What Does Physical TherapyHave To Do With Sex?
If you’ve ever had back pain, sprained your ankle, or experienced shoulder surgery, you might have gone to see a physical therapist. If you did, you probably experienced a combination of hands-on therapy and exercises that (hopefully) helped you move better, decreased your pain, and got you back to a relatively normal life.
On the other hand, if you’ve ever had pain with sex, trouble going to the bathroom, or leaking when you cough, a physical therapist may not have been the first person you thought of. Most people don’t know who to ask when it comes to pelvic floor problems. Not only that, but many doctors completely avoid talking about sex with their patients, despite the fact that up to 1 in 4 women report having pain with intercourse1.
So what does this have to do with physical therapy? It may surprise you to learn that there is a whole field of physical therapists dedicated to treating the issues that no one else talks about. I’m one of the few PT’s who regularly asks my patients about their sex lives, their bowel movements, and if they are leaking after having their baby. Nothing is “too much information” here!
The Pelvic Floor
How in the world can a physical therapist help with painful sex? Physical therapists are the experts of musculoskeletal rehabilitation. And the pelvic floor is a group of muscles! Therefore, it’s something that we have full capability of treating.
So what is the pelvic floor? You’ve probably heard the term, but you may only have a vague idea about what it actually means.
The Pelvic Floor
How in the world can a physical therapist help with painful sex? Physical therapists are the experts of musculoskeletal rehabilitation. And the pelvic floor is a group of muscles! Therefore, it’s something that we have full capability of treating.
So what is the pelvic floor? You’ve probably heard the term, but you may only have a vague idea about what it actually means.
Your pelvic floor consists of a group of muscles and connective tissue that sit at the bottom of your pelvis and act like a “hammock” to support your internal organs. It also controls urination and defecation, helps with breath support and posture, and is important in sexual functioning. You have conscious control of your pelvic floor – you can contract and relax it, and it also subconsciously contracts and relaxes when you go to the bathroom, while exercising, and during sex. It has been shown to react to stress and fear by tightening up2.
Why Sex Might Be Painful
Normally, all of these functions are done without you having to think about it! Occasionally however, something happens that may throw the whole system out of balance, and things stop working the way they should. This could be from aging, pregnancy, giving birth, a change in sexual status, or any sort of trauma. The pelvic floor may stop relaxing and contracting fully, which may lead to it carrying too much or too little tension. As a result, you might experience pain with sex.
For example, in some people, the pelvic floor muscles may spasm whenever sex is attempted. A vicious cycle is created where sex is painful, which causes anxiety (remember how the pelvic floor reacts to fear?) The muscles tighten up more, and sex continues to cause pain. This condition is called “vaginismus”, one potential reason why a person might experience pain with sex.
How Physical Therapy Can Help
Like I said before, PT’s are the experts on musculoskeletal rehabilitation. We combine manual therapy like massage and scar tissue release with specific exercises, breath work, and down-training to help patients manage spasms, relax tight muscles, and learn how to control their pelvic floor. Physical therapy has been shown by research to be very effective in helping retrain the brain and muscles to allow for sexual activities with less pain3.
So if you ever have pain with intercourse, leakage, or any other pelvic floor issue, pelvic physical therapists are here to help you get back to living your best life!
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Book a session with one of our Pelvic Health Physical Therapists. Get in touch with us for more information or inquiries.
Citations
- Mitchell KR, Geary R, Graham CA, et al. Painful sex (dyspareunia) in women: prevalence and associated factors in a British population probability survey. BJOG. 2017;124(11):1689-1697. doi:10.1111/1471-0528.14518
- Van der Velde J, Everaerd W. The relationship between involuntary pelvic floor muscle activity, muscle awareness and experienced threat in women with and without vaginismus. Behav Res Ther. 2001;39(4):395-408. doi:10.1016/s0005-7967(00)00007-3
- Ghaderi F, Bastani P, Hajebrahimi S, Jafarabadi MA, Berghmans B. Pelvic floor rehabilitation in the treatment of women with dyspareunia: a randomized controlled clinical trial. Int Urogynecol J. 2019;30(11):1849-1855. doi:10.1007/s00192-019-04019-3