A lot of patients ask us, “Does pelvic therapy mean pelvic massage?”
” Wait, you also massage me internally?“
What is manual therapy for pelvic floor? Do you do a pelvic massage?
Manual therapy for the pelvic floor are gentle, hands on work provided to a patient by a board certified, licensed physical therapist who specializes in pelvic health. This approach helps to alleviate localized inflammation and promotes both local and central nervous system desensitization, leading to reduced pain and improved function.
These can include (but does not absolutely have to) both external and internal pelvic floor work.
External pelvic floor work includes hands-on therapy along the lower back, groin, thighs, sacrum, external genital area.
Internal manual work involves using a gloved, lubricated digit inside the vaginal or rectal area. We only do internal work when it is deemed appropriate and helpful. Consent from a patient is always taken. A patient may never feel ready for internal work and that is ABSOLUTELY okay. Patients can also stop physical therapists at any point if they feel remotely uncomfortable or not ready.
We can still make progresses!
Why do we use manual therapy?
Manual techniques for the pelvic area goes beyond simply releasing muscle “knots.” Persistent pelvic pain often results from the brain interpreting pelvic sensations as threatening, leading to heightened pain perception. Therefore, the goal of pelvic floor massage is not just to stretch or manipulate muscles but to retrain the brain’s response to pelvic sensations, reducing pain and discomfort.
We use gentle, non-painful techniques, such as deep abdominal breathing combined with myofascial release, to desensitize the pelvic floor muscles and nerves.
The key is not the tool itself but the process of engaging with the pelvic floor in a mindful and non-threatening way. This approach encourages the brain to reinterpret pelvic sensations as safe, thereby decreasing pain and discomfort associated with pelvic floor dysfunctions.
What are other manual techniques used in pelvic floor therapy?
Manual therapy for pelvic floor goes beyond just “massaging” the pelvic floor. Some other manual therapy techniques we use at EmpowerHeal Physical Therapy in Bethesda are:
Myofascial therapy
Joint mobilization
Muscle energy techniques
Manual therapy can be a powerful technique to get access into a highly sensitized system. Each person is different and you physical therapist will do a comprehensive evaluations to check to see what might be the most helpful for you.
EmpowerHeal Physical Therapy will help you find a personalized treatment plan. We serve Bethesda, MD and the greater Washington DC community.