Prolapse can be one source of pelvic pain. There are lot of women that sit in my office and tell me they experience a dragging sensation low and deep in the abdomen. Some ladies report a sudden onset of severe sharp pain with a heavy lift or push, (eg. the lawn mower through long grass). Why there is pain most likely due to ligamentous strain, just like it might hurt when you sprain your ankle. For a grade 1 or 2 prolapse pelvic floor exercises can be very effective in relieving the symptoms of pain, discomfort and or bulges at the entrance to the vagina. If you have a significant bulge at the entrance to the vagina it best to see a GP who will guide you from there. How does the pelvic floor support the pelvic organs. Imagine your pelvic organs are like boats sitting at dock, the boats are held in place by ropes and supported by the sea. The ropes are like your ligaments and the sea is like your pelvic floor. If the sea dissappears, so does the support fro the boats, your pelvic organs. And a prolapse is a possible outcome.
International Pelvic Pain Conference On the 8th October I will be flying off to Washington DC. I have been invited to present 3 posters on pelvic pain at the International Pelvic Pain Conference. I will be presenting 3 cases that I have successfully treated, that are all due to muscle imbalances around the pelvis. What I am starting to discover by working through and reflecting on theses cases is that there is probably such a thing as abductor syndrome. I haven’t found any references in the literature that such a thing exists. So I will be doing some research into this over the next few years. Surprisingly all 3 cases had pain with intercourse as one of their primary complaints. It is often assumed that this is due to pelvic floor muscle trigger points, but in these cases this was not the primary causative factor.
The deep front line fascial train passes through and surrounds the pelvic floor. This fascia extends from tibialis posterior in the lower leg up to diaphragm and into scalenes in the neck. The fascial network is continuous and very little in known about its functional relationship to muscle tension and less is known about changes that may occur during pelvic floor rehabilitation, (exercises) and surgery. Meyers a well known fascail train expert and myofascial therapist believes that fascia is a highly adaptive structure that can change in response to forces placed through the body. We do know that fascia is made mostly of elastic tissue and has no contractile elements like muscle. We can also demonstrate fascia is able to lengthen or tighten, depending on loads applied. Lets argue that a weak pelvic floor, which is essentially bowl shaped, deepens. This deepening potentially stretches the fascia over time, maybe 1-2 years. Which then leads to less support through the pelvic floor for the pelvic organs. Strengthening the pelvic floor leads to reduced stretch of the pelvic fascia. Therefore we could assume that those that get some relief from their pelvic pain by lying down, especially if the pelvis is higher than the shoulders, may get relief from long term pelvic floor strengthening routines. We could also assume that some of the pelvic pain may be due to altered tension of the pelvic fascia.