The reasons why your pelvic floor is tight is multifactorial and complex and should be addressed and treated by a multidisciplinary team.1 Along with addressing diet, toileting habits, medical conditions, psychological factors and other contributions, myofascial release and trigger point therapy can be useful tools to help relax hypertonic muscles and relieve the accompanying symptoms.
In this post we’ll explain what myofascial pain and myofascial trigger points are as they relate to your pelvic floor. We will then provide three suggestions on how to relax your pelvic floor muscles using myofascial release and trigger point therapy techniques.
What is myofascial pain and why do we use myofascial release and trigger point techniques?
Myofascial pain is pain originating from a muscle that has typically been contracted from stress, repetitive physical strain or trauma. This can cause muscle tension, nerve entrapment, decreased circulation, muscle shortening, decreased movement and the creation of myofascial trigger points. Myofascial pain and trigger points can subsequently cause dysfunction in the muscle and the surrounding tissues.
Myofascial trigger points can be found in many areas of the pelvis including the vagina, rectum, abdomen, low back and back side of thighs.
Myofascial release uses deep pressure massage, stretching, joint mobilisations, foam rollers and other trigger point release techniques to help increase flexibility of the muscle, decrease trigger point related pain and tension and improve muscle function.
How to relax the pelvic floor using myofascial release and trigger point techniques.
As pelvic dysfunction is complex and multifaceted, a full assessment by health professionals should be used to determine what is contributing to your specific dysfunction and what lines of treatment would be best for you.
The pelvic floor muscles are internal muscles, and as such, the most effective way to perform a release on these muscles is internally. A trained pelvic floor physiotherapist can perform these releases and teach you how you can perform these releases yourself, usually with the aid of a pelvic wand.
There are also ways to influence the pelvic floor externally using a tennis ball, trigger ball or a foam roller for myofascial release and trigger points. Below are some examples releasing the deep hip rotators including obturator internus, adductor magnus and levator ani.
For all exercises, ideally hold for 90 seconds and repeat 1-2x/day when experiencing symptoms from a tight pelvic floor or 3x/week preventatively. All releases should be felt with some discomfort, but not so much that you are tensing or holding your breath. If the trigger point is too intense, change the tool you are using to a softer one (ie// a tennis ball rather than a trigger ball) or modify the position you are in so less pressure is placed through the trigger point.
Obturator Internus and Deep Hip Rotators:
Equipment: trigger ball
Lie on your back with your knees bent. Place one foot on the opposite knee to make a figure-4. Follow the thigh of the supported leg down to the hip joint. Place the ball right underneath the hip. This may be enough pressure, or you may want to intensify the release by slowly dropping the knee towards the ground.
An alternative to this position is up against the wall. This might be used if you are not comfortable getting down onto the floor or the intensity on the ground is too much.
To perform up against the wall, angle yourself approximately 45 degrees away from the wall so the ball will be sitting on the back/side of your hip. Find the widest/ bony part of your hip and place the ball straight back from here.
Adductor Magnus
Equipment: Foam Roller
Lie on your stomach with one leg bent up and turned out towards the side. Knee and hip will both be bent around ninety degrees. Place foam roller under the inside of the thigh, close to your pubic bone/ pelvis.
Levator Ani and Transverse Perineal muscles
Equipment: Tennis Ball/ smaller soft ball
Levator Ani and Transverse Perineal muscles (muscles of the superficial and deep pelvic floor)
Seated in a chair, lean over towards one side and find your ischial tuberosities/ sit bones. These are the firm bumps you sit on under your bottom. Once located, bring the ball just inside one of these sits bones. The ball will be between the sit bone and your perineum. Slowly lower your hip back down towards the chair until reaching an appropriate pressure and hold. Repeat on the opposite side.
Myofascial release and trigger point therapy can be a great tool in improving pelvic floor tightness. Where you need to perform myofascial releases and trigger point therapy differs from person to person. These therapies, like most therapies, are best backed up with a consistent, graded exercise routine and multimodal approach to why your pelvic floor tension is occurring. Discussions with a trained professional, such as one of our women’s health coaches at PEAK can address the best course of action for you.
Try out some of these myofascial techniques at home as a head start in relieving some of your pelvic floor tightness. For next steps or to find what works best for you, book in with one of our coaches today!
References
Berghmans, B. Physiotherapy for pelvic pain and female sexual dysfunction: an untapped resource. Int Urogynecol J 29, 631–638 (2018). https://doi.org/10.1007/s00192-017-3536-8
Aredo JV, Heyrana KJ, Karp BI, Shah JP, Stratton P. Relating chronic pelvic pain and endometriosis to signs of sensitization and Myofascial pain and dysfunction. Semin Reprod Med. 2017;35:88–97.
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