Content warning: This story contains references to suicide and physical and emotional trauma, which may be upsetting or triggering for some readers.
The only thing that stopped Zoe* from taking her own life was the love she had for her two children. Yet, the chronic pain she endured was so severe that it overshadowed every aspect of her daily life. Despite visiting nearly a dozen doctors, none could provide a definitive answer for her suffering; many dismissed her complaints outright. As Zoe, now 48, recounted, “They washed their hands of me,” leaving her feeling alienated amid her profound pain.
After a long year of medication and consultations, Zoe sought help from a pelvic floor physical therapist. It was here she was diagnosed with a hypertonic pelvic floor, a condition characterized by overactive and tight muscles. This diagnosis opened the door to the healing process she desperately needed.
Understanding the Pelvic Floor
The pelvic floor is a complex structure of muscles and tissues that supports the pelvic organs, including the bladder, bowel, and uterus. As Lauren Garges, PT, DPT, a women’s clinical specialist, describes, it functions like a hammock. However, just like any other muscle group in the body, pelvic floor muscles can become either too weak or too tight. Trauma, whether acute or chronic, can significantly disrupt the function of the pelvic floor, leading to various pelvic floor dysfunctions, as Garges explains.
Pelvic floor dysfunction encompasses numerous conditions, including urinary incontinence, painful intercourse, constipation, and a persistent need to urinate. Left untreated, these issues can lead to more complex conditions, inflicting chronic pain on the hips and back that can be challenging to diagnose.
The Impact of Trauma on the Pelvic Floor
The pelvic floor is not only a location housing significant organs but also where the vagal nerves are located, connecting it to the autonomic nervous system, which regulates bodily functions such as digestion and heart rate. According to Alexandra T. Milspaw, PhD, a consultant specializing in chronic pelvic and sexual pain, experiencing stress triggers the fight-or-flight response, leading to tightening within the pelvic floor.
Trauma is subjective, and its effects can vary significantly among individuals. Events such as childbirth can cause both physical and emotional trauma, and if recovery remains unaddressed, complications may arise well into the future. Garges has worked with patients recovering from sexual assault, where physical responses such as vaginismus may occur as a protective measure following trauma. Importantly, emotional trauma can manifest physically, placing undue stress on pelvic floor muscles.
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Physical tension initiates a cycle of inflammation that often escapes detection in medical imaging, making diagnosis all the more challenging. Milspaw points out that unresolved anxiety or stress can create an ongoing cycle of discomfort that affects not just the pelvic region but also gastrointestinal health and emotional well-being.
For Zoe, working with both a pelvic floor physical therapist and a counselor marked a pivotal turning point. Together, they uncovered painful memories ingrained in her nervous system and altered her perception of pain, leading her towards a path of healing.
The Consequences of Unresolved Trauma
For others like Dianna B., dismissing trauma has far-reaching implications. Dianna, 55, faced life’s stresses in silence until compelled by her husband to seek professional help. For years, due to personal and familial trauma—highlighted by a traumatic childbirth experience—Dianna suffered from pelvic pain and incontinence yet insisted her issues were purely physical.
Therapy unveiled suppressed memories connected to her past, allowing her to see a correlation between her childhood trauma and current issues. Just as Milspaw explains, trauma’s effects are cumulative, affecting not only emotional states but also physical functions, particularly in the pelvic area.
Steps to Address Trauma-Induced Pelvic Floor Issues
Recognizing that trauma affecting the pelvic floor is treatable is crucial, although stigma often complicates the journey toward healing. Many practitioners lack formal training in pelvic health, and societal taboos make it difficult for individuals, especially women, to openly discuss their pelvic pain. This stigma can lead to feelings of isolation, with patients feeling brushed aside by the medical community.
Some may not even recognize their symptoms as abnormal, remaining unaware that they deserve treatment. For those like Savannah T., diagnosed with endometriosis, understanding the link between her mental health and pelvic floor dysfunction proved instrumental in her recovery journey.
Pelvic floor physical therapists engage in diverse therapeutic techniques, including targeted exercises, stretches, and manual tissue release. The ultimate goal is to create a physical and emotional safe space for patients, allowing them to explore and address their trauma.
Additionally, teaching coping mechanisms such as emotional freedom techniques can be vital. Once a sense of safety is established, more traditional therapeutic approaches become effective.
As patients like Zoe, Dianna, and Savannah continue their healing journeys, they serve as a reminder to advocate for oneself and persist until symptoms are taken seriously. “It’s been a journey,” Zoe reflects, underscoring the importance of resilience and self-discovery inherent in the healing process.
*Names have been changed, where indicated, to protect privacy.
