Retraining The Pelvic Floor Muscles with Manual Therapy

*Use for prescribed patients with treatment plan*

Self-performed manual therapy is designed to reinforce the work done in PT, giving you more power and control over your healing process. The point is to retrain not only the muscles, fascia, and other tissues; but also to retrain your nervous system to recognize rest, to release chronic protective patterns, and to redefine safety.

Supplies:

Lubrication
Hand mirror (optional)
Gloves (optional)

Positioning:

Begin in a semi-reclined position, supported by pillows, with both legs bent and supported so that you remain in an easy, restful position, head propped up. You may also choose to perform this in a bathtub or other supportive structure.

Procedure:

Use heat applied to the lower abdomen or low back prior to, or in conjunction with the following techniques.
Apply a moderate to large amount of lubrication to your thumb or index finger. (Using the thumb may be easiest, with less strain on the upper body.)
Apply lubrication to the outer opening of the vaginal canal as well for comfort.
Spread the labia minora to allow access to the vaginal opening. Place the tip of your thumb or finger, just at the opening toward the direction of the rectum or floor.
Take several long, deep breaths, allowing the lower abdomen to release as much as possible. Check-in with your body and allow yourself to come to a sense of rest prior to beginning.
When you feel ready, insert your finger about one inch into the vaginal canal, or to the first knuckle, directing pressure downward. Continue to take long, deep breaths, inhaling into the nose and exhaling out the mouth.
Hold pressure downward toward 6 o’clock position for 90 seconds to two minutes, or, until you feel a release of tension and resolution of pain. Pain level should be manageable. If pain resolves quickly, continue to hold pressure for the entire duration of time to reinforce the release.
Gently release pressure to the 6 o’clock position and move treating finger toward the 5 or 7 o’clock positions. Repeat procedure. Do the same at 4 and 8. Keep treatment area below 9 and 3 o’clock.

Some Notes:

You may find that initially, the act of placing your finger at the vaginal opening is the farthest you feel comfortable going. That is okay. The point is to go at your own pace and to allow your body and nervous system to guide you. Continue to check in with yourself and note any thoughts or emotions that may come up. It is okay to be uncomfortable. Recognizing these thoughts and emotions can be helpful to begin to release the tension and pain in your pelvic floor, however, do not push yourself to the point of distress. If you need to take a break, take a break. Work your way up to comfort and remind yourself that you are the one that is in control.
You do not have to treat the entire area every day. Optimally, take a rest day between sessions, or, treat separate areas. Perhaps you only focus on the right side one day and then the left the next.
Complete 2-3 times a week. If treating separate areas, it is safe to perform every day. Pay attention to your tolerance, as everyone’s bodies and nervous systems are different.