Your pelvic floor muscles are a group of muscles at the base of the pelvis. In addition to supporting the bladder, they close the urethra, rectum, and vagina. These muscles lie just inside the pelvis. We typically learn to control muscles during the first few years of life when we become toilet-trained. Unlike the abdominal muscles, they are not easy to feel and it is important for patients to try to develop a mental awareness of their pelvic muscles. The pelvic floor muscles attach to the tailbone, wrap along the side toward the hips, and extend to the front of the pelvis near the pubic bone.
The pelvic floor muscles can become very painful if they are tightened for a period of time. People often tighten these muscles as a result of injury to the pelvis, a difficult vaginal delivery, hemorrhoid surgery, or extensive pelvic reconstructive surgery. Additionally, some people never learn to relax their muscles totally, and often they give a history of a lifelong problem of frequency, urgency, recurrent UTIs, and/or chronic constipation. Another common symptom associated with this diagnosis is the problem of burning discomfort at the entrance of the vagina, often misdiagnosed as a chronic yeast infection. This muscle tightness may become a subconscious habit causing these symptoms on a continuous basis. These instructions will help you learn how to keep the pelvic muscles relaxed.
During the Period of Treatment
- Try to keep your surroundings quiet so that you can concentrate on relaxation therapy. ∙ Enjoy quiet, relaxed reading instead of watching television.
- Try to get 8 -9 hours of good sleep each night and take naps if possible during the day (your physician might give you medication if necessary to help induce a good relaxed sleep if your body needs medication).
- Take warm tub baths to help your relaxation efforts, lying in the bath with your knees up.
- Avoid wearing tight clothing, avoid using tampons, and avoid sitting longer than 15 minutes at a time (particularly sitting in a hard seat or riding in the car for long distances).
A Technique to Relax Pelvic Muscles
- The purpose of these exercises is to help you feel and become aware of your pelvic muscles so that you can develop the “awareness” of muscle tension and muscle relaxation and most important, to develop the control so that you can reestablish normal pelvic muscle function.
- Placing your hand in the vaginal area with the middle finger resting on the surface of the skin between the vagina and the rectum is the easiest place to feel these muscles in action. Developing a mental awareness of the degree of muscle tension and the ability to relax these muscles is the key to your successfully eradicating this problem.
- In order to feel your pelvic muscles relax, pretend you are relaxing your muscles to allow the passage of rectal gas. There should be an obvious descent or relaxation that your finger will feel and that your mind will become aware of.
- It is important that you do not bear down or strain to make your pelvic muscles descend, but instead to relax on their own.
- Squeezing your muscles (i.e., Kegel squeeze) should demonstrate this same area of tissue between the vagina and rectum elevating or pulling up inside you. Because our emphasis is not on improving the ability to squeeze, but instead on the ability to relax these muscles, the squeeze should be long enough so that we can induce the awareness of muscle tension and then quickly and completely relax these muscles.
- Squeeze for one second then relax for ten seconds, imagining the pelvic floor dropping like an elevator. Repeat the squeeze/relax 10 times twice a day.
- Your goal is to keep your muscles relaxed at all times while you are involved in your everyday activities. Therefore, frequently be aware of your rectal and vaginal muscles and attempt to relax them (as if to pass gas) and you will often find that you were tense and did not realize it. Your goal is to “check” your pelvic floor muscles and find them already relaxed.
- At first, you may be able to keep your muscles relaxed only while lying down. Later on, you will be able to stay relaxed while standing or sitting.
- Practicing muscle relaxation may not bring immediate relief, but over time it may help to reduce your pelvic floor pain.