Rehabilitation & Other Therapies
Chronic pelvic and abdominal pain program
Dyspareunia means painful intercourse. You may also be having
trouble with wearing snug clothing, sitting, walking, using tampons or even
wearing underwear. Several conditions can contribute to dyspareunia:
- Childbirth: Pain can come from episiotomy scars,
vaginal tears, injured vaginal tissue from forceps or vacuum delivery,
coccyx fractures, or damaged pelvic nerves from the pressure of the
baby's passage through the birth canal. Low estrogen levels
associated with breast-feeding can also contribute.
- Menopause: Low levels of estrogen can cause the
vaginal tissue to lose lubrication, become thinner and less elastic.
- Vulvar Vestibulitis (VV) or Vulvodynia: Pain
& sensitivity caused by any pressure around the vaginal opening.
The pain is often described as burning or stinging or razor blades.
Intercourse is usually impossible. Sitting, walking or wearing
jeans or underwear can be irritating. Pain often spreads to the
surrounding areas: buttocks, abdomen, thighs and clitoris.
- Vaginismus: An involuntary tightening
of the vagina in a subconscious effort to prevent penetration during
intercourse or even gynecological exams. In some cases the body
"remembers" past childbirth trauma, painful gynecological procedures,
physical, sexual or verbal abuse, and the vagina spasms to prevent any
- Chronic Prostatitis: In men, the pelvic floor
muscles spasms can cause pain with sitting on a bike or chair, pain with
bowel movements, or even ejaculation.
How physical therapy helps
Our physical therapists are specially trained in women's health and
are skilled in the treatment of chronic pelvic and abdominal pain.
Counseling or sex therapy in addition to physical therapy can be very
Pelvic floor biofeedback
Safe and gentle, this is a proven, effective treatment for vaginal
pain and pelvic tension syndromes. A small sensor is inserted into the
vagina, which allows you to "read" your pelvic muscle function on a computer
monitor. For those unable to insert the sensor, small electrodes can be
placed on the outer vaginal/rectal area. The exercises prescribed during
biofeedback relax muscle spasms, increase circulation to the damaged tissue
and strengthen the pelvic floor muscles.
- Soft tissue techniques: The physical therapist uses
gentle hands-on techniques to release trigger points (muscle "knots"
that cause referred pain), mobilize pelvic, hip & spinal joints, and
balance muscles. Ultrasound or electrical stimulation may be used
to heal episiotomy scars or relax muscle spasms.
- Dilators: Once the vaginal or pelvic floor muscles
can tolerate touch, you may be shown how to release muscles internally.
This can be done with your finger (or a partner's) placed in the vaginal
opening. After 8-12 weekly sessions, most women can resume
intercourse and report much less pain.