Connective Tissue Dysfunction
Connective tissue – connects things in our body. It is one of four types of tissues in the body including skin, muscle and nerve tissue. Connective tissue (CT) is found throughout the body and it is the fascia, or supportive tissue which holds us together. The connective tissue in the pelvic floor area is the sleeve or container of the muscle, and it lies between the skin and muscle layer. CT can become restricted as a result of dysfunction in underlying muscle, nerves, joints and organs. When the connective tissue that attaches the skin to the muscle becomes restricted it causes pain.
Connective Tissue and Pregnancy
According to Rachel Carroll, a Neuromuscular Therapist, “For those women who have been pregnant, one of the more prominent areas for the connective tissue to bind and adhere is around the uterus and bladder due to the amount of strain placed on both organs during pregnancy. If you happen to have an caesarian section you will have scar tissues. If this is left untreated, the scar tissue can bind and adhere to the connective tissue underneath and around, and can also eventually adhere to the uterus, ovaries, and bladder and impede movement and function of the pelvic floor muscles. Women with this condition may experience urinary or vaginal pain, sexual dysfunction, or back, pelvic or groin pain.” Read more of her article here.
Signs of Connective Tissue Disorder
According to an article by Pelvic Health Solutions, connective tissue stiffness is a very important component of the tissue problems that we see with persistent pelvic pain. They site the following symptoms of connective tissue dysfunction:
- Itching, burning, numbness and pain
- Genital hypersensitivity
- Clothing, underwear, sitting intolerance
- Organ irritation or dysfunction (in other words, your connective tissue can get irritated because your bladder is infected or irritated, OR your bladder can get inflamed or irritated because your connective tissue is irritated: it is a vicious cycle)
- Poor tissue integrity: vaginal and rectal fissures, or small tears in the tissue
- Colour changes in the skin, usually darker or blotchy
- Sympathetic Nervous System up regulation (winds your nervous system up further and contributes to your Sensitive Nervous System)
Stephanie Prendergast, MPT from Pelvic Pain Rehab explains that there is a strong association between active trigger points and connective tissue restriction exists. As a result, treating the connective tissue restriction can relieve trigger points activity and/or make trigger points more responsive to treatment. YES – this is good news for pelvic pain sufferers. I just had this done (March 2016) and it was very helpful.
Manual Test for Connect Tissue Restriction
The manual test that Ms. Prendergast uses to determine if a patient has connective tissue restriction is the “pinch-roll test.” She states, “When a PT carries out a pinch-roll test he or she will roll a fold of skin between his or her fingers, and note whether the tissue is thickened. This is painful to the patient. It should be noted that typically, there is only pain if the tissue is restricted. Healthy connective tissue does not produce pain in response to this test.”
She goes on to state that, “Patients with pelvic pain typically have connective tissue restrictions in the thighs, along the pelvis, in the glutes, and in the abdomen. For instance, patients with pain with sitting may have connective tissue restriction, particularly in the medial to ischial tuberosities, glutes and medial and post-thighs. And patients with perineal pain may have connective restriction along the pelvis, abdomen, and/or perineum.”
Seriously – show this to your pelvic floor PT and get to work! This could be your answer to the pain in your pelvic floor! Please read the rest of her great article here. She is a wealth of knowledge – so follow her on Twitter.
This is a very clinical article on this problem. It has some great diagrams.