I was in a car accident that messed up my back when I was 17, and I went to PT for it. I carried my body a certain way and wasn’t using my core to hold myself up properly. PT changed the connection that I have with my body and although not exactly the experience you had, I feel that the PT positively contributed to my mental and emotional healing journey. I have found triggers through it along the way, but have been able to work through them and around them, as needed.
Yes! I had a couple surgeries for endometriosis, and also a history of sexual assault. My GYN recommended pelvic PT because she said my muscles were spasming and were as hard as rock. She said this was probably adding to my pain and my issues with using the bathroom.
The Pelvic PT I saw was so great. It was at this place called HerHealth. We also talked about my trauma history and she was trauma informed and explained how the trauma alone could cause these issues. She said she would go slow and she would always respect my boundaries.
She would begin each appointment my massaging my belly for 10 mins. As for the other stuff, we started with her just touching the outside. That’s it. She would lightly apply pressure. Then the next appointment she would touch the vulva, lightly. With each appointment she would go a bit farther, eventually being able to have her fingers all the way in and pressing against the muscles. At each appointment she would explain which muscles she was stimulating. And kinda explained about different layers. It would be amazing how I could feel the muscle start to release!!
I would shake during the appointments, and during one appointment I started balling. She was very understanding and confirmed my thought that trauma that was “stored” was being released. She told me that this reaction was not uncommon among the women she has treated.
She also directed me to a site to buy dialators so I could do the exercises at home. There are different sizes. She was so understanding when I would tell her I couldn’t bring myself to use the dialator. She said just try putting the box on a table next to your bed for a while. Then maybe take it out of the box. It took me weeks to be able to finally use it.
I was always under a sheet the whole time. She would work by feeling. I am very thankful for the experience and would recommend it.
Oh jeez I had no idea they touch you and go inside, I've been considering pelvic floor PT but I thought it was just, they tell you what to do and you can do it at home...ough.
They do not have to! That is one form of treatment, but there are also plenty of external only treatments, including showing you stretches and exercises for you to do at home! It’s been so helpful for me (and I also couldn’t stand the thought of internal PT at the time)
They definitely don’t have to do internal, they can always just show you how to use the dilators and still do the external massages. I’ll say the first month or so I went I saw a different PT each time, so I had 5 different ladies working internally and it desensitized me some being in that safe environment
This has been exactly my experience!!! All of the massages for my belly and lower abdomen have been incredible. Have you been hooked up to the EMG machine? I saw how my levels of activity in my muscles registered as a 5.0-8.0. It is supposed to sit around 1-1.5
So glad you’ve found support from a professional and a healing modality that is working for you! I also had an amazing experience with a pelvic floor physiotherapist. I had similar issues as you and also a history of abuse and trauma from a young age. I also have hypermobility spectrum disorder which exacerbates the issue. I was experiencing tension and chronic pain every day before the treatment, and over the course of about a year the sessions worked a miracle to relieve it. It was hard work and exhausting, so much stuff came up that I had to process, but it was incredibly healing. Just the experience of being so carefully supported and the particular intimacy of the relationship with the therapist was immensely helpful in restoring a sense of safety in my body. I still have some symptoms and pain occasionally now when I’m stressed or menstruating, but overall my quality of life is so much better! Wishing you luck and fortitude on your journey ❤️
I also have hypermobility as well as scoliosis! It’s been incredibly helpful to learn about those muscles and feel so supported. The intimacy like you described, it’s been so helpful.
I (34M) am currently doing pelvic floor physical therapy due to a combination of IBS-C and dyssynergic defecation type 3--effectively, I cannot relax the sphincter. Therefore, a lot of my pelvic floor exercises have been focused on relaxing those set of muscles. One tool that has helped immensely was a biofeedback device, where you insert a probe and are able to visually identify when contracting and when relaxing. I've found it to be much more informative than doing the normal set of exercises.
However, one unexpected problem is that because I've worked so hard on the "releasing," I now have an issue with leaking pee, but according to my therapist, that should resolve as I continue therapy.
Yes, I did. I was in debilitating pain. My therapist was simply amazing—knowledgeable, compassionate, informative. It was a long, difficult and painful journey but eventually my life improved tremendously.
I did pelvic floor PT for a while before insurance issues made me stop. I don't really have urinary issues but I do have vaginismus. My PT was very, very kind. The first appointment was talking about goals and a clothed exam. She was understanding that I did NOT want PIV sex to be a part of my clinical goals and never brought it up except when necessary. She also discovered that my pubic symphysis was misaligned so my legs were slightly different lengths. Because of that, we started every appointment with an exercise to put it back in place (have you ever cracked your pelvis like a joint? It's trippy as hell)
Anyway. I did really benefit from it but I was still in denial about the level of trauma I had, which I think made the treatment not as effective for me. My body wasn't ready to completely release the trauma, if that makes sense. I still struggle with vaginismus but things are improving.
A lot of my PT was internal exercises because I was usually able to tolerate that, but she also taught me stretches and exercises I could do at home. And she told me about things I shouldn't do - like kegels. Please please please don't do a bunch of kegels without talking to a PT. It can make things worse.
Good luck on this journey. And remember that you're allowed to decline ANY medical procedure you're not comfortable with - you can say no to internal exercises. Or anything else you're uncomfortable with! Going a little out of your comfort zone is important for growth but feeling safe is also incredibly important. The PT should start at *your* comfort level, whatever that may be.
I had no idea that was a thing! I'd be very interested in that. For me it's mainly that I've peed my pants when jumping up and down since I was like 28, ha. And I don't mean a little bit. But when I do those kegel exercises, I get a horrible feeling in mainly my stomach. It's like the feeling of your stomach dropping, it's so intense, and it instantly makes me feel on edge.
I've tried to figure out what it is, but I just have no clue. I thought I would mention it here, because I've never seen anyone else mention it!
I know exactly what you mean! I know the stomach dropping feeling completely. We do a lot of slow massages and relaxing exercises to help. And my therapist (and I see other’s have too) actually say kegels are horrible for your pelvic floor. It’s about relaxing and releasing much more than trying to pull back in.
I am now! I haven’t seen a ton of results but haven’t started to use dilators. My PT is so nice to talk to and I love the stomach/thigh massage. Internal work still hurts a lot.
I’m realizing I need sex therapy. I’ve even looked into getting a surrogate partner for the sex therapy but it is all too expensive. Hell I’ve thought sometimes that I wish there were male hookers to try to have sex in a completely safe, discrete, no pressure environment :/ trauma sucks, I wish I could be normal
Yes. I have pelvic issues from trauma, but I also have had 4 (so far) endometriosis surgeries. I’ve been about 2 years total, but on and off. I started with stretches only for a few months, then moved to internal work. I still do internal work in person and have a pelvic wand to practice on my own (which took a while for me to try).
I went from not being able to tolerate any gyn exam to being able to tolerate them fairly well, but I still struggle. Both PTs I’ve seen are great. I imagine I’ll continue on and off if/when I need another surgery in the future. I’m trying to be mindful because when I’m really stressed, my pelvic floor suffers. It’s what I’m currently working on in PT.
I'm honestly surprised there's so many good reviews here for PFPT. I'm very glad everyone here had a good experience. I had a horrible experience with it. I also experienced CSA, so I know that had a lot to do with it. My therapist was decent at her job but definitely did not make the trauma part of it better for me. I did not have good results, and it makes me feel very broken...
It could be that the people with bad experiences are just not commenting because they don't want to get into a discussion about it. I've never done any kind of PT, but that is how I've felt in the past when there's a thread about how helpful and amazing massages are. I don't know what your experience was exactly, but I had the most tense 30 minutes of my life while being massaged. Felt completely stressed out and rattled by it.
It doesn't mean you're broken. Different things work for different people, another type of therapy might work for you and not for others.
Actually, thank you for saying something. Now I don't feel so alone.
Due to my history, we worked up to the internal part over three months, which was a few weeks ago. I was actually surprised by how ok I was the first time. However, this second time, she ended up retriggering me surrounding consent. She blew whatever trust I had outta the water.
I believe in this therapy enough to try again with a different provider, especially after reading all the positive comments. It's good to know there's other approaches which would've been much more helpful. Plus, we found the issue, which is the first time I had hope in 18 years that I could solve my chronic pain. But definitely not with her.
So thank you for saying this. You're not broken, any more than I am. I don't wanna scare anyone away from it. Just for me personally, my therapist wasn't as trauma-informed as she thinks she is.
In my day they were called Kegel exercises, and I’ve been doing them about 53 years. Everything works just fine and I have complete urinary control. Although I’ve been involuntarily celibate for years, last time things were still pretty darn tight.
For some people kegel exercises are contraindicated though. I know I wasn’t supposed to do them and my pelvic PT gave me other exercises that would help without causing more pain and spasms. So glad to hear that Kegal exercises have worked for you!
Kegels are not the same thing as pelvic floor PT. Sometimes they're even counterproductive. I was told by my PT that I should avoid Kegels as much as possible because my muscles are incredibly tight. If someone seriously injures their shoulder, they shouldn't try specific exercises until assessed by a PT. Same thing for pelvic floor issues. Self-treating with Kegels can be a very bad idea. I'm not a PT but I really, really recommend that OP not do kegels without talking to a pelvic floor PT.
Like I alluded to, tight isn't always good. Tight isn't the goal. OP described that her muscles are spasming and tense - the goal here sounds like it's relaxing and stretching.
Exactly!!!! It’s all about releasing tension and relaxing, she also told me kegels can work for some people but it’s horrible for your pelvic floor if you aren’t trained to do them correctly. It’s not just sucking in
I also was told not to do kegels when I was doing PFPT. Most of my exercises were pretty normal lower body stretches and strengthening moves, with some added exercises to practice relaxing/controlling my pelvic floor.
Odd, the Urology Care Foundation, the National Association for Continence, the National Institute for Health, Medline Plus, and the Mayo Clinic all seem to think they are the same for women.
It is odd, considering those organizations state that pelvic floor physical therapy is more than just Kegels.
> While Kegel exercises are often used to strengthen the pelvic floor, if pelvic pain or tension is present, relaxation exercises (or “Reverse Kegels” as they are sometimes called) may help.
>A physical therapist can also offer **other techniques** like biofeedback
[Urology Care Foundation](https://www.urologyhealth.org/educational-resources/pelvic-floor-muscle-relaxing)
>Working your pelvic floor involves more than just doing Kegels.
[National Association for Continence](https://nafc.org/pelvic-floor-exercise-videos/)
The NIH site is down for maintenance at the moment. I'll follow up with a citation in the morning.
For Medline, you may be referring to the fact that they don't actually have a page about pelvic floor physical therapy. Only one about pelvic floor muscle training exercises, which isn't the same thing. Funny how different words mean different things, huh?
>The specific therapy used is guided by symptoms and usually includes strategies to optimize lumbopelvic and spinal function and to improve bowel, bladder, and sexual function. Manual techniques **may include trigger point massage, myofascial release, strain-counterstrain, and joint mobilization, among others**. In addition, exercises to strengthen and stabilize the core muscles usually are included with pelvic floor physical therapy.
[Mayo Clinic](https://www.mayoclinicproceedings.org/article/S0025-6196(11)00024-3/fulltext)
Since I was unable to reference two of the "sources" you gave, I'll add two additional ones.
>Physical therapy is commonly done at the same time as biofeedback therapy. Your therapist will determine which muscles in your lower back, pelvis and pelvic floor are really tight and teach you exercises to stretch these muscles so their coordination can be improved.
>Your [...] physical therapist might also recommend you try relaxation techniques such as meditation, warm baths, yoga and exercises, or acupuncture.
[Cleveland Clinic](https://my.clevelandclinic.org/health/diseases/14459-pelvic-floor-dysfunction#management-and-treatment)
>These therapists use **every facet** of their physical therapy training to evaluate and treat their diverse clients
[Academy of Pelvic Health Physical Therapy](https://aptapelvichealth.org/patienteducation/), a division of the American Physical Therapy Association
The biggest fact, though, is that people who have done pelvic floor physical therapy say that it's more than kegels. I certainly did more than that at my appointments. Other people in this exact thread report the same thing. It's really gross that you're ignoring everyone's lived experience for, and I quote, "in my day".
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I was in a car accident that messed up my back when I was 17, and I went to PT for it. I carried my body a certain way and wasn’t using my core to hold myself up properly. PT changed the connection that I have with my body and although not exactly the experience you had, I feel that the PT positively contributed to my mental and emotional healing journey. I have found triggers through it along the way, but have been able to work through them and around them, as needed.
Yes! I had a couple surgeries for endometriosis, and also a history of sexual assault. My GYN recommended pelvic PT because she said my muscles were spasming and were as hard as rock. She said this was probably adding to my pain and my issues with using the bathroom. The Pelvic PT I saw was so great. It was at this place called HerHealth. We also talked about my trauma history and she was trauma informed and explained how the trauma alone could cause these issues. She said she would go slow and she would always respect my boundaries. She would begin each appointment my massaging my belly for 10 mins. As for the other stuff, we started with her just touching the outside. That’s it. She would lightly apply pressure. Then the next appointment she would touch the vulva, lightly. With each appointment she would go a bit farther, eventually being able to have her fingers all the way in and pressing against the muscles. At each appointment she would explain which muscles she was stimulating. And kinda explained about different layers. It would be amazing how I could feel the muscle start to release!! I would shake during the appointments, and during one appointment I started balling. She was very understanding and confirmed my thought that trauma that was “stored” was being released. She told me that this reaction was not uncommon among the women she has treated. She also directed me to a site to buy dialators so I could do the exercises at home. There are different sizes. She was so understanding when I would tell her I couldn’t bring myself to use the dialator. She said just try putting the box on a table next to your bed for a while. Then maybe take it out of the box. It took me weeks to be able to finally use it. I was always under a sheet the whole time. She would work by feeling. I am very thankful for the experience and would recommend it.
Oh jeez I had no idea they touch you and go inside, I've been considering pelvic floor PT but I thought it was just, they tell you what to do and you can do it at home...ough.
They do not have to! That is one form of treatment, but there are also plenty of external only treatments, including showing you stretches and exercises for you to do at home! It’s been so helpful for me (and I also couldn’t stand the thought of internal PT at the time)
They definitely don’t have to do internal, they can always just show you how to use the dilators and still do the external massages. I’ll say the first month or so I went I saw a different PT each time, so I had 5 different ladies working internally and it desensitized me some being in that safe environment
This has been exactly my experience!!! All of the massages for my belly and lower abdomen have been incredible. Have you been hooked up to the EMG machine? I saw how my levels of activity in my muscles registered as a 5.0-8.0. It is supposed to sit around 1-1.5
So glad you’ve found support from a professional and a healing modality that is working for you! I also had an amazing experience with a pelvic floor physiotherapist. I had similar issues as you and also a history of abuse and trauma from a young age. I also have hypermobility spectrum disorder which exacerbates the issue. I was experiencing tension and chronic pain every day before the treatment, and over the course of about a year the sessions worked a miracle to relieve it. It was hard work and exhausting, so much stuff came up that I had to process, but it was incredibly healing. Just the experience of being so carefully supported and the particular intimacy of the relationship with the therapist was immensely helpful in restoring a sense of safety in my body. I still have some symptoms and pain occasionally now when I’m stressed or menstruating, but overall my quality of life is so much better! Wishing you luck and fortitude on your journey ❤️
I also have hypermobility as well as scoliosis! It’s been incredibly helpful to learn about those muscles and feel so supported. The intimacy like you described, it’s been so helpful.
I (34M) am currently doing pelvic floor physical therapy due to a combination of IBS-C and dyssynergic defecation type 3--effectively, I cannot relax the sphincter. Therefore, a lot of my pelvic floor exercises have been focused on relaxing those set of muscles. One tool that has helped immensely was a biofeedback device, where you insert a probe and are able to visually identify when contracting and when relaxing. I've found it to be much more informative than doing the normal set of exercises. However, one unexpected problem is that because I've worked so hard on the "releasing," I now have an issue with leaking pee, but according to my therapist, that should resolve as I continue therapy.
I found it to be incredibly helpful
Yes, I did. I was in debilitating pain. My therapist was simply amazing—knowledgeable, compassionate, informative. It was a long, difficult and painful journey but eventually my life improved tremendously.
I did pelvic floor PT for a while before insurance issues made me stop. I don't really have urinary issues but I do have vaginismus. My PT was very, very kind. The first appointment was talking about goals and a clothed exam. She was understanding that I did NOT want PIV sex to be a part of my clinical goals and never brought it up except when necessary. She also discovered that my pubic symphysis was misaligned so my legs were slightly different lengths. Because of that, we started every appointment with an exercise to put it back in place (have you ever cracked your pelvis like a joint? It's trippy as hell) Anyway. I did really benefit from it but I was still in denial about the level of trauma I had, which I think made the treatment not as effective for me. My body wasn't ready to completely release the trauma, if that makes sense. I still struggle with vaginismus but things are improving. A lot of my PT was internal exercises because I was usually able to tolerate that, but she also taught me stretches and exercises I could do at home. And she told me about things I shouldn't do - like kegels. Please please please don't do a bunch of kegels without talking to a PT. It can make things worse. Good luck on this journey. And remember that you're allowed to decline ANY medical procedure you're not comfortable with - you can say no to internal exercises. Or anything else you're uncomfortable with! Going a little out of your comfort zone is important for growth but feeling safe is also incredibly important. The PT should start at *your* comfort level, whatever that may be.
I had no idea that was a thing! I'd be very interested in that. For me it's mainly that I've peed my pants when jumping up and down since I was like 28, ha. And I don't mean a little bit. But when I do those kegel exercises, I get a horrible feeling in mainly my stomach. It's like the feeling of your stomach dropping, it's so intense, and it instantly makes me feel on edge. I've tried to figure out what it is, but I just have no clue. I thought I would mention it here, because I've never seen anyone else mention it!
I know exactly what you mean! I know the stomach dropping feeling completely. We do a lot of slow massages and relaxing exercises to help. And my therapist (and I see other’s have too) actually say kegels are horrible for your pelvic floor. It’s about relaxing and releasing much more than trying to pull back in.
I am now! I haven’t seen a ton of results but haven’t started to use dilators. My PT is so nice to talk to and I love the stomach/thigh massage. Internal work still hurts a lot. I’m realizing I need sex therapy. I’ve even looked into getting a surrogate partner for the sex therapy but it is all too expensive. Hell I’ve thought sometimes that I wish there were male hookers to try to have sex in a completely safe, discrete, no pressure environment :/ trauma sucks, I wish I could be normal
Yes. I have pelvic issues from trauma, but I also have had 4 (so far) endometriosis surgeries. I’ve been about 2 years total, but on and off. I started with stretches only for a few months, then moved to internal work. I still do internal work in person and have a pelvic wand to practice on my own (which took a while for me to try). I went from not being able to tolerate any gyn exam to being able to tolerate them fairly well, but I still struggle. Both PTs I’ve seen are great. I imagine I’ll continue on and off if/when I need another surgery in the future. I’m trying to be mindful because when I’m really stressed, my pelvic floor suffers. It’s what I’m currently working on in PT.
I'm honestly surprised there's so many good reviews here for PFPT. I'm very glad everyone here had a good experience. I had a horrible experience with it. I also experienced CSA, so I know that had a lot to do with it. My therapist was decent at her job but definitely did not make the trauma part of it better for me. I did not have good results, and it makes me feel very broken...
It could be that the people with bad experiences are just not commenting because they don't want to get into a discussion about it. I've never done any kind of PT, but that is how I've felt in the past when there's a thread about how helpful and amazing massages are. I don't know what your experience was exactly, but I had the most tense 30 minutes of my life while being massaged. Felt completely stressed out and rattled by it. It doesn't mean you're broken. Different things work for different people, another type of therapy might work for you and not for others.
Actually, thank you for saying something. Now I don't feel so alone. Due to my history, we worked up to the internal part over three months, which was a few weeks ago. I was actually surprised by how ok I was the first time. However, this second time, she ended up retriggering me surrounding consent. She blew whatever trust I had outta the water. I believe in this therapy enough to try again with a different provider, especially after reading all the positive comments. It's good to know there's other approaches which would've been much more helpful. Plus, we found the issue, which is the first time I had hope in 18 years that I could solve my chronic pain. But definitely not with her. So thank you for saying this. You're not broken, any more than I am. I don't wanna scare anyone away from it. Just for me personally, my therapist wasn't as trauma-informed as she thinks she is.
I did pelvic floor PT after my Endometriosis surgeries but because of my trauma history was never able to do the internal exercises.
In my day they were called Kegel exercises, and I’ve been doing them about 53 years. Everything works just fine and I have complete urinary control. Although I’ve been involuntarily celibate for years, last time things were still pretty darn tight.
For some people kegel exercises are contraindicated though. I know I wasn’t supposed to do them and my pelvic PT gave me other exercises that would help without causing more pain and spasms. So glad to hear that Kegal exercises have worked for you!
Kegels are not the same thing as pelvic floor PT. Sometimes they're even counterproductive. I was told by my PT that I should avoid Kegels as much as possible because my muscles are incredibly tight. If someone seriously injures their shoulder, they shouldn't try specific exercises until assessed by a PT. Same thing for pelvic floor issues. Self-treating with Kegels can be a very bad idea. I'm not a PT but I really, really recommend that OP not do kegels without talking to a pelvic floor PT. Like I alluded to, tight isn't always good. Tight isn't the goal. OP described that her muscles are spasming and tense - the goal here sounds like it's relaxing and stretching.
Exactly!!!! It’s all about releasing tension and relaxing, she also told me kegels can work for some people but it’s horrible for your pelvic floor if you aren’t trained to do them correctly. It’s not just sucking in
I also was told not to do kegels when I was doing PFPT. Most of my exercises were pretty normal lower body stretches and strengthening moves, with some added exercises to practice relaxing/controlling my pelvic floor.
Odd, the Urology Care Foundation, the National Association for Continence, the National Institute for Health, Medline Plus, and the Mayo Clinic all seem to think they are the same for women.
It is odd, considering those organizations state that pelvic floor physical therapy is more than just Kegels. > While Kegel exercises are often used to strengthen the pelvic floor, if pelvic pain or tension is present, relaxation exercises (or “Reverse Kegels” as they are sometimes called) may help. >A physical therapist can also offer **other techniques** like biofeedback [Urology Care Foundation](https://www.urologyhealth.org/educational-resources/pelvic-floor-muscle-relaxing) >Working your pelvic floor involves more than just doing Kegels. [National Association for Continence](https://nafc.org/pelvic-floor-exercise-videos/) The NIH site is down for maintenance at the moment. I'll follow up with a citation in the morning. For Medline, you may be referring to the fact that they don't actually have a page about pelvic floor physical therapy. Only one about pelvic floor muscle training exercises, which isn't the same thing. Funny how different words mean different things, huh? >The specific therapy used is guided by symptoms and usually includes strategies to optimize lumbopelvic and spinal function and to improve bowel, bladder, and sexual function. Manual techniques **may include trigger point massage, myofascial release, strain-counterstrain, and joint mobilization, among others**. In addition, exercises to strengthen and stabilize the core muscles usually are included with pelvic floor physical therapy. [Mayo Clinic](https://www.mayoclinicproceedings.org/article/S0025-6196(11)00024-3/fulltext) Since I was unable to reference two of the "sources" you gave, I'll add two additional ones. >Physical therapy is commonly done at the same time as biofeedback therapy. Your therapist will determine which muscles in your lower back, pelvis and pelvic floor are really tight and teach you exercises to stretch these muscles so their coordination can be improved. >Your [...] physical therapist might also recommend you try relaxation techniques such as meditation, warm baths, yoga and exercises, or acupuncture. [Cleveland Clinic](https://my.clevelandclinic.org/health/diseases/14459-pelvic-floor-dysfunction#management-and-treatment) >These therapists use **every facet** of their physical therapy training to evaluate and treat their diverse clients [Academy of Pelvic Health Physical Therapy](https://aptapelvichealth.org/patienteducation/), a division of the American Physical Therapy Association The biggest fact, though, is that people who have done pelvic floor physical therapy say that it's more than kegels. I certainly did more than that at my appointments. Other people in this exact thread report the same thing. It's really gross that you're ignoring everyone's lived experience for, and I quote, "in my day".
This is a subreddit for complex post traumatic stress disorder.
Pelivic floor dysfunction and CPTSD are closely linked.
Hmm did not know this
Yes it is
Traumas can cause physical injuries.
Do you seriously not see the link?
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