been dealing with pelvic pain, endometriosis and adenomyosis symptoms since I was 12 years old. I fought many long and hard years until the age of 33 to be officially clinically diagnosed as having endometriosis through my most recent laparoscopic surgery. I have lived many years with severe chronic pelvic pain and had to go through many more years and doctors before I got to this point; I just wanted everyone to know where I’m coming from and the real life experience I personally have with pelvic pain and trying so many different things to alleviate said pain.
Before I had my surgery but just after getting my clinical diagnosis I decided it was time to attempt some online support groups for people such as myself. I remember just lurking in the background of a few of them before truly diving in head first. During my lingering there were many whispers about how a certain type of physiotherapy could help with not just pelvic pain but pelvic floor dysfunction as well. As someone with periods so draining and painful they could knock the toughest off their feet, all I knew was that I had severe chronic pelvic pain and never once thought that dysfunction fell into that category. How wrong was I? EXTREMELY! That’s how wrong. So all I did was tuck those whispers away for potential future use or to pass on this advice to other endo-warriors who mention pelvic pain. For me personally however, it never went any further until one fateful day.
If you have any sort of reproductive or pelvic pain issue then you’ll have experienced a doctor or specialist at one point in your journey tell you that pelvic exams should be a breeze and shouldn’t cause any sort of pain. Here’s the thing: for a lot of us that isn’t even remotely close to the truth, especially if your issues have caused other issues such as pelvic floor dysfunction. I was at my first appointment with yet another new specialist (this one turned out to be amazing and I still have her as my endo specialist today) and after quite some time of going over the usual - medical history, questions, menstrual cycle issues, and medication - it was time for the portion I dreaded the absolute most: the pelvic exam. See, I’m one of those 1000’s of women whom those hurt, A LOT! So as per usual I got undressed and draped the thin covers over me expecting the usual comments of, “Relax, I can’t do this unless you relax,” and yet it never happened. Her very first comment was, “You have an extreme amount of pelvic floor dysfunction, please call this physiotherapist and make an appointment. It’s very important for before and after your surgery to help with some of your pain.” I sat there in shock and not the bad kind of shock either. For the first time in over almost 2 decades I didn’t hear the words, “Just relax and it won’t hurt as much.” For the first time ever I didn’t feel like I was being blamed or was doing something wrong while getting my exam done. But then I had a whole slew of other questions; such as:
What exactly is pelvic floor dysfunction and what type of physiotherapy would help me?
What does it do?
How long do I have to go for?
Will it really help? (I mean, will it help my day-to-day, and my sex life??)
Pelvic Floor Dysfunction is when the muscles of the pelvic floor are not functioning normally and are often too tight, and or weak. This can lead to a wide range of issues or symptoms that occur as a result of those muscles not able to function as they should be.
A few of them are:
Severe or chronic pelvic pain
Pelvic Inflammatory Disease (aka chronic internal inflammation)
Lower Back Pain
Groin/ Glute Pain
Painful Sex
Painful Urination
Constipation/Frequent bowel movements
These muscles, and of course other tissues, form a type of supportive sling that starts at the pubic bone and ends at the tailbone. They support your abdominal organs, help with sexual activity, bladder control, bowel control, as well as your posture. Pain of any kind, but especially constant pain can cause those muscles to stay tensed 24/7 and therefore cause them to become overactive due to overuse; which in turn can actually cause more pain and other subsequent issues to follow. The biggest one being the inability to contract or relax those muscles consciously or otherwise.
What exactly is Pelvic Floor Physiotherapy?
It is a very real and medical form of physiotherapy that should go as follows: the therapist should always start by assessing not just your medical history but you, physically, and how you’re feeling at the time of your appointment(s). They will and should assess for a range of conditions and then will provide hands on internal and external manual physiotherapy techniques proven and practised specifically for pelvic floor issues. Now, this may seem uncomfortable and a little odd, and I won’t lie the first couple of times might very well be, but trust me it’s all so very worth it. And yes, in case you were wondering you can go during your period and is usually left up to you if you wish to continue with internal therapy or external therapy only. External-only help is definitely optional but both are recommended. They do know and understand that we have extreme bleeding during our periods so that’s why the type of therapy techniques that are used during that time is up to you.
It’s extremely thorough, and the awkwardness does eventually wear off; which definitely helps with relaxing and loosening those muscles that are already too tense in the first place. I have had both internal and external physio and both have done different worlds of good for me. The internal “massaging” (it’s the closest descriptive word I could find) is more so about releasing internal tension by applying pressure with appropriate breathing techniques. The external is closer to regular physio with some slight stretching, proper movement lessons, breathing, and relaxing techniques. All of them applied together work as they should, especially if you do your homework.
How long do you have to go for?
Well that is somewhat up to you/your body and somewhat up to your therapist. Honestly, most people I have spoken to go for as long as it is covered by their insurance or as long as they can afford to go if they don’t have insurance. Then they continue at home until it is covered again or is within affordability. Any little amount of at-home upkeep is still way better than nothing. I’ve learned this firsthand and can 100% vouch for that concept. Something that helps when you live in pain is always better than nothing. That doesn’t mean spend $1000’s chasing random “internet cures” that haven’t been proven to work in any way. This concept has a backbone of success for many types of patients.
Now, I’m not here to tell you that it will work for everyone, because I honestly can’t say that it will. According to people I have spoken to there’s about a 50-60% success rate. Success is also dependent on why you have dysfunction, how long you go for, as well as how disciplined you are to do the at home exercises given to you at the end of each appointment. All of that together is extremely important and is the reason why when I suggest trying it, I truly suggest going for at least a full month or longer if possible to see if it is going to be helpful for you; because it sure helped me with so many things.
Biggest question would be: Did it work for me?
Short answer is yes. At first it was a bit rough for me as even just getting a finger into the vaginal canal was so painful I’d tear up. Yes it was that painful, and no, sex wasn’t an option for me and my husband. Small aside here- he was REALLY amazing about it and HIGHLY supportive/understanding. We went from a pretty sexual marriage to abstinence for 8 months due to how excruciating the pain was.
I went to physio twice a week for the first 2 weeks and during that time movement of any kind was difficult and painful, sleeping was virtually impossible, bowel movements hurt, sitting longer than 15 minutes hurt, lying down hurt unless I applied heat; you get the picture, life was painful and miserable. At my first appointment I cried due to the pain but I knew I had to push through and keep going. I had to give it more time. I was given a pool noodle that I had to position on each side of me while I sat, breathed, and tensed, then relaxed my muscles in a certain manner. I had to do up to 30 seconds per side a few times a day, every day. My second appointment was a bit better but not great, I won’t lie. Then something happened- something internally literally shifted and I could feel some of the tension release itself and not come back. She could internally assess me so much easier with way less pain. By the end of the first month I was only required to go once per week and all of my internal assessments were completely pain-free. HUGE DEAL!! By the end of the second month I was told I was able to attempt sex again but I had to prep my muscles first; and minus the fact that it had been such a long time in between activity there was no excruciating pain. HALLELUJAH!! I only went for as long as my insurance covered it but I do still work on it at home and since then sex has actually been pleasurable again. My hips don’t hurt half as much or as often, walking no longer hurts, and I can actually workout again. MIRACLE; RIGHT?! Yes it is, except not really. It’s science, hard work, and knowledge. Even after surgery healing wasn’t terribly difficult or nearly as painful as I had expected it to be. It was so helpful, so freeing, and so worth EVERY MOMENT and EVERY PENNY. At the very least I would suggest to those who are on the fence about it and it has been recommended to them by a doctor, try it, give it some time, be open minded, and see if it helps. You’ll never know unless you try. Try to give it all the time you can and do your homework.
Remember, you’re not alone; you can do and get through anything you put your mind to.
Love, Light, and Healing Vibes,
Kat <3
References:
https://my.clevelandclinic.org/health/diseases/14459-pelvic-floor-dysfunction
https://www.physiocarephysiotherapy.com/Services#women