Pelvic Floor Massage: Using it to improve pelvic pain

Highlights

• Pelvic floor massage is one modality practiced by physical therapists with expertise in the pelvic floor that can help address pelvic floor dysfunction and its symptoms.
• There are different modalities of pelvic floor massage, and a typical session may combine techniques.
• It’s of utmost importance to find a pelvic floor physical therapist with whom you feel comfortable and can talk through any questions or concerns.
• Sound Cycle’s physical therapist search can help you find a PT with pelvic floor or woman’s health expertise who can guide you through the best treatment plan for you.

When you think of a massage, you likely think of a peaceful spa where you go to unwind and rest. But massages can be highly functional, targeting regions of the body or specific sources of injury and pain. Pelvic floor massage is often performed by trained physical therapists and is used as one element of a broader physical therapy program alongside other components like pelvic floor exercises, electric stimulation, or biofeedback.

They focus on a range of muscles around the abdomen, groin, glutes, and pelvic floor itself. A course of pelvic floor therapy treatment will often involve a series of massages, performed weekly or multiple times per week for a fixed amount of weeks. As with any massage, it’s of utmost importance that you find a therapist you trust for your sessions. 

Safety considerations for pelvic floor massage

It’s understandable that pelvic floor massage may make some feel skeptical or uncomfortable at first, and it’s important you only seek out a pelvic floor massage therapist if it feels right to you. It’s particularly important to do your diligence and find a therapist who inspires confidence and trust.

In addition to Sound Cycle’s physical therapist database, the American Physical Therapy Association and the International Pelvic Pain Society are two resources you can use to find a therapist who is both qualified and credible. 

During your first appointment, your therapist should provide you with a detailed explanation of the massage and other work that they plan to perform, particularly anything invasive. The explanation may include diagrams or three-dimensional models of the pelvis, and should highlight the pelvic floor muscles and anatomy involved before any hands-on work is undertaken.

Throughout the session, a physical therapist should explain what they are doing and why–if you have questions, feel free to ask at any point. In particular, physical therapists should not perform transvaginal massage unless they have explained in detail what’s involved and received your consent.

What types of massage can be beneficial for the pelvic floor?

Pelvic floor exercises take on many forms, so consult with your physical therapist about what combination of exercises will work best for you and your symptoms. Often, a physical therapy session will combine techniques, and you may be asked to practice exercises at home in between sessions.

• Myofascial Manipulation/Trigger Point: Like elsewhere in your body, your pelvic floor muscles contain trigger points that may bring outsize sensitivity or pain. By targeting these trigger points and manipulating the fascia of your pelvic floor muscles, trained physical and massage therapists can reduce much of the tightness and pain associated with this region.
• Rhythmic Massage: Rhythmic massage, a specific variety of massage developed in the 1920s, has been shown to reduce pain levels among those experiencing menstrual cramping and pain. In practice, it has some similarities to a Swedish massage but is often more targeted.
• Thiele Massage: Thiele massage focuses on the posterior (rear) section of the pelvic floor, and uses soft tissue manipulation of some of the muscles inside the pelvis to reduce pain in areas that would otherwise be hard to reach.
• Transvaginal soft tissue mobilization: This treatment is most effective for women experiencing dyspareunia, or pain with intercourse. Techniques are performed to help stretch and relax the muscles of the vaginal walls, or can be taught for self-administration. A trained physical/massage therapist should ensure that any patient is comfortable with the treatment before performing.
• Additionally, full body massage has been shown in some studies to be effective at moderating pain associated with menstrual cramps or pelvic muscle tightness.

What symptoms and conditions can pelvic floor exercises help treat?

Pelvic floor massage is a particularly effective remedy when targeting various sources of menstrual and pelvic pain, but massage can also help combat other symptoms like urinary incontinence, fecal incontinence and digestive issues.

• Cystitis or bladder tenderness: Cystitis, or bladder inflammation, can be caused by a bladder infection or UTI, and can cause significant pain or difficulty urinating. Treating the root cause of cystitis is important, but while you’re still experiencing pain, massage can be a valuable technique to help relieve symptoms.
• Pelvic floor dysfunction: a common cause of incontinence, regional pain, and digestive issues. Pelvic floor dysfunction is an umbrella term for when the muscles of your pelvic floor are weak, injured, or otherwise not performing properly. It can occur as a result of childbirth or independently.
• Pelvic/menstrual pain and cramping: Many people who menstruate experience pain or cramping with their period each month. Pelvic floor massage techniques can be an effective way to reduce pain associated with the monthly cycle, particularly for those with specific health conditions like Endometriosis and PCOS. Pelvic floor massage can also target other sources of pelvic pain, like dyspareunia.

Pelvic floor massage can be an effective modality for many conditions and symptoms that are otherwise hard to treat. Sound Cycle’s pelvic floor physical therapist database can help you identify a therapist who makes you comfortable and has the expertise you need to start feeling better.