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Pelvic Pain Pelvic Floor Muscle (PMF) Relaxation Exercises

ips for Penetration For situations when vaginal penetration necessary, such as sex, tampons, vaginal examination, vaginal ultrasound, Pap smear, be aware of the following: Lots of other muscles in your body can switch on when you experience pain or you anticipate that something will be painful, this can cause your PFM to switch on in a protective response; If you clench your jaw closed your PFM may clench also, try keeping your jaw open so that your PFM are more inclined to open; If your hands are gripping the examination table, bed, or each other your PFM may be gripping closed also, try keeping them soft & relaxed so that your PFM are soft & relaxed; Breathing if you hold your breath your diaphragm will be rigid and same with your PFM. To help the PFM relax try exhaling with a big O shaped mouth; Anything going into the vagina should go in slowly, in stages, approximately 1 cm at a time, coinciding with each breath out (i.e. with you letting go of your PFM); If this is still difficult, the PFM contract-hold-relax exercises that you will be taught later may also be used for penetration in stages with each relax of the contract-hold-relax exercises.

The Vagina At rest the vagina is roughly the shape of the letter H (i.e. at rest it gently relaxes down on itself), but it can stretch out to a circle shape quite easily.

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Tel: 1300 722 206 Fax: (02) 9382 6244 Email: info@whria.com.au Web: www.whria.com.au
Pelvic Pain You may have vaginal and / or vulval (i.e.just outside vaginal opening) skin issues, such as sensitive skin, redness, tearing, itching, dryness, or burning. These issues may need to be investigated and treated before PFM therapies will help.

You may have issues in your pelvis such as endometriosis, bladder or bowel irritation which may need to be investigated and treated before PFM therapies will help. You may have current or past issues or stresses which can compound your pain. A pain psychologist may be able to help you work through these issues and teach you pain management strategies. Increasing your participation general exercise will improve your fitness and may help with your ability to manage your pain.

Your Pelvic Floor Muscles....... Are what we call voluntary muscles, i.e. you can control them, as opposed to smooth muscle like in your gut; Are skeletal muscles, i.e. they attach to your bones, they allow movement, they support your pelvic organs, they help control your bladder & bowel; Are the same as your hamstrings, biceps, calf, thigh muscles, etc; Are approximately 3 - 4 cm into the vagina and are V shaped around the vagina.

It is normal that this type of muscle, on request, can contract, hold a contraction, relax and allow some stretching. Think of your biceps: on request it bends your elbow, can keep it bent, relaxes it out straight & can be stretched. Your pelvic floor muscles can do this too! They can contract, hold, relax & stretch.

Try a hamstring and / or calf stretch to the point of burning. In your mind (and in your leg muscles!) you now have a reference point for the sensation of normal voluntary muscle when it stretches it can hurt, but you dont stress when your hamstrings hurt. This reference point can be useful when attempting any penetration, i.e. is the vaginal pain you are feeling any worse than the hamstring stretch? If it is no worse, can you persevere?

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Tel: 1300 722 206 Fax: (02) 9382 6244 Email: info@whria.com.au Web: www.whria.com.au
PFMRelaxation Exercises
C = Contract Do a medium squeeze H = Hold Even hold for _____ seconds R = RELAX Let the PFM release fully Contract-Hold-RELAX Can you let go / relax a little further each repetition? CHR exercises Do _____ repetitions am & pm Awareness During the day if you are stressed/in pain what are your PFM doing? Up? Contracted? Tight? Contract-Hold-RELAX

The Bony Pelvis and some of your Pelvic Floor Muscles The PFM relaxation exercises are NOT to strengthen your muscles but to teach you to relax them

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