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 further trauma.
  • 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 helpful.

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.

Other treatments

  • 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.