What to do about Pelvic Pain- Tips and Resources for Better Management
Pelvic pain is really quite common in pregnancy and postpartum. Many women experience it and it can range from a dull, deep ache to a sharp pain that feels like you’re going to rip in half at the pelvis. This can also include pain with intercourse, what feels like a muscular pain or spasm in the pelvic floor muscles, and pain with cycles.
Pelvic pain can often pop up in pregnancy as SPD, symphysis pubis dysfunction, where pain is felt in the front of the pelvis at the pubic bone, and can sometimes be felt on one or both sides of the lower back or in the perineum. Pelvic pain can persist postpartum or be present before even having kids as painful intercourse or pain with insertion of a tampon. Often it can be really frustrating and cause women more than physical pain, but mental and emotional distress as well.
Personally, I’ve experienced pelvic pain at various times in my life. As a young child I experienced intense, debilitating lower abdomen pain that went undiagnosed. In my late teens and early twenties, I was diagnosed with vaginismus after experiencing extremely painful intercourse. This went untreated and eventually resolved-ish. After the birth of my son, I experienced sharp pelvic pain with certain movements at the gym or at home.
All this to say, I’ve often felt alone in my journey with pelvic pain. I often felt unheard and emotionally drained from trying to figure out my body. It’s also one of the reasons pelvic pain is a huge topic of mine, because I don’t want anyone else to feel the way I did. I want to offer as much help and hope as I can, which is why I’m writing this blog!
In this blog, I’m going to give you some tips on managing pelvic pain, including where to go for diagnosis and treatment as well as some things you can do to ease discomfort during exercise.
Talk to Your Doctor
If you’re experiencing pelvic pain of any kind, the first step (always) is to talk to your doctor. This is an important step to rule out anything that may be going on beneath the surface- like if your pain is being caused by endometriosis, ovarian cysts, etc.
Let me just say this, I’ve had some less than thrilling experiences with doctors regarding my pelvic pain, but in order to be safe and get a clear diagnosis and treatment plan, this is your first step. There are pelvic pain specific doctors you can ask to be referred to if you feel like you are not getting the treatment or care you need. When in doubt, ask to be referred out. There is absolutely nothing wrong with asking for more care and more help in figuring out what is going on. Which brings me to my next point....
Ask for a Referral to a Pelvic Floor Physio/Physical Therapist
If your pelvic pain is met with a shoulder shrug and “it’s normal”, ask to be referred to a pelvic floor physical therapist. If your pelvic pain is persistent, ask for a referral to a pelvic floor physical therapist. In most cases I would most definitely suggest this, actually.
Pelvic floor physical therapy is an absolutely underutilized and AMAZING resource. A PT will be able to internally asses for pelvic floor function and give you more individualized treatment to help with your specific pelvic floor needs. A great pelvic floor physical therapist can help you return to living your life without pain or symptoms and give you hope for the future. We’ll talk more about where and how to find one at the end of this blog.
If your pelvic pain is impacting your ability to stay active, these next two tips are for you…
Find Pain-Free Ranges of Motion and Move/Train in Them
When it comes to pelvic pain, especially in pregnancy and postpartum, it can feel like a never-ending battle of figuring out what flares it up and what doesn’t. I’ve talked to so many women who have stories of lunging and feeling like their pelvis was breaking, or barely being able to walk due to pain.
My biggest tip for this… find pain-free ranges of motion and train in them. This may mean that your lunge doesn’t look like a traditional lunge anymore or you have to reduce the range of motion of your squat or the length of your stride while walking. That’s totally ok. Find an option that reduces pain and stick with it. Not forever, just for now! Eventually you’ll be able to return to your old patterns of movement, but for now a shift may be necessary.
If you need more tips on this, I’ve been sharing some of my favorite tips to reduce pelvic pain during common exercises on Instagram. Go have a look-see and feel free to reach out! Pelvic pain is so very individual, so these tips are never one-size-fits-all but are more a library of things to try if you’re feeling stuck.
I often recommend glute work for my clients with pelvic pain as well. The glutes help stabilize the pelvis and glute specific work can help someone mourning the loss of their activity level feel a good burn while remaining pain-free. You can sign up for my email list for more tips on pain-free movement and a free download with some of my favorite glutey moves HERE.
The BIGGEST game changer for dealing with pelvic pain, though?
Find a Team Who Will Offer Help and Hope
Y’all, this one is so important. I often talk to women who were not given hope, who were not referred to physical therapy or given options for pain-free anything. They felt alone, broken, and like this was just life. This is normal and how it is.
More often than not, that IS NOT the case. The team can make ALL the difference in your treatment of any kind of symptoms (and in your birth, but another post for another day), not just chronic pelvic pain.
If you feel unheard, find someone new. If you are with someone who doesn’t support your goals, go somewhere else. If you feel worse after leaving an appointment or session instead of better, that’s your cue that you need a new team member.
When building a team of people who can help you manage pain or symptoms and reach your goals, find a doctor who you jive with and who will answer all of your questions without bias. Find a pelvic floor PT who will support your activity goals and share your diagnosis and treatment with you in terms you can understand and in a way that actually fits into your real life. If you’re wanting to stay active or return to activity, find a fitness professional who will listen to your story and connect with your team to help you reach your goals. Find support from other people who have been there, I promise you so many people have. A team is SO important for both your physical and your mental healing.
But how do you find such a team? An amazing resource was just released by Tracy Sher, an incredible pelvic health PT in the United States. The Global Pelvic Health Alliance is a database that will help you find all kinds of affiliated pelvic health related practitioners including PT’s, doctors, fitness professionals, midwives, doulas, sex therapists, and many others all over the world. It is truly a much needed resource and I am so happy to be a part of its launch. You can search the database for professionals near you HERE.
Pelvic pain is so very common, but it certainly doesn’t have to be normal. Wherever you are in your pelvic pain journey, I urge you to build your team to support you and help you find more hope and help in reaching your goals whether it’s just to move more comfortable or to return to high level athleticism without pain. There is hope and help out there for you. I hope this blog gave you some of that!
For more pain and symptom-free fitness tips, join my email list. I send out a tip every Friday that will help you feel stronger and more confident in your body throughout mom-life. If you’re looking for more support in navigating pelvic pain in exercise or life, let’s chat about how to do just that! You can book a free discovery call here.