Manual Therapy

As a secondary treatment to the breathing exercises described in this web site, patients can engage on a course of manual therapy. This treatment can take place in parallel with breathing based treatment.

Manual therapy is the process of physically releasing tight muscles that will not let go voluntarily. It can be performed by the patient themselves or with the assistance of a physiotherapist.

Manual therapy techniques for the pelvic floor include stretching and trigger point treatment where a muscle is tense. A short or tense muscle is identified by internal examination and then stretched centrally along the bulk of the muscle or at the attachment to bone which is often more uncomfortable. A trigger point will often refer pain elsewhere in the pelvic floor or to the hips or rectum or may just be painful on the spot. Once held for a few seconds the pain eases and the therapist moves on to the next point. There are also nerves in the pelvic floor and they can be mobilised along their pathways. There is often external tension in the pelvis and abdomen linked to internal restriction, this is known as a connective tissue restriction. This can be successfully released through manual therapy externally on the identified areas.

Manual therapy should not be so painful that the patient reacts by tensing up. The pelvic floor muscles should not be sore after manual therapy.

We are currently working on a section on manual therapy which will be helpful to patients and their physiotherapists. This will include:

1. Pelvic Floor Manual Therapy
2. Connective Tissue Manipulation
3. Pelvic Girdle Manual Therapy