Pelvic floor muscle spasms can be painful, as well as mess with healing and your confidence. They can also clue you in to specific areas of pelvic floor dysfunction that you can work on. These muscle spasms can be felt as sharp pains or deep aches in the vaginal/rectal area and may be just on one side -- usually opposite an injured area (such as from an episiotomy or tear during delivery). Different from pain that is on the outer skin, these spasms are felt deeper in the first 2-3 inches of the vaginal opening. Pelvic floor spasms can cause pain with sex or tampon use and difficulty with bowel movements from pushing stool against a tightened muscle. Spasms restrict blood flow slowing healing and can lead to very tired muscles - not just in the pelvic floor but the groin/upper leg muscles. This muscle fatigue typically improves with rest. If your pelvic pain is better in the morning but you have more discomfort as your day moves on you may be experiencing muscle spasm in your pelvic floor muscles. Are pelvic muscle spasms cramping your style? Try these techniques at home to help you relax, soothe muscle spasm and reenergize your day with confidence.
The pelvic floor muscles are arranged in two layers: superficial and deep. They sling like a hammock in the pelvis supporting the bladder, uterus and rectum, intertwining through the spaces around the urethra, vagina and anus. Stretching and straining during pregnancy and childbirth can leave both layers of pelvic muscles irritable. For irritable muscles (and mommies), a little R&R goes a long way. Help your pelvic floor muscles relax by slipping into a warm bath for 15 min (ideally) then practice the following stretch.
Pelvic Floor Stretch and Breathing
Lying on your back, draw both knees toward your chest then let your knees separate so they line up with your armpits on either side. Hold this position, relaxing your upper body and allowing the bottom of your hips to open wide. While you breathe in, imagine your pelvic floor softening and opening with each breath (Wallace). Hold this stretch for 2 to 3 minutes. This breathing and imagery also works to facilitate a bowel movement by relaxing the appropriate muscles.
Pelvic floor muscle spasms can feel like cramping that you get with your period and can come either intermittently or be very painful and constant. Trigger points are painful areas caused by persistent muscle spasm. Imagine a muscle bound up so tight in a knot that it can't release. Massage or pressure on these tender points will help the muscles relax.
Trigger Point Release for Pelvic Floor Muscle Spasm
Lie on your back with knees bent and supported with pillows, or while sitting on the toilet, insert your thumb into the vagina and feel the vaginal walls both sides and back toward the rectum for areas of tension. When you find a tender spot press with your thumb gently at first then gradually increase pressure as you picture (and feel) that muscle relaxing. If the area is getting more painful use less pressure. Pain from a trigger point will melt away as you feel the muscle relax. You may have an area that needs several sessions of gentle pressure before it will release. Try this trigger point release once daily over 5 to 7 days. Then repeat as needed (Wallace).
Typically women are encouraged to wait until after the 6 week postpartum visit to resume having sex. Intimacy is an important aspect of your relationship and concerns about discomfort should be discussed with your partner and medical provider. For example, vaginal dryness is very common postpartum due to hormone levels, especially while breastfeeding. Muscle spasm with added dryness can make sex difficult to say the least. Selecting a silicone or water-based lubricant that works well for you can smooth out your nerves and help avoid discomfort. Other issues like scar pain or adhesions may be affecting your confidence in bed. Physical Therapist Kathe Wallace talks more in-depth about reducing muscle spasm, scar massage, and lubricants in her book "Reviving Your Sex Life After Childbirth" -- a definite must-read for anyone looking for additional guidance on addressing concerns about intimacy postpartum.
Use the 50/50 Rule
We see more and more in the women we work with, that choosing to focus half your time on relaxation techniques makes significant leaps forward in your ability to strengthen the pelvic floor. For those with lots of tension, pelvic strengthening exercises may become nearly impossible until the ability to consciously relax the pelvic floor is achieved. For women who continue to have difficulty relaxing the pelvic floor, a pelvic floor specialist is trained to help (using biofeedback and imagery) by teaching you how to relax first, then begin strengthening in order heal.
Releasing trigger points, stretching and relaxing tight muscles, as well as slipping a lubricant into your dresser can help ease your return to regular activity and intimacy. Soaking in a warm bath while you read Kathe’s book is a great way to start your R&R and learn more about your postpartum body. At Mommy Ready we hope you’ll recognize that these symptoms happen commonly after childbirth and to discuss pelvic pains with your medical provider because they can improve with some simple techniques as described above. Being able to reduce spasm and relax your pelvic floor is just as important as learning to correctly do your pelvic floor exercises. When your pelvic floor can relax appropriately, your strength and healing both improve.
Reference: Wallace, Kathe, "Reviving your sex life after childbirth: Your guide to pain-free and pleasurable sex after the baby," (2014). Purchase the book at www.kathewallace.com.