Pelvic Floor Muscle Spasms (Vaginismus)

The pelvic floor muscles attach from the pubic bone to the tailbone. They help to support the internal organs and aide in sexual, reproductive, and urinary functions. When these muscles become spasmed or shortened, they can produce a variety of unpleasant symptoms. Like any other muscle in the body, these muscles need to be treated appropriately in order to release.

Symptoms

– Vaginal pain, constant or intermittent
– Pain with penetration
– Painful orgasm
– Painful menstrual cycles
– Constant arousal
– Constipation
– Difficulty starting urinationor feeling like you need to urinate more frequently

Causes

There are many possible causes for pelvic floor muscle spasms. Some causes can be related to pelvic pain disorders including but not limited to endometriosis and vulvodynia. Endometriosis is a condition in which cells similar to the lining of the uterus, which typically shed during a menstrual cycle, can actually shed into othe rareas of the pelvis or abdominal cavity. Vulvodynia is severe pain around the opening to the vagina. Other causes may be related childbirth (vaginal delivery), hysterectomy, constipation, and/or trauma.

For a moment, think of a muscle other than the pelvic floor, such as the biceps. When the biceps are fatigued, like after a tough workout, or if they are used for daily activities and never get stretched, the muscle tissue may spasm. When muscle tissue spasms, the fibers of the muscle are actually in a shortened position. When pelvic floor muscles are weak and then are asked to perform all of their duties throughout the day, they may easily become fatigue and then spasmed (similar to biceps after a tough workout). Pelvic floor therapy can relieve those spasms and lengthen the muscle back to their original state.

Diagnosis

Your physical therapist will perform a thorough evaluation to assess your symptoms and try to pinpoint the reason for the spasms, if unknown. Being the evaluation will be internal and external, you and your therapist will work together to ensure your comfort throughout the entire process. If your therapist feels you may need further examination or testing, she will refer you to an MD.

Treatment

Treatment for pelvic floor spasms will consist of releasing the muscle spasms throughout the pelvic floor musculature through various exercises and gentle manual techniques. Manual techniques will mostly be internal. Imagine when you have pain throughout your neck, so you or a friend applies pressure for it to release. This is exactly what will take place with the muscles in your pelvis. You may feel pressure or mild discomfort with this technique but it is effective in releasing muscular stress. Your therapist and you will also discuss home exercises and strategies to reduce your pain and discomfort.

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