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Have you got Vulvodynia or Vaginismus?

Vaginismus is basically just tight pelvic floor muscles, which makes getting a tampon in or having penetrative sex painful or difficult. Your pelvic floor can be generally tight all the time (think about how tight your hamstrings get when you’ve been sat driving all day, the day after a run or you’ve never stretched them until that yoga class and down-dog was an experience..). Your pelvic floor muscles can also go into spasm when thinking about or having anything penetrate the vagina (like when your calf goes into cramp in the night). Both aren’t pleasant, and both are totally treatable. Treatment is exactly what you’d do with any other muscle – learn to relax them and give them a gentle (and regular) stretch. It shouldn’t hurt.

Vulvodynia is a pain in and on the vulva, where tests have shown there to be nothing ‘wrong’. I like to think of vulvodynia in these terms: your body has decided that your vulva is under atta

I’ve been wanting to talk about male pelvic pain. Men have pelvises and get pelvic pain. Why does it remain a taboo? This one is for both patients and clinicians.

Karl and I have been friends for a while. He’s a wonderful human, therapist, pain expert, collaborator… he generally defies labels. From a background in sports and advanced clinical massage therapy and specialist training in Arvigo Techniques of Maya Abdominal Therapy (ATMAT)  he’s built a wonderfully holistic clinic and practice that serves men with pelvic pain. You can find out about Karl here and his clinic here.

It speaks volumes that only in the last few years have we made the transition from “Women’s Health” physiotherapy (with physios who also treat men) to “Pelvic health physiotherapy” – a much more apt name for the treatment of pelvises, regardless of gender identity nor anatomy. It’s a pelvis, we treat the inside and outside.

We sat down after a recent co

This is a Really exciting time in pelvic health where our understanding of the brain, pain and how we can change someone’s experience are all evolving. By this I don’t just mean in the psychological way, but in a true “pain experience” sense as well as thinking about how we can change biological markers and antecedents to pain, such as inflammation, with our words and how we approach people with chronic pain.

Sandy Hilton is a Doctor of Physical Therapy based in Chicago, America. She has contributed to multiple book chapters, papers, and co-authored “Why Pelvic Pain Hurts” and is an international instructor and speaker on treating pelvic pain for professionals and for public education. She’s also a regular contributor on health related podcasts, and is co-host of the Pain Science and Sensibility Podcast with Cory Blickenstaff, which I can wholly recommend as both a source of evidence and a great lesson in how to unpick and understand it.

Sandy was

I just had the pleasure of an EPIC chat with Dr Jessica Reale (Doctor of Physical Therapy) all about our clinical interpretation of the latest methods of treating pelvic pain. How and why do we do what we do? There’s some great examples and pearls of wisdom I’ve taken from this, as well as being a good benchmarking that we are all approaching it in a similar way. I’ve linked to all the apps and references for the papers mentioned below. You can find out more about her on her website by clicking HERE, along with a great blog of resources

It fills my soul with joy to connect with other physios interested in understanding and treating pelvic pain. To borrow her phrase, at this point in time it really does feel like we’re “pioneers” in this work. I’d put it less eloquently but the meaning is the same; we have pain and dysfunction based research not specific to the pelvis that we’re all trying to apply in a mean

It’s time to be honest. Working in pelvic health can sometimes be lonely, in the UK we’re often in tiny clinics away from our teams. I’m certainly someone who thrives on discussing, debating and being challenged. So here are some of the things I’ve been doing with Graded Motor Imagery, how I’m approaching it at the moment and the realities of how it’s going – it takes time!

If you’ve got any comments, are using GMI or are passionate about treating or researching BPS I’d love to hear from you! Only from sharing our knowledge do we all improve. At the end of the day, that’s my mission – getting better at getting people better. Enjoy!

I’m really pleased to be able to bring you Jane’s story, in her own words. I’m incredibly proud of how far she’s come and how well she’s doing. It takes great emotional resilience to overcome the challenges she’ll tell you all about. If you’ve got Endometriosis or know someone who has, please share her story. Well timed Pelvic Health Physio can help people to avoid surgery by improving painful symptoms, and will always also support them through their complex surgical recovery to regain their lives.

Jane

Where to begin? Well, in the words of Julie Andrews, let’s start at the very beginning, a very good place to start.

I always had very heavy periods but I was told that periods hurt, it’s normal, just take some painkillers and just get on with it. Which I did. I didn’t really let it bother me, but as I grew older, I found that I was sometimes in agony with pain. The pain got worse whe

What is Bladder Pain Syndrome?

The first thing to say about Bladder Pain Syndrome is what it’s Not….

Initially people went to their doctors with the symptoms of a chronic infection – a urinary tract infection or cystitis. They had an urgent need to pass urine, felt like they needed to go often and it would be accompanied by pain in the bladder region, perineum (between the legs) or in the urethra (tube from the bladder). However this went on much longer than an infection should, and often after taking antibiotics. The lining of the bladder is called the interstitium and so it was thought that when people presented with this group of symptoms they had a chronic infection of the bladder lining. This is how the name Interstitial Cystitis came around.

It’s now understood that Interstitial Cystitis/Bladder Pain Syndrome is much more complex, and many people do not have a chronic infection of the bladder or urethral lining. Even If they do have a chronic infection it may not be causing

Watch the vlog here.

A few weeks ago I was given this paper by Gill Brook (thanks Gill!), and I think it’s another important step forwards in our knowledge about the aeteology of Bladder Pain Syndrome.

The full title of the paper is:
Will cesarean section increase the risk of interstitial cystitis/painful bladder syndrome?
Kun-Min Chang, Ming-Huei Lee, Hsuan-Hung Lin, Shang-Liang Wu, Huei-Ching Wu
Neurourology and Urodynamics. 2018;1–7.
DOI: 10.1002/nau.23704

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