Trigger Point Therapy for Pelvic Pain

Trigger_Point_therapy-painSkeletal muscle accounts for 40% of our body weight. Each one of us has over 400 muscles but unfortunately any one those muscles can develop “knots”. Painful ones..

Myofascial trigger points, also known as trigger pointstrigger sites, or muscle knots, are hyper – irritable spots in the fascia surrounding skeletal muscle. They are associated with palpablenodules in taut bands of muscle fibers.[1]

Trigger points do not appear randomly in our bodies but occur in predictable locations. Symptoms of trigger points can include dull ache, localized tenderness, burning feeling, reduced range of motion, or even sharp, point-specific pain. Trigger points can refer pain to another locations on the body.

Trigger points happen in predictable locations, and can rise to the surface and increase in size due to trauma, overuse, strain, poor posture, bad ergonomics, structural imbalances, improper body mechanics, or such things as poor nutrition and psycho-emotional stress or exposure to cold temperature.

Releasing trigger points helps to reestablish proper movement patterns, pain free movement, and ultimately enhances performance. You can assist in breaking up these muscle knots, resuming normal blood flow and function by treating your own trigger points.

Why not consider trying self-myofascial release! It provides YOU, the user, the ability to control the healing and recovery process by applying pressure in precise locations, because only you can feel exactly what is happening.

Trigger points respond best to four things; heat, pressure, massage, and stretching.

Various Ways To Treat Trigger Points

  1. Heat up a grain (magic) bag in the microwave and then place it on the areafoam-rolling-pelvic-pain
  2. Massage the area. To do this, put a little lotion or oil on the area and rub it until the sensitivity in the area decreases. (Then add some peppermint oil to the area to help stimulate healing)
  3. Visit a massage therapist. Trigger points are hard to reach on our own bodies. Massage therapists can get at all of these spots as well as find other trigger points that are contributing to your pain.
  4. Dry Needling. Uses a thin filiform needle to penetrate skin and stimulate underlying trigger points, muscular and connective tissues for the management of neuromusculoskeletal pain and movement impairments.
  5. Self-myofascial release. Which basically means self-massage to release muscle tightness or trigger points. This method can be performed with a foam roller, lacrosse ball, TheracaneYogaTuneUP ballsMassage Blocks or your own hands. This greatly assists in breaking up these muscle knots, resuming normal blood flow and function.

Need more help? Check out the following trigger point therapy resources and check out my entire page devoted to Trigger Point Therapy

Jill Miller : The Roll Model

Clair Davies: Trigger Point Therapy

 Donna Finando &  Finando Steven: Trigger Point Therapy for Myofascial Pain

NAMTPT: Symptom Checker

Trigger Point Online Guide

Trigger Point Performance Therapy – They even have classes



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Every Journey has a Beginning

I never thought that I would create this website. Of course I never thought that I would be a pelvic pain sufferer either. It all started when I was getting ready to go on a trip to Bermuda with my husband. I developed a urinary tract infection and promptly treated it with antibiotics. The infection went away, but the pain in my pelvic region persisted.

For the next four years I struggled on and off again with pelvic pain with consistent burning, and I could no longer wear clothing that pushed on my pelvic region. I suddenly became an avid skirt and baggy pant wearer!

I tried many things and saw many people. Eventually Dr. Google prompted me to consider that something must be wrong with my pelvic floor. I went to see a lovely Naturopathic doctor and she suggested I could possibly have vulvodynia and/or vestibulodynia (vulval vestibulitis). She recommended a low oxalate diet  and various supplements. 

My pain persisted, so I followed through with an appointment I had set up previously, with a pelvic pain physiotherapist I had located in Nova Scotia. While I lay on the exam table, my amazing physiotherapist, Erika Burger explained to me that my pelvic floor, specifically —the pelvic-floor muscles, when they misbehave, can disrupt the normal functioning of my urethra, vagina and bowel. And in my lightning fast mind I thought, hmm, could this account for my various boughts with constipation and irritable bowel? Could this be why I have burning down there?

Before the physical exam, Erika conducted a thorough interview involving everything from my reproductive history to my diet, to previous surgeries and to my sleep patterns. She then had me undress and started some inter-vaginal exploration.  Using her fingers, she pushed firmly into the various pelvic floor muscles. My pain was through the roof on most of the muscles she pressed. One of the muscles actually radiated pain to my uretha – alas, had I found what had been causing me to burn? I think so!

She not only worked on my muscles finding all the trigger points that were causing me immense pain, she also worked on my old episiotomy scars. It was so hard to believe that that much pain could cause so much future relief. I went home and had my first realtively pain free day in months. 

Over the next couple of years I have been seeing a pelvic floor physical therapist for this pain, with amazing results.  We work on all the pelvic floor muscles and on the trigger points in my abdominals.  I also have a tendency to chest breathe, so we work on my diaphragmatic  breathing, as both affect my pelvic floor symptoms. 

I know there must be other people that struggled with this type of pain – so I created a website devoted to educating myself and others.  There are cures to pelvic floor pain, we just need to work together to find them, and then talk about it. 

Please share your journey in the comment area below and please wander around the website! Please send me any information that you feel would be a great addition to the site. If you are in pain please reach out, I would hate anyone to live like I have these past few years. It’s not like you bring this up with anyone…I mean really!

Posted in Low Oxalate, Pelvic Floor, Pelvic Pain, therapy, trigger point, Vestibulodynia, Vulvodynia Tagged with: , , , , ,

Diastasis Recti (DR)

Diastasis Recti (also known as abdominal separation) is a disorder defined as a separation of the rectus abdominis muscle into right and left halves.

diastasis recti - pelvic painA mid line of more than 2 to 2.5 finger-widths, or 2 centimeters, is considered problematic. Diastasis Recti can occur anytime in the last half of pregnancy but is most commonly seen after pregnancy. 

A small amount of widening of the mid line happens in all pregnancies and is normal. 

Diastasis Recti reduces the integrity and functional strength of the abdominal wall and can aggravate lower back pain and pelvic instability. Separation in a previous pregnancy significantly increases the probability, and severity, of the condition in subsequent pregnancies. Women expecting more than one baby, petite women, those with a pronounced sway back, or with poor abdominal muscle tone are at greatest risk. Genetics also plays a big role. For some women, it simply how their bodies respond to pregnancy.

Listen to podcast by Katy Bowman for more about the why of DR. You would be smart to  check out Diane Lee as well. These educated health professionals are a good go to for this problem.

Diastasis Recti/Abdominal Separation Test

This simple self-test will help you determine if you have Diastasis Recti. I found this test on the BeFit-Mom website. You can go there to see a lot more great information on this condition.

  • Lie on your back with your knees bent, and the soles of your feet on the floor.
  • Place one hand behind your head, and the other hand on your abdomen, with your fingertips across your midline-parallel with your waistline- at the level of your belly button.
  • With your abdominal wall relaxed, gently press your fingertips into your abdomen.
  • Roll your upper body off the floor into a “crunch,” making sure that your ribcage moves closer to your pelvis.
  • Move your fingertips back and forth across your midline, feeling for the right and left sides of your rectus abdominismuscle. Test for separation at, above, and below your belly button.

A midline separation of 2-2 1/2 finger width is considered problematic. With a larger diastasis, it can create several problems such as chronic lower back pain, lumbar instability, digestive problems and worse of all, hernias.

If you have a large separation, before you even think of having surgery, with the correct exercises, you can actually come close to closing the gap and repairing the damage done! 

You can be making your Diastasis Recti worse if you are doing traditional abdominal work like crunches, sit ups, bicycle crunches etc., and let your abdominals balloon/bulge/inflate during the exercise. Continually performing exercises can also create postural problems, lower back issues, pelvic instability and pelvic floor pain.

Types of Movement to Avoid 

  • Upper body twists where the arm on that side extends away from the body, such as “triangle pose.”
  • Exercises that require lying backward over an exercise ball.stop-pelvic-pain
  • Yoga postures that stretch the abs, such as “cow pose,” “up-dog,” all backbends, and exaggerated “belly breathing.”
  • Exercises that flex the upper spine off the floor or against the force of gravity such as: as crunches, obliquecurls, “bicycles,” roll ups/roll downs, etc.
  • Pilates exercises that use the “head float” position, upper body flexion, or double leg extension.
  • Exercises that cause the abdominal wall to bulge out upon exertion.
  • Lifting and/or carrying heavy objects.
  • Intense coughing when your abdominal is not supported.
  • In general it is best to avoid anything that “jack-knifes” the body, by pivoting at the hip and placing strain on the abdominals. Examples of these movements are straight leg lifts or holds while lying on your back.

How to get rid of it?

I am not an expert – but I have found some amazing people on the web that now a lot more that can really help you out. Please consider checking them out.

If you are pregnant I would really watch this video by Julie Wiebe, PT right now! I would also watch this one as well. I have been following Julie’s tips for a while, such wisdom! 

A fantastic blogger tells her story at Diastasis Rectified. It is WELL worth reading! You can follow her on twitter @diastasisrecti as well. Take a look at Kangaroo Fitness  as well for more great information.

Take a look at the Mutu System (Wendy Powell) and Restorative Exercise (Katy Bowman) as a way to heal your DR. I am using both to help with my pelvic floor issues, and coming along nicely because of what they share. They are a must follow if you want to get better in my humble opinion. 

Katy Bowman has a book entitled Diastasis Recti-The Whole-Body Solution To Abdominal Weakness And Separation and a podcast devoted to Diastasis Recti that are so worth buying/viewing.  She is a real expert on this issue.

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