Pelvic floor massage is recommended by pelvic health physical therapists to relieve symptoms of pelvic floor dysfunction and chronic pelvic pain.

Learning to massage the musculoskeletal system of the pelvic floor can alleviate painful trigger points, strengthen weakened pelvic muscles, and relieve symptoms like constipation, pain during sex, pelvic muscle spasms, and urinary incontinence. 

What Is the Pelvic Floor? 

Along with the help of the abdominals, back muscles, and diaphragm, the pelvic floor is a group of muscles, ligaments, and tendons that help stabilize and move the body.

Connecting like a hammock from the pubic bone to the tailbone and either side of the pelvic bowl, the pelvic floor also protects and supports the pelvic organs such as the bladder, bowel, rectum, urethra, uterus, and vagina.  

A contraction (or temporary tightening) of the pelvic floor muscles, for example, typically closes the openings of the anus, urethra, and vagina. When the pelvic muscles relax, however, an opening of these orifices is allowed for the excretion of feces, gas, and urine, as well as sexual arousal and pleasurable sex.  

If the pelvic floor muscles weaken or tighten, the function of the above-mentioned organs can be adversely affected. Known under the general term of pelvic floor dysfunction, weak or tight pelvic floor muscles can result in symptoms like:

  • Chronic pelvic pain
  • Urine or fecal incontinence
  • Constipation
  • Pain during urination or bowel movements
  • Pain during sex (dyspareunia)
  • Trigger points in the pelvis that are painful to touch

What is a Pelvic Floor Massage?

Pelvic floor massage is a typical component of pelvic floor physical therapy but it can also be performed at home to relieve chronic pelvic pain and pelvic floor dysfunction. Also incorporating the bones, cartilage, connective tissues, ligaments, and tendons of the pelvic area, pelvic floor massage helps to re-train and improve mobility of the pelvic floor muscles. 

If you are looking to rejuvenate weak pelvic floor muscles, reduce pelvic pain and trigger points, or alleviate the symptoms of pelvic floor dysfunction, pelvic floor massage can help relax the deep muscles of the pelvic floor. 

Although part of a pelvic floor massage is performed internally via the vagina or rectum, it also involves external massage and stretching.  

Benefits of Pelvic Floor Massage

Pelvic floor massage can help alleviate discomfort and improve overall pelvic health by relaxing tight muscles, enhancing circulation, and reducing pain in the pelvic area. It can be particularly beneficial for those experiencing conditions like pelvic floor dysfunction, chronic pelvic pain, or after childbirth.

  • Reduces symptoms of pelvic floor dysfunction
  • Improves blood circulation in the pelvic region
  • Alleviates chronic pelvic pain
  • Enhances sexual health and function
  • Supports postpartum recovery
  • Decreases urinary incontinence symptoms

How to Perform Pelvic Floor Massage at Home

Because it can be difficult to locate the pelvic floor, women experiencing pelvic floor dysfunction or chronic pelvic pain are normally advised to schedule a consultation with a pelvic floor physical therapist to learn about pelvic floor massage. If that is not possible, the following step-by-step guide to performing pelvic floor massage at home will help. 

  • Begin by washing your hands thoroughly and find a quiet area in your home where you won’t be disturbed. Have a bottle of water-based lubricant at hand that won’t irritate the vaginal tissues,
  • Using blankets or pillows as props, lay down and find a comfortable position where your body feels relaxed. 
  • To prepare the pelvic musculoskeletal area for massage, perform some warm-up stretches by bringing your knees toward the chest. Breathing calmy in through the nose and out through the mouth, gently circle the knees three times in one direction and three times in the opposite direction.  
  • Laying on your back or turning on your side, use the blankets or pillows to find a position where you can comfortably reach your vagina. (For many women, it helps to lay on the back, bend the knees, and keep the feet flat.)  
  • Take a minute to relax into your breathing, feeling your abdomen gently rise as you inhale and fall as you exhale. Finding a gentle rhythm of breathing like this will help to relax your pelvic floor. Continue to breathe gently until you feel ready to start your massage.   
  • Begin by massaging externally by applying some lubricant to the perineum, which is the area of the body between the vagina and anus. For thirty to ninety seconds apply some gentle circling pressure from your first two fingers to massage the area, relax the muscles, and improve blood flow. 
  • For an internal pelvic floor massage, apply lubricant to your vaginal opening and insert the thumb or index finger about an inch inside the vagina, allowing the remaining fingers to relax along the inside of your thigh. If it feels more comfortable, you can also use the thumb and index finger together. 
  • Imagine the vaginal canal as a clock, where the anus is 6:00 and the pubic bone is 12:00. 
  • Placing the thumb or finger at the 6:00 position, apply a very gentle amount of pressure and slowly move it counterclockwise against the wall of the vaginal canal. (To prevent contact with the urethra or bladder, avoid pressing the area between 11:00 and 1:00) 
  • Moving slowly, identify tender spots or trigger points and press the thumb or finger gently against it for thirty to ninety seconds while breathing in through the nose and out through the mouth. If it feels good, you can also move the finger or thump in a circular motion against the painful spot. 
  • Finding these trigger points and tender spots, helps to establish a deeper connection with the pelvic floor muscles. When massaged and relieved through the regular practice of massage, the symptoms of pelvic floor dysfunction and chronic pelvic pain can be relieved.  
  • If the massage feels too painful, release some pressure on the painful spots and try to continue more gently. 
  • Now move slowly clockwise and gently apply pressure to any tender spots or trigger points you encounter. Release pressure if the massage feels painful, and once again avoid the area between 11:00 and 1:00, 
  • As you progress with pelvic floor massage, the finger or thumb can be inserted as much as four inches into the vaginal canal, rotating clockwise and counterclockwise to identify pain and apply massage for relief. Always make sure to move slowly and gently. 
  • When you’re ready to stop the massage, perform the same warm-up stretch to cool down. This will allow the pelvic muscles, ligaments, and tendons to relax before you stand up and go about your day.  

Why Would Someone Need a Pelvic Floor Massage?

A pelvic floor massage, often referred to as pelvic floor physical therapy, may be necessary for several reasons. It is typically used to relieve symptoms associated with pelvic floor dysfunction such as chronic pelvic pain, urinary or fecal incontinence, and sexual discomfort.

This type of massage can help relax tight pelvic muscles, improve blood circulation, and enhance overall pelvic health. Additionally, it can be beneficial for both men and women recovering from surgery or childbirth, aiming to strengthen and stabilize the pelvic region.

What Causes Pelvic Floor Dysfunction & Chronic Pelvic Pain? 

Pelvic floor dysfunction and chronic pelvic pain are often interrelated, in that, one often causes the other. Pelvic floor dysfunction is described as the failure to correctly contract and relax the pelvic floor muscles. Chronic pelvic pain is described as pain that lasts for more than six months. This type of pain can be consistent or it can come and go. 

In women, causes of chronic pelvic pain and/or pelvic floor dysfunction can include, but are not limited to the following: 

  • Pregnancy 
  • Childbirth
  • A sedentary lifestyle
  • Pelvic injuries or surgeries 
  • Poor posture
  • Muscle disorders or dysfunction
  • Holding your urine for too long
  • Pelvic trauma
  • Sexual abuse
  • Stress and anxiety

Underlying conditions that are known to cause female chronic pelvic pain and/or pelvic floor dysfunction include: 

  • Endometriosis
  • Untreated vaginal infections
  • Chronic pelvic inflammatory disease
  • Fibromyalgia
  • Fibroids
  • Irritable bowel syndrome
  • Interstitial cystitis
  • Vaginismus
  • Vulvodynia

Manual Therapy in Pelvic Physical Therapy

Given the intimacy of the area involved, it’s understandable that women might feel too embarrassed to speak to a professional about it. It might help to know that pelvic floor physical therapists are experts in the field of pelvic health and performing pelvic floor massage as a part of manual therapy is a routine part of their profession that causes them no embarrassment. 

It might also help to know that after you’ve learned how to perform a pelvic floor massage, you can continue in the comfort of your own home. For those who don’t feel comfortable using their finger or thumb for pelvic floor massage, pelvic floor physical therapists can also recommend pelvic massage wands, and/or vaginal dilators. Which is better for you, will largely depend on your condition and what has caused your pelvic floor dysfunction. 

What’s important to remember is that the benefits of pelvic floor massage are life-changing for those suffering from chronic pelvic pain and/or pelvic floor dysfunction.

Through pelvic floor massage, patients can begin to build confidence in touching pelvic areas that are sensitive or painful. They can also reduce or completely alleviate chronic pelvic pain, improve bladder & bowel control, as well as increase sensations of sexual arousal, and enjoy more pleasurable sex.  

Conclusion

If you are suffering from chronic pelvic pain or pelvic floor dysfunction, don’t be embarrassed to speak with your healthcare provider or a pelvic floor physical therapist in your area about pelvic floor massage. Whether it is performed with your finger, thumb, pelvic massage wand, or vaginal dilator, the results can significantly improve your quality of life.

References

Physiopedia – Pelvic Floor Anatomy - https://www.physio-pedia.com/Pelvic_Floor_Anatomy

Cleveland Clinic – Pelvic Floor Dysfunction - https://my.clevelandclinic.org/health/diseases/14459-pelvic-floor-dysfunction

American College of Obstetricians & Gynecologists – Chronic Pelvic Pain - https://www.acog.org/womens-health/faqs/chronic-pelvic-pain

Aeroflow Urology – A Guide to Pelvic Floor Massage: Enhance Your Health & Wellness - https://aeroflowurology.com/blog/pelvic-floor-massage

The Pelvic Hub – Vaginal Dilator Therapy: What Exactly Is It? - https://www.thepelvichub.com/ask-the-experts/vaginal-dilator-therapy

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