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Natural Awakenings South Jersey

Understanding Pelvic Floor Pain and Dysfunction by Amanda Heritage

Nov 04, 2019 08:23AM ● By Michelle Vacanti

The Restful Pelvis

Rest. Relax. Take a deep breath. These are common statements or even commands we hear during mindful movement practices like yoga and meditation. Currently, our lifestyle of go-go- go challenges our innate ability to relax and quiet our bodies. But why is it so difficult?

 There are many factors, but for many, the answer is related to chronic pain. It can be especially difficult to relax, rest and restore when pain is present in the body and mind. It is our body’s natural tendency to stay on alert and protect itself when there is pain. This is especially true with chronic pelvic pain and pelvic floor dysfunction. It is estimated that at least one in three men and women suffer from pelvic floor dysfunction, specifically pelvic pain.

Pelvic floor dysfunction, specifically pelvic pain, is considered pain from the umbilicus to lower hips lasting greater than six months. The onset of pelvic pain occurs for many reasons including painful periods, pregnancy, birth-related trauma, pelvic/abdominal surgery or falling onto the tailbone.

The pelvic floor is a fundamental part of the core made up of a group of muscles within the pelvis. These muscles support the pelvic organs, maintain continence, stabilize the pelvic bones and hips, enhance sexual function and promote vascular exchange from the lower legs to the heart. Both men and women rely on the pelvic floor musculature to support daily eliminations like urination and defecation, enjoy intimacy, go for a run, and for women specifically, giving birth. Like any other skeletal muscle injuries, the pelvic floor needs to appropriately contract and then lengthen―or relax―to meet the demands of the activity at hand. This group of muscles is often overlooked as the driver of pain in the lower back, hips and groin.  

 Pacifying the Pelvis

Chronic pelvic pain can be difficult to address―like other chronic pain like fibromyalgia, chronic regional pain syndromeand chronic low back pain―as many systems are involved. 

Meditation and deep breathing are prescribed to address pain and to minimize protective tensions in the pelvis or body. However, because the brain’s pain response involves multiple systems of the body, therefore addressing the nervous system can ultimately have a more positive affect. It’s important to understand that we need the nervous system’s “slow” system as much as we need the “go” system. One way to prime the nervous system’s brakes is to address the cranial nerves, a group of nerves closest to the brain which includes the vagus nerve and the nerves that coordinate sensory input from the eyes, the ears and taste. 

 Physiological Quieting

 Physiological quieting is used to normalize the nervous system’s ability to down regulate the “go” system and elicit a parasympathetic response, the “slow” system, by tapping into the cranial nerves. As a physical therapist, I like to tap into this system to prepare the body for relaxation and learning. By specifically addressing the cranial nerves, we can prepare the body for healing and which lends an overall sense of relaxation to the nervous and musculoskeletal system. 

Using specific movements, like humming and gently moving the eyes, I find these sensations change in facial muscle tension, slowing of breathing patterns and an overall sense of relaxation. 

 Layering the cranial nerve input with repetitive rhythmical body motions mediate the accelerators and brakes ultimately affecting the central nervous system and state of relaxation.

Try this pelvic quieting move before any hands-on therapy, stretching, core stability and balance activities. 

1)    Begin lying on your back with your knees supported on a chair, wedge or cushion.

2)    Inhale and let your breath flow to your hips and abdomen.

3)    Exhale as you “hum” to release your breath.

4)    Repeat five times.

 To advance this movement:

1)    Continue the same breathing pattern above.

2)    As you exhale “hum” and gently rock the pelvis backward.

3)    Inhale as you rock the pelvis forward

4)    Repeat this “rocking” pelvis as you breathe to relax tension from your skull to your pelvis.

 Dr. Amanda Heritage, PT, DPT, owner of Breathe Life Physical Therapy and Wellness, has diverse treatment background including orthopedic, adolescent populations and pelvic health with a special focus on pelvic rehabilitation for women and men, optimizing health and restoring control of urinary and bowel incontinence, pelvic pain, pelvic organ prolapse, and support for women during/after pregnancy. Location: 987 Haddon Ave., Collingswood. For more information or to schedule an appointment, call 856-210-3517, email [email protected] or visit

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