Updated: Oct 11, 2021
The senses of our body including sight, sound, touch, learning, communicating, emotions, are ways we communicate with our bodies and relate to the natural world around us. Our brain and body connection is able to simultaneously learn and adapt to changes in and around us everyday! But what happens when we have an injury or have not “used” a part of our body in a long time.
When you think of pelvic floor therapy, or any therapy for that matter, you think of strengthening, stretching, balancing or exercising to return to life before injury. But what matters most, is how our body is communicating and connecting the ability to healthily strengthen, stretch and move! This is where our senses including our touch, emotions, and learning are absolutely essential to rehab and the pelvic floor!
For true healing, we must first sense what's happening in the body by our nerves. Our nerves are like antennas for the body. Each nerve sends a message to the brain, which then perceives the information, creates an action, then sends the message back out to the body via the nerve again. Before we start down the road of neurology 101, let’s make it simple. Think of how the first telephonic communications connected one caller to another. Take the telephone operator in the 1930s. The telephone operator is like the brain. The operator receives information from one caller, connects the information to another caller by plugging in the correct numbers on the switch board. Once connected, the information can be sent out to another party. Your body does the same thing! Your brain receives information from a sensation somewhere in the body, then interprets it and creates a plan of action of what to do with the sensation, then sends the plan back out to the body via nerves!
All of the sensations, planning and execution are great, but what happens if you have had an injury and have not used the muscles, nerves and surrounding tissues to their fullest potential! Sometimes the wires get crossed or lose connection. Stepping into the 21st century, it's like trying to make a call on a 4G network with 1 bar of service vs a 5G network with 5 bars of service. Yes, I still try to make calls with 1 bar of service as I drive through the Pine Barrens...sorry Mom, I know I drop the call every time.
You've got nerve!
Our nerves perceive different types of sensations including hot vs cold, sharp vs dull, itchy vs numb or stretch vs compress. After an injury like a perineal tear or C-section, the nerves will continue to share information with the brain, however the wiring to the brain may not know how to interpret what's going on. Think of the wires getting crossed or not having great service on your phone.
Real world nerve or muscle injury may feel something like this, “I have pain with arousal, sex, urination, or a bowel movement.” But is it truly “pain”? The word pain can mean so many things and is expressed differently by each person. Instead, I like to use the word sensation, as it allows for a broader expression of what's actually happening in the pelvis or in the body. The pelvis not only can sense pain as pressure, sharp, dull, warm, dull, but can share a sense of urgency to urinate or have a bowel movement and arousal with pleasure. This is why I love the pelvis so much! It communicates so many things!
Why is my pelvis confused?
Recently, I've worked with several clients who experience chronic “pain” in the pelvis and have been unable to enjoy sex, or have a pain free gynecological exam. (And no! It is not normal to have pain with sex!) Because the mind and body have been through so much due to the pregnancy and birth related changes, the sensations of the pelvis have been dampened or even ignored as a way to protect the space. The body is truly intelligent and will preserve itself from harm or stressors. (This is a whole other blog in itself.) With this decreased awareness of what’s going on down there, something as simple as using a tampon or having a bowel movement may feel wildly different than before. For example, many women share when using a tampon again after having a baby, it feels weird or even painful. Once sitting with the sensation for a moment, the sensation actually is “This tampon feels huge”. Did the tampon size change or did the communication of the pelvis change due to the changes in pelvic muscle and bone structure during pregnancy and labor? Or maybe you've experienced this with your C section scar. You go to put jeans on and you feel every fiber of the jeans touching your body. You got it! It's the sensation of the muscles and nerves telling the brain-- this is different! Differences are not always painful or wrong. It is just a communication the brain does not understand how to interpret!
Another common sensation shared is “I am not sure what I am feeling”. Some women share that they feel they need to urinate, have a bowel movement or question arousal with any stretch of the pelvic muscles during intimacy or pelvic muscle massage. The experience of all the sensations at once is the brain communication- something is different. But when we really sit with the sensation and get to know it, it wasn't so much pain or any of these sensations! The brain questioned what it was receiving and did not know what action to send back to the body! So it threw every sensation it knows out into the world! This is normal, but can be fine tuned to allow the body to understand the right sensation for the right action! You want to feel pleasure with sex, not like having to poop! The lines may become crossed and you may be connected to the wrong caller, but this is where pelvic therapy can help to reconnect those lines of communication.
Reconnect with the Nerves
So ask yourself, what is your body saying to you? What sensation is being communicated from your pelvis to your switchboard. No need to fear the sensation at first. Sit with it. Let your brain make the connections on the switchboard and then listen for the response. It is not always an easy thing to listen to and interpret, but seeing a pelvic physical therapist is like adding a switch board operator to assist you! Next time, you feel a pain and do not know what to do with it, ask yourself, “How can I connect you?
If you want assistance with connecting you back to your body, reach out and schedule an appointment to see how we can restore and revive your core and pelvic floor!
In the South Jersey area and want one on one care with the Breathe Life Team? Schedule an appointment for your complimentary 15 min phone call to see how pelvic therapy can help you!
Dr. Amanda Heritage, PT, DPT is the owner of Breathe Life Physical Therapy & Wellness, LLC located in Collingswood, NJ. She has been practicing physical therapy for over 10 years with a strong focus on pelvic health. She enjoys encouraging women and men about pelvic therapy as a treatment option for those suffering with pelvic pain, incontinence or constipation.