Our world has very much changed with the onset of a global pandemic (COVID 19). We are forced to stay at home, isolate, deal with changing economic situations, work, teach our children, eat right, exercise… it’s a lot to keep up with. It’s stressful and whether we realize it or not, our body does. For many of us out there, we may tend to hold stress and tension in our pelvis and not even know it. Pelvic pain can present as any pain anywhere from below the belly button to the thighs. It can be sharp stabbing pain, or it can be diffuse, dull aching. It can also be sporadic pain or nagging, everyday discomfort. There are so many presentations of pelvic pain and you know what? Stress flares it up. Exercise is a great way to handle stress. So, should I exercise if I have pelvic pain?
The Short Answer is YES
While the answer is yes, the research is a bit mixed. Some studies indicate exercise can increase irritation of already painful pelvic floor muscles because of added strain from abdominal pressure and more movement on irritated muscle tissue. When pelvic pain is flared up, the muscles are not in optimal position and strength for the increase in downward force that occurs, creating more inflammation and pain. Conversely, some studies support the hypothesis that exercise is good and strengthens the pelvic floor and accessory muscles surrounding the pelvis (abdominals, hip rotators, glutes, etc). When the pelvic floor and its accessory muscles are all strong, they are more balanced, which allows them the ability to contract and relax symbiotically.
In the instance of pelvic pain, the pelvic floor and accessory muscles are out of balance with one group or the other being overactive while the other is underactive. What the research is clear on is that exercise is good for you and you feel better after. Exercise also induces some physiologic relaxation of the tissues when applied correctly.
So, let’s get moving then…but where do I start?
Choose your Mode Wisely
When you are experiencing pelvic pain, the hardest part may be getting yourself started. Choosing an appropriate method of exercise is a great place to start. Exercises that limit pelvic floor strain are recommended. Some of these modes of exercise may be walking, riding an elliptical machine, or swimming. You can also consider some Pilates-based exercises for building your core strength because research studies indicate that the pelvic floor pressure during Pilates-based exercises is less than the pelvic pressure sustained when getting up out of a chair. Running, biking, weight training, and high-intensity interval training may add to your pelvic pain flare up due to increases the downward pressure on the pelvic floor. Those are some great modes to get started!
Start Slow and See How it Goes
Once you have decided which mode of exercise you’d like to try, it’s important to not go all out right away! Keep in mind that how your body feels, especially your pelvic pain, is the most important guide. Whether it is just a few minutes or 30+ minutes, be sure that your pelvic pain does not get significantly worse. One way to monitor how much pain you are in is to rate your pain before starting; then not let the pain number rise more than 2 points. For example, if you had pain of 4/10 prior to starting, exercise shouldn’t raise it above 6/10 (0 no pain-10 worst pain possible).
Lastly, do not forget to take some time to stretch after exercise. Forgetting to stretch can keep all your muscles in the shortened, tight state that is prone to continuing the pelvic pain pattern. Be cautious and let your body be the guide and you are off to a great start to relieving your pelvic pain.
A Pelvic Rehabilitation Physical Therapist Can Help
If all of this is a bit intimidating to take on or it still sounds a little daunting to try exercising with your pelvic pain, reaching out to a Pelvic Rehabilitation Physical Therapist is a very good idea.
Whether you’d like a safe and customized exercise plan or a few sessions using their skilled techniques to help relax your pelvic floor prior to starting an exercise routine, The Pelvic Rehabilitation Team at Apex Physical Therapy & Wellness Center can really improve your quality of life.
Call or message us to learn more.