PAINFUL SEX PREVENTION
Prevention is a noun. An action. Something we have to do. While the triggers or reasons for persistent painful sex and chronic pelvic pain disorders can be complex, interconnected, and varied let's start with what we do know.
Tight and clenched stomach, buttocks, legs and chest-breathing, carried over into everyday tasks and daily living, can be harmful to the pelvic floor. And a tight, tense, and too "turned-on" pelvic floor will eventually lose its proper function.
Many sporting activities require these tight body positions in order to perform them well. Dance, running, gymnastics, track, soccer, martial arts, and others place heavy emphasis on core strength, tight body positions and breathing from the chest instead of the abdomen.
Along with overly clenching techniques associated with training for many of these sports, there have been more injuries to young women over the past number of years with increasingly competitive young female athletes. Injuries to ankles, knees, hips, tailbones, and straddle type vulvar traumas all have contributed to chronic pelvic and sexual pain, as well.
The book entitled: “Warrior Girls: Protecting Our Daughters Against the Injury Epidemic in Women’s Sports” by Michael Sokolove points out the consequences of cumulative injuries in young women, not necessarily solely from the lack of appropriate training over the course of their pre and post pubertal years, but also by the exuberance and passion and competitiveness that so many girls exhibit during the course of their athletic years. He points out that so much has been learned in the fields of sports medicine and training that could be preventative for injury, but that commonly, many factors prevent the implementation of good practices by the coaches, trainers, and even the parents of these young women.
These cautions are certainly not meant to endorse quitting sports all together. Instead, we are asking you to be aware that you need to let clenched body positions go when you walk out of practice or performance. If you are a family member or friend of a young female athlete who may have the early symptoms of pelvic pain, try to talk to them about the consequences of holding clenched body positions even though this is quite counter-cultural right now, because it seems everyone is out there trying to actually “strengthen their core”.
If you are injured or feel pain, don’t allow yourself or a family member or friend to “push through the pain” to keep performing. If you would like to learn about our prevention and education initiatives or would like to donate to the program please visit The Foundation for the Prevention of Chronic Pelvic Pain at thefpcpp.org (Now teamed up with Bridge for Pelvic Pain).
Watch the CHapter on Prevention:
The long-awaited Video Guide Healing the Pain 'Down There': A Guide for Females with Persistent Genital & Sexual Pain is now available for purchase.
A woman with chronic pelvic pain brought together a team of multidisciplinary professionals to create this instructional and educational DVD guide for those suffering with “pain down there”. The team represents over 50 years of experience in women’s health related fields including OB/GYN, physical therapy, mindfulness techniques, and human sexuality with their focus being on the treatment of pelvic pain. This educational video is intended for women of all ages who are experiencing pain during intercourse who want to learn why they have their symptoms and learn strategies to improve them. This video is also for teens and young women who may be at risk for developing these symptoms, and for clinicians who are practicing in the field of women’s health.
“Groundbreaking … “
Jill Osborne, MA
ICN Founder & CEO
“A well designed comprehensive view of pelvic pain from a multidisciplinary perspective and clear options for returning to health and well being.”
Sandra Hilton, PT, DPT, MS
“A very important resource for many women...”
Frank Tu, M.D., MPH
" Respected pelvic practitioners create a road map to navigate the challenging path of healing pelvic pain."
Dustienne Miller PT, MS, WCS
An important way to promote or restore function and control of the pelvic floor is through the breath. Clenched abdomen and habitual breathing from the chest directly affects the pelvic floor, making it too tight/tense and "turned on" which can contribute to sexual pain. Shallow chest breathing also cues our bodies into the tensing, fight or flight mode of the nervous system (see previous blog).
Breathing is meant to come from the abdomen/diaphragm, not from the chest. If you've been taught by sports or cultural influences to suck in your abs and breathe from your chest you may need to re-train your body to breathe appropriately. Musculoskeletally, the respiratory diaphragm and the pelvic floor work together.
As you inhale .... the diaphragm lowers and the pelvic floor expands.
As you exhale... the diaphragm and pelvic floor return to their elevated positions.
Therefore, if you are constantly breathing from your chest, your pelvic floor never gets a chance to relax and expand. Mentally check into your breath pattern throughout the day to ensure proper breathing techniques. We go more in depth about how to do this in the DVD, Healing the Pain 'Down There': A Guide for Females with Persistent Genital and Sexual Pain.
Take a look at this image. The Autonomic Nervous System is responsible for managing our breathing, heart rate, and other basic survival processes. This system is not in our conscious control. There are two branches of the Autonomic Nervous System: Sympathetic and Parasympathetic. The Sympathetic branch initiates a fight or flight response. The opposite is the Parasympathetic branch: calming, relaxing, restorative. Both Sympathetic and Parasympathetic are phases of the Autonomic Nervous System. Remember, the Autonomic Nervous System is not in our conscious control.
Stick with me here. When signals from injury or previous injury are interpreted by our brain and our nervous system as painful enough, the Sympathetic branch of the nervous system (the fight or flight response) kicks in. It is an evolutionary response that is meant to be protective. It leads to physiological changes: muscle tension, increased heart rate, increased blood pressure, shallow and rapid breathing, sweating, dry mouth, slowed immune response, inhibited digestion. All this to give us the strength to either fight or run away. It is a stress response.
This response could save our life in moments of real and imminent danger. But we want to stay out of this branch of the Autonomic Nervous System during the times we don't need it, which for many of us makes up the majority of our time. We don't want to 'hang out' here. The question you should be asking at this point is: but how can I help it, since it's not under my conscious control?
GREAT QUESTION! Enter the Somatic Nervous System. The Somatic Nervous System is within our conscious control. It makes possible our body movements as well as how (not whether) we breathe. That means that through the conscious manipulation of breath we can cue into the Parasympathetic branch of the Autonomic Nervous System and induce a relaxation response. Deep, diaphragmatic breathing stimulates the Parasympathetic nerves, which has a calming effect on the entire body. This is where we want to 'hang out'. Shallow, chest breathing cues us right into the Sympathetic system - a tensing, fight or flight type breathing.
1. Ask yourself "how do I breathe?"
2. Is the way that you breathe cueing you into the Sympathetic (fight/flight, tension, stress) system or the Parasympathetic (relaxing, calming) system?
Is your posture and the way that you breathe negatively affecting your pelvic floor, meaning contributing to pain and dysfunction, or positively affecting your pelvic floor, meaning contributing to function and health in the pelvic region?
Stephanie Yeager: Passionate about spreading the word of hope and healing for those like her, influencing a paradigm shift in the medical community toward greater understanding of chronic pelvic pain disorders, and prevention initiatives that may protect young women before onset can occur.