Trauma-Informed Pelvic Floor Care

Welcome to this blog post expanding on the fascinating and important topic we explored in our latest podcast episode, "Is Trauma Stuck in My Hips?". As discussed in the episode with pelvic floor physical therapist Dr. Alicia Jeffrey-Thomas, the connection between trauma and the pelvic floor is more profound than many realize. In this post, we'll delve deeper into the intricacies of this relationship, exploring how past trauma can manifest in pelvic health issues and offering guidance on finding practitioners who provide sensitive and effective trauma-informed care. Just as we learned in the episode, the pelvic floor is something everyone has and needs to take care of. So whether you've experienced pelvic issues or are just looking to learn, let's jump in!

Introduction: The Pelvic Floor and Trauma - More Connected Than You Think

The pelvic floor, a group of muscles that support the bladder, uterus (in women), prostate (in men), and rectum, plays a crucial role in various bodily functions, including bowel and bladder control, sexual function, and core stability. While often discussed in the context of postpartum recovery or age-related incontinence, its connection to trauma is frequently overlooked. Trauma, whether physical, emotional, or sexual, can have a lasting impact on the nervous system, leading to chronic muscle tension, pain, and dysfunction in various parts of the body, including the pelvic floor.

The pelvic floor is not just a set of muscles; it's also deeply intertwined with our emotional and psychological well-being. It's an area of the body that can hold tension and stress, often unconsciously, as a result of past experiences. Understanding this connection is the first step towards providing and receiving truly holistic and effective pelvic floor care.

Understanding the Pelvic Floor: It's Not Just a Female Thing!

One of the most common misconceptions about the pelvic floor is that it's exclusively a female concern. While pelvic floor dysfunction is often associated with women due to pregnancy and childbirth, men also have a pelvic floor that is just as important. In both sexes, these muscles support the pelvic organs and contribute to core stability. Pelvic floor dysfunction in men can manifest as urinary or fecal incontinence, erectile dysfunction, and chronic pelvic pain.

The pelvic floor muscles are arranged in layers, forming a sort of hammock at the base of the pelvis. These muscles contract and relax to control the opening and closing of the urethra, anus, and, in women, the vagina. They also work in coordination with the abdominal muscles, diaphragm, and back muscles to support the spine and maintain proper posture.

Common causes of pelvic floor dysfunction include:

• Pregnancy and childbirth
• Chronic constipation or straining
• Obesity
• Heavy lifting
• Surgery in the pelvic region
• Nerve damage
• Trauma (physical, emotional, or sexual)

Understanding the anatomy and function of the pelvic floor is crucial for both practitioners and individuals seeking care. Recognizing that pelvic floor dysfunction affects both men and women and can be influenced by a variety of factors, including trauma, is essential for providing comprehensive and effective treatment.

The Mind-Body Connection: How Trauma Impacts the Pelvic Floor

The mind-body connection is a fundamental principle in understanding the impact of trauma on the pelvic floor. Trauma can disrupt the nervous system's ability to regulate muscle tension, leading to chronic contraction or weakness in the pelvic floor muscles. This can manifest as a variety of symptoms, including:

• Pelvic pain
• Painful intercourse
• Urinary or fecal incontinence
• Constipation
• Muscle spasms
• Difficulty emptying the bladder or bowels

When a person experiences trauma, the body's natural stress response is activated, leading to the release of hormones like cortisol and adrenaline. In the short term, this response is adaptive and helps the individual cope with the stressful situation. However, when trauma is prolonged or unresolved, the nervous system can become dysregulated, leading to chronic activation of the stress response. This can result in persistent muscle tension, including in the pelvic floor.

Furthermore, trauma can impact the way a person perceives and experiences their body. Survivors of sexual trauma, for example, may develop a sense of disconnect or alienation from their pelvic region. They may experience pain, numbness, or a feeling of being "out of touch" with their bodies. This disconnect can make it difficult to engage in activities that involve the pelvic floor, such as sexual activity or even exercise.

Addressing the mind-body connection is crucial for healing from trauma and restoring pelvic floor function. This involves working with both the physical and emotional aspects of trauma, using techniques such as:

• Trauma-informed therapy
• Mindfulness and meditation
• Yoga and other movement therapies
• Pelvic floor physical therapy
• Somatic Experiencing

Anxiety in the Hips: Exploring the Link Between Mental Health and Physical Tension

As we discussed in the podcast episode, anxiety and mental health can also significantly impact the pelvic floor. Many people hold tension in their hips and pelvic region when they are feeling anxious or stressed. This tension can lead to chronic pain, muscle spasms, and difficulty with pelvic floor function.

The hips and pelvis are often referred to as the "emotional center" of the body. This is because these areas are closely connected to the limbic system, the part of the brain that processes emotions. When we experience stress or anxiety, the limbic system activates the stress response, leading to muscle tension in the hips and pelvis.

Over time, chronic tension in the hips and pelvis can lead to a variety of physical problems, including:

• Hip pain
• Back pain
• Sciatica
• Pelvic pain
• Tightness in the hamstrings and hip flexors
• Difficulty with posture

In addition to physical symptoms, anxiety and tension in the hips can also contribute to emotional and psychological problems, such as:

• Difficulty relaxing
• Feeling "stuck" or "trapped"
• Anxiety and depression
• Difficulty with intimacy
• Low self-esteem

Releasing tension in the hips and pelvis can have a profound impact on both physical and emotional well-being. Techniques such as yoga, stretching, massage, and mindfulness can help to release tension and restore balance to the hips and pelvic floor. Addressing underlying anxiety and mental health issues is also crucial for long-term healing.

The Problem with 'Just in Case' Peeing

One seemingly harmless habit that can contribute to pelvic floor dysfunction is "just in case" peeing. This refers to the practice of emptying the bladder even when you don't feel the urge to urinate, often done out of convenience or fear of not having access to a restroom later. While it may seem like a proactive measure, "just in case" peeing can actually weaken the bladder muscles and disrupt the natural signals that tell you when you need to go.

The bladder is a muscle that stretches and expands as it fills with urine. When the bladder reaches a certain capacity, it sends signals to the brain, creating the urge to urinate. Regularly emptying the bladder before it's full can reduce its capacity over time, leading to increased frequency and urgency. This can also weaken the pelvic floor muscles, which play a crucial role in supporting the bladder and controlling urination.

In addition to weakening the bladder and pelvic floor, "just in case" peeing can also contribute to anxiety and stress. Constantly worrying about needing to find a restroom can lead to increased tension in the pelvic floor muscles and a heightened sense of urgency.

Instead of "just in case" peeing, it's important to listen to your body's natural signals and only empty your bladder when you feel the urge to urinate. This will help to maintain bladder capacity, strengthen the pelvic floor muscles, and reduce anxiety related to urination.

Finding a Trauma-Informed Pelvic Floor Practitioner: What to Look For

If you suspect that trauma may be contributing to your pelvic floor issues, it's essential to find a practitioner who provides trauma-informed care. A trauma-informed practitioner understands the impact of trauma on the body and mind and creates a safe and supportive environment for healing.

Here are some things to look for when searching for a trauma-informed pelvic floor practitioner:

• Experience and training: Look for a practitioner who has specific training in trauma-informed care or who has experience working with trauma survivors.
• A safe and supportive environment: The practitioner should create a space where you feel comfortable and safe to share your experiences. They should be patient, understanding, and non-judgmental.
• Informed consent: The practitioner should explain the treatment process clearly and obtain your informed consent before proceeding with any interventions. They should respect your boundaries and allow you to stop or modify treatment at any time.
• Collaboration: A trauma-informed practitioner will often collaborate with other healthcare professionals, such as therapists or counselors, to provide comprehensive care.
• Awareness of triggers: The practitioner should be aware of potential triggers that may arise during treatment and take steps to minimize their impact. This may include modifying treatment techniques or providing grounding exercises.

When you meet with a potential practitioner, ask them about their experience with trauma-informed care and their approach to treating pelvic floor dysfunction. Pay attention to how you feel in their presence. Do you feel safe, respected, and understood? Trust your instincts and choose a practitioner who you feel comfortable working with.

Why Trauma-Informed Care Matters for Pelvic Health

Trauma-informed care is essential for pelvic health because it addresses the underlying causes of pelvic floor dysfunction, rather than just treating the symptoms. By acknowledging the impact of trauma on the nervous system and the mind-body connection, trauma-informed practitioners can provide more effective and holistic care.

Traditional pelvic floor treatments often focus solely on the physical aspects of pelvic floor dysfunction, such as strengthening the muscles or releasing tension. While these treatments can be helpful, they may not be sufficient for individuals who have experienced trauma. Trauma can create deep-seated patterns of tension and dysfunction that require a more comprehensive approach.

Trauma-informed care integrates an understanding of trauma into all aspects of treatment, from assessment to intervention. This includes:

• Creating a safe and supportive environment
• Building trust and rapport
• Providing education about trauma and its impact on the body
• Using gentle and respectful touch
• Empowering individuals to take control of their healing process

By addressing the root causes of pelvic floor dysfunction, trauma-informed care can help individuals to heal from trauma, restore pelvic floor function, and improve their overall quality of life.

Resources: Connecting with Dr. Alicia Jeffrey-Thomas and Further Learning

As mentioned in the introduction, this blog post is inspired by our conversation with Dr. Alicia Jeffrey-Thomas. You can find more information about her and her work on her website: The Pelvic Dance Floor. You can also follow her on Instagram and TikTok: @thepelvicdancefloor.

Here are some additional resources for learning more about trauma-informed pelvic floor care:

• The International Pelvic Pain Society: https://www.pelvicpain.org/
• The Herman & Wallace Pelvic Rehabilitation Institute: https://hermanwallace.com/
• The Trauma Center at Justice Resource Institute: https://www.traumacenter.org/

These organizations offer valuable information, resources, and training opportunities for both practitioners and individuals seeking care.

Conclusion: Reconnecting with Your Body and Healing from Trauma

The journey of understanding and healing the connection between trauma and the pelvic floor is a deeply personal and often challenging one. However, by recognizing the mind-body connection, seeking out trauma-informed care, and empowering ourselves to take control of our healing process, we can reconnect with our bodies and find relief from pelvic floor dysfunction.

Just as we discussed in this week's episode "Is Trauma Stuck in My Hips?" with Dr. Alicia Jeffrey-Thomas, understanding the pelvic floor and taking care of it is something everyone can benefit from. This goes for men and women of all ages. It's vital to remember that healing from trauma is possible, and that you are not alone. By seeking out the right resources and support, you can reclaim your body and live a life free from pain and dysfunction.

Remember to listen to your body, trust your instincts, and be patient with yourself. Healing takes time, and there will be ups and downs along the way. But with the right support and a commitment to self-care, you can achieve lasting relief and reclaim your well-being.