“A what? For where?!” These are the two questions I get in rapid-fire succession when I tell my non-pelvic health physical therapy friends about one of my favorite pelvic health tools, the TheraWand. As physical therapists, we are used to providing our patients with home programs to help maintain their progress and allow them to independently manage their symptoms. We give out elastic bands to strengthen shoulders and hips, foam rollers to work out stiff legs, but when it comes to problems deep inside the pelvis, we sometimes forget about the great tools we have at our disposal to speed the recovery process and to allow our patients to take charge of their own conditions. The TheraWand is a beautiful S-shaped tool that helps to release trigger points within the pelvic floor to help it function better and with less pain. It is an essential part of my practice.
What is the pelvic floor and why do I need to worry about it?
The pelvic floor has generated a lot of buzz lately. You hear instructors in Pilates and yoga classes instructing you to use it. Some people go to physical therapy for it. But what is it exactly?
The pelvic floor is the name for the area of muscles between your legs. These muscles have 3 functions. 1.) Sexual, 2.) Sphincteric , and 3.) Structural. It’s a pretty big job, for such a small area of the body, thanks pelvic floor!
The sexual function of the pelvic floor is performed by muscles in the outermost layer. These muscles engorge with blood when one is aroused, contract to provide help with erection in both clitoral and penile tissue, they also provide pleasurable sensations during orgasm.
The sphincteric function helps to maintain continence. It controls urination, defecation, and flatulence. This is the portion one uses to suppress gas and hold urine and feces until an opportune moment.
The final function is structural and is the deepest layer of muscle in the pelvic floor. It helps to maintain the alignment of not only the pelvis but provides support to the low back during both intense and everyday activities.
If the pelvic floor is not functioning well, you may notice that one of the above three functions will start to decline. You may experience sexual pain, difficulty with erection, difficulty holding gas, feces, or urine. You may experience pain in your low back or sacroiliac joint. When these symptoms pop up, it is time to take a close look at the pelvic floor.
So what can go wrong with the pelvic floor to cause symptoms?
From a musculoskeletal standpoint, it can be one of two issues. Either the pelvic floor is too loose to generate a strong enough contraction to fulfill its duties, or it can be too tight or have trigger points, which prevent it from being able to generate enough force to do its job. Patients with pelvic floors at are entirely too loose, without any trigger points, are the unicorns of my practice. They are mythical creatures that I hardly ever see, (they do exist). In the case of too loose pelvic floors, we typically start a strengthening program and send them on their way while incorporating changes in posture and daily habits to help facilitate their progress.
The far more common scenario are patients with muscles that are too tight or have trigger points (taut areas of muscle spasms) that prevent the muscle of the pelvic floor from generating enough force when it contracts to have the appropriate effect. These patients need a little more hands on work. Patients with trigger points or pelvic floors that are too tight do not get better and often get worse from strengthening alone. Physical Therapists work to manually release and stretch the muscles to help restore their full function. Often times, once the muscle is released, we find a great increase in strength without actually doing any formal strengthening.
One of the frustrating parts of releasing the pelvic floor is it sometimes can require a lot of work and for the busy clientele who come to our Manhattan based clinic, it is not always possible to come in the amount of times required a week to affect change in the muscle.
That’s where TheraWand comes in! I use it to help augment the work I do on the muscles of the pelvic floor in between sessions. It allows my patients the ability to access all the areas of the pelvic floor that need attention and can help expedite their progress to help them get out of the clinic and back to their everyday lives.
What makes the TheraWand different from other tools?
Why the TheraWand? Why not a dilator, why not my finger? Dilators and (CLEAN!) fingers are great, the work well on stretching the outer most portion of the vagina and work especially well for women who have trouble accommodating penetration secondary to tight superficial muscles.
What they aren’t so great at is accessing deeper muscles in a thorough fashion. Imagine the pelvic floor as a bowl with either one or two holes in it (one if you are a man, two if you are a lady). Now imagine trying to touch the entire inside of the bowl with straight object by maneuvering through the hole. It would be pretty difficult. That’s essentially what the drawback is for straight tools; they have limited access to the entirety of the pelvic floor.
What I love, love, LOVE about the TheraWand is its curved S-like shape. The curve of the wand allows the user to access all of his or her pelvic floor without having to constantly re angle the tool. It allows the user to access deeper parts of his or her pelvic floor without having to take it out to readjust.
Although I specialize in pelvic floor physical therapy, I do care for all of my patients’ body parts, even not just the pelvis. TheraWand clearly does too!
How do I know the TheraWand is right for me?
The TheraWand is a tool in the rehabilitative process. Like all rehabilitative tools, the guidance of a physical therapist will help to ensure your safety and that you select the right tool and program for your particular condition. The pelvic floor is a complex area and is the intersection of many different organ systems. It is important to get a skilled eye to help guide you through your healing for optimal results.
Fiona McMahon, DPT