External pelvic health massage may be approached in several ways, but all have a focus on pelvic floor/perineal health. This often includes overcoming vaginismus & vulvodynia, erectile dysfunction, overactive bladder or painful bowel movements. While the scope of practice for registered massage therapists in British Columbia does not include internal pelvic floor massage, external work may be effectively performed in related tissues.
When would I have pelvic health concerns?
Pelvic health concerns can occur for ANYBODY with a pelvis. In many cases, these concerns may arise from unknowingly holding tension in the “pelvic floor,” possibly due to psychological distress, nervous system facilitation or an injury (post-delivery, from an assault, or post-vaginoplasty for cis-gender or transgender people). Pelvic tension or dysfunction can affect our sex lives, going to the bathroom, menstrual care and even sitting down.
The pelvic floor includes some muscles of the hips, abdominals, anus and genitalia that work for anal and sexual function, as well as supporting pelvic organs.
How does external massage benefit my pelvic health?
Depending on symptoms, visceral manipulation treatment may be indicated. Alternatively, your massage provider may work on areas of the body which are closely tied to your pelvic floor structures, through fascia and other soft tissues. Fascia is an abundant, connective tissue that supports and organizes muscles and nerves. During a pelvic health massage, it is useful to manipulate the fascia or other structures of the thigh, glutes/buttocks and abdomen that are associated with your pelvic floor. Massage that is profoundly relaxation based can assist with certain conditions rooted in pelvic floor tension, with secondary priority being given to the physical work being done. Skeptical? Consider that talk therapy is routinely part of successful outcomes for people living with vaginismus (alongside manual therapy). Consider what that means for the significance of psychologically initiated hyperactivity of the nervous system. Our nervous system is the conductor for both our mental and physical processes. There should be no astonishment or shame in acknowledging the psychological components of physical problems – it’s our nature.
Is massage the best option?
Massage may play an important complementary role in recovery or maintenance of your symptoms for many conditions. RMTs will always provide external treatments. Many health journeys combine multidisciplinary care on the path to wellness. Should your pelvic health symptoms not improve quickly with external massage therapy, your RMT may refer to another modality of care such as a pelvic floor physiotherapist, who is licensed to perform internal work, if indicated. Pelvic floor PTs play an important role in understanding which muscles may be facilitated, detecting possible prolapse, and prescribing internal dilators.
Before beginning treatment, your massage practitioner will provide an initial assessment of your symptoms to rule out or possiblyidentify more serious lesions and will discuss a treatment plan with you. Conditions such as endometriosis, bowel nerve damage, or Crohn’s disease would likely involve the care of your primary health provider.
Pelvic floor conditions, while common, may have a variety of root causes and should not be ignored. If you choose to work with an RMT or other care provider for treatment for a pelvic floor condition, it’s a good idea to speak with them about their experience and specific training/methods of treatment so that you are informed and comfortable moving forward. Our skilled massage provider, Flora Perritt, is happy to help.