Pelvic pain is a diagnosis we see commonly here. Pelvic Pain generally encompasses pain anywhere from below the belly button to the thighs. The pain can be diffuse (ie all across the low back and pelvis) or quite focal (ie vaginal or rectal pain).
When you are experiencing pain, exercise can seem like a near impossible task. However there are things that you can do to keep you moving and exercising even if you are dealing with pelvic pain.
One of the things we know about pain is that exercise is actually really important to relieving pain symptoms. You might be too intimidated to even know what kind of exercise to do if you have pelvic pain. Maybe you have wanted to exercise, but you don’t know what exercises are right for you and what exercises are wrong for you with pelvic pain.
Exercise is really anything that is physical activity that you put effort towards. It can be as simple as stretching or diaphragmatic breathing. It could be crossfit, walking, running, yoga, stretching, tennis, or weight lifting. Any of those things are considered exercise. When you are experiencing pelvic pain or pain in the pelvic region, it’s just important just start moving. All you need to do is start somewhere and listen to your body as you’re starting to move.
Ideas to Start or Keep Exercising with Pelvic Pain
1. Start with a simple stretching routine. Stretching is a really great way to help alleviate pain. It gets muscles more flexible. It gives you more mobility. Try to hold a stretch for at least 30-60 seconds and avoid bouncing into the stretch. Start slowly and see how your body reacts to the stretch. If it feels like it is making your pelvic pain worse, you should back off the stretch.
2. Simply Walk. If you are not a walker or if have pain when you move, start with a very short, flat, no-incline walk for about 5 minutes. See how your body feels and then next time, if your pain did not increase with the walk, go ahead and add a little more time. Try to work up to doing at least 30 minutes of walking a day. Don’t worry if you can’t do it all at one time, short bursts of movement are great way to get started.
3. Scale Back in Intensity If you are an avid exerciser that is starting to have pain with exercise, the best thing that you could do is to scale back – as hard as it might be. For example, if you are a runner, you could go for more interval jogs where you jog for a little bit and walk for a little bit. See how your pain behaves. You could also go for time versus distance. If you are a weight-lifter you may make modifications by doing less reps or lifting lower weight amounts.
When it comes to exercising in pain, if you are exercising and your pain is getting worse, you need to make some modifications to what you are doing. We frequently tell patients to rate their pain before they start exercising, a few times while they are exercising, and again after exercise. If their pelvic pain is a 3/10 before they start exercising and stays at a 3-4/10 during exercise, then it is okay for the patient to continue. IF the pain starts to spike to 5-6/10 then then patient should back down and modify.
Things NOT To Do When Exercising with Pelvic Pain
1. As stated before, don’t push through your pain.
2. Don’t get stuck in the mindset that you have to push yourself to exhaustion for the exercise to be beneficial. You can do easy, simple movements and still be exercising and doing good things for your body. Don’t go into it with this all or nothing mentality that I have to do this 30-minute program and have to be sweating to get the benefits out of it. You can do something very easy like walking, swimming or yoga and still be getting good exercise.
3. Don’t put a heavy focus on abdominal exercises- specifically crunches. These are not a great thing for pelvic pain because as you are crunching, you are putting so much pressure onto the abdomen and pelvis and that could be exacerbating your symptoms. If you’re finding that your core workout or your ab workout is making your pelvic pain worse, it’s best to scale back on those. One of the things that we would recommend doing instead would be to work with your whole core as a unit. Work the whole pelvis versus just your abdominals.
4. Don’t do alot of kegels (contractions of the pelvic floor muscles). Some people have worse pain when they do a kegel exercise. If you kegel and you have worse pain, it could be that you are over-tightening your pelvic floor muscles or can even go into cramping or spasming because of it. Doing kegels is not necessarily going to help your pain and definitely if you are doing them and they make your pain worse, you need to discontinue them.
When it comes to pelvic pain, it is always best to be cautious about what you’re doing and ease into things. Then, of course, listen to your body every step of the way. Regardless of where you are in your fitness and your exercise, taking a first step to move better and get more movement into your life is key. If you’re able to do that and you take that first step, congratulate yourself for taking that initiative in conquering some fears when it comes to exercising with pain.
If you aren’t sure how to get started with exercising with your pain, you could always give us a call here at Legacy. Our experienced pelvic physical therapists will be happy to help answer your questions about pain and exercise.