By Ayelet Connell-Giammatteo, PhD, PT, IMT,C
o you suffer from pelvic pain? Is it chronic or does it just present when you are performing certain activities,
such as riding a bicycle or having sex? Is it diffi cult to sit for long periods of time, like at a movie or at work?
Pelvic Pain and Manual Therapy D
The muscles cannot relax until the spine
is back in alignment. Manual Therapy is a tool that can successfully restore pelvic and spinal alignment, thereby reducing pelvic pain.
Pelvic pain can be debilitating. Imagine not being able to perform the most basic and mundane activities, such as sitting, and how that would affect your life.
Experienced by 25% of Women in the US The incidence of pelvic pain and pelvic
fl oor disorders is rising. According to the National Institutes of Health, roughly one quarter of US women are affected by pelvic fl oor disorders. One study, published in the Journal of the American Medical Association in 2008, showed that the frequency of pelvic fl oor disorders increases with age, affecting more than 40 percent of women between 60 and 79 years of age, and about 50 percent of women 80 years and older.
Injuries Must be Considered In traditional physical therapy settings,
pelvic pain is generally regarded as a muscle problem, where pelvic muscles are in a state of spasm and tension, leading to pain. What often is not considered is the person’s potential trauma history, such as a car acci- dent or sports injury. Imagine being in a car accident. The impact can contribute to our spine and pelvis being out of alignment. It is important to note that our pelvic muscles attach to our pelvis and skeleton. The result of the pelvis and spine being moved out of alignment (because of the force of the colli- sion) can be strain in the pelvic muscles.
18 Natural Nutmeg - May/June 2015
Gentle Therapy that Corrects the Cause Manual Therapy is a hands-on ap-
proach that is practiced by many physical therapists and massage therapists. A par- ticular advanced form of Manual Therapy is Integrative Manual Therapy (IMT). Integrative Manual Therapy is a gentle type of treatment that can identify underlying reasons for pain. IMT practitioners look at the ability of the joints to move, for example, the low back and pelvis. They also assess the alignment of the joints. Gentle techniques are used to improve mobility and alignment. IMT thera- pists assess the tension of the fascia in the low back and pelvis to determine areas of compression. Assessment goes beyond the joints and includes soft tissue, to fi nd pos- sible underlying contributors to pain. IMT is benefi cial in creating a more neutral align- ment in the low back and pelvis, to support reduction and elimination of pain.
Keep in mind that even minor falls can cause the pelvis to shift out of alignment. Some of the pelvic muscles are positioned in a sling-like arrangement in the pelvis from one side to the other. Let’s say you slip on the ice and fall on your butt; it is unlikely that you land perfectly in the middle. Very likely, one side hits the ground fi rst. This force can cause the pelvis to shift, creating pelvic and low back pain. By using IMT, we can create healthier balance between the two sides of the pelvis and restore align- ment, thereby reducing pelvic pain.
Sneezing and Stress Incontinence Some women suffer from stress in-
continence when they sneeze. The pelvic muscles in this sling-like formation have a distinct right side and left side. One side can go into spasm secondary to a fall or other physical trauma, while the opposite side is not in spasm. In the center of these two muscles is the sphincter that allows urine out of the bladder. When there is an imbal- ance between the two sides of the pelvic muscles, the sphincter can be affected, con- tributing to stress incontinence. By restoring alignment of the pelvis, and by focusing IMT on the pelvic muscles to reduce the spasm, pressure is taken off of the sphincter and urinary function is improved.
Strengthening the Immune System In addition to a physical trauma, some
people have histories of women’s or men’s health issues in the pelvis. Many of these types of issues, such as bladder and bowel dysfunction, can be infl ammatory and are often accompanied by pelvic pain. The infl ammation and toxicity in the pelvis can affect the strength of the pelvic bones, especially the sitting bones, which can lead to pain. In addition to correcting the align- ment of the pelvis and low back, it is often benefi cial to focus IMT on strengthening the immune system and promoting circulation and drainage to and from the pelvis. This can create more strength in the pelvic bones and help to relieve symptoms brought on with different activities.
Dietary Changes are Another Option In addition to IMT as a tool to restore pelvic alignment and reduce pelvic pain, making some basic dietary changes is
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