What Is Pelvic Congestion Syndrome?
Pelvic Congestion Syndrome occurs when veins within the pelvis become enlarged and blood does not flow through them as efficiently as it should. This can contribute to increased pressure within the pelvic veins and chronic pelvic discomfort.
PCS can be difficult to recognize because its symptoms can overlap with several other pelvic health conditions.
Symptoms may include:
- Chronic or aching pelvic pain
- A feeling of heaviness or pressure in the pelvis
- Pain that worsens after prolonged standing or sitting
- Increased discomfort later in the day
- Pain during or after intercourse
- Low back, hip, or abdominal discomfort
- Pelvic symptoms that may change around menstruation
Not everyone with pelvic pain has PCS, and these symptoms can occur with many other conditions. Proper medical evaluation is important for determining whether pelvic venous problems are actually contributing to your pain.
Can Pelvic Floor Physical Therapy Help PCS?
Pelvic floor physical therapy does not repair or eliminate the enlarged veins responsible for Pelvic Congestion Syndrome. PCS is a vascular condition and may require evaluation and treatment by an appropriate medical specialist.
However, chronic pelvic pain can cause secondary changes throughout the pelvic floor, hips, abdomen, back, and nervous system. Muscles may begin guarding in response to pain, breathing patterns can change, movement may become more restricted, and everyday activities may become increasingly uncomfortable.
This is where PCS pelvic PT can be helpful.
Rather than treating the abnormal veins directly, pelvic floor PT can address the musculoskeletal and movement-related problems that may develop alongside chronic pelvic pain.
What Might Pelvic PT Address?
A pelvic floor physical therapist may address:
Pelvic floor muscle tension: Chronic pain may cause the pelvic floor muscles to remain guarded or overactive. Learning how to relax and coordinate these muscles may decrease an additional source of discomfort.
Breathing and pressure management: The diaphragm, abdominal muscles, and pelvic floor work together to manage pressure within the abdomen and pelvis. Improving breathing mechanics and pressure management may help reduce unnecessary strain during everyday activities.
Hip and low-back mobility: Pelvic pain often affects how people sit, stand, walk, and exercise. Addressing mobility restrictions around the hips, pelvis, and spine may improve movement and decrease secondary muscle pain.
Core and hip strength: Avoiding painful movements for long periods can contribute to weakness or altered movement patterns. Gradual strengthening can help improve support and confidence with activity.
Nervous system regulation: Persistent pain can make the nervous system increasingly sensitive. Relaxation strategies, breathing exercises, graded movement, and other pain-management techniques may help decrease this heightened response.
Activity modification: If standing, sitting, exercise, or certain daily activities worsen your symptoms, your therapist can help identify strategies for modifying those activities without unnecessarily avoiding movement altogether.
What Does Pelvic Floor PT for PCS Look Like?
There is no single exercise program that works for everyone with Pelvic Congestion Syndrome.
Your first visit may include an assessment of your posture, breathing, core function, hip and spinal mobility, pelvic floor function, and the movements or positions that reproduce your symptoms.
Treatment may include gentle mobility exercises, breathing and relaxation techniques, pelvic floor muscle down-training when appropriate, manual therapy, progressive strengthening, and education about managing symptoms during daily activities.
An internal pelvic floor examination may sometimes be helpful, but it is not automatically required for every patient. Your treatment should be based on your symptoms, comfort, consent, and clinical findings.
Should I Do Kegels if I Have Pelvic Congestion Syndrome?
Pelvic pain does not automatically mean your pelvic floor is weak. Some people experiencing chronic pelvic pain actually have pelvic floor muscles that are already overactive or have difficulty relaxing.
Adding repeated Kegels without first determining what your pelvic floor needs could potentially increase muscle tension or discomfort.
A pelvic floor assessment can help determine whether you need strengthening, relaxation, coordination or a combination of these approaches.
Physical Therapy Should Be Part of a Team Approach
Because PCS involves the pelvic veins, pelvic floor PT should not replace appropriate medical evaluation.
Depending on your symptoms and diagnosis, your healthcare team may include your gynecologist, primary care provider, vascular specialist, interventional radiologist, or other specialists in addition to your pelvic floor physical therapist.
This multidisciplinary approach allows the underlying vascular condition and its effects on your muscles, movement, and daily function to be addressed appropriately.
Consider discussing pelvic floor physical therapy with your healthcare provider if PCS is accompanied by:
- Persistent pelvic or abdominal discomfort
- Pelvic floor muscle pain or tightness
- Pain during or after intercourse
- Hip or low-back pain
- Difficulty exercising comfortably
- Increased muscle guarding
- Changes in movement because of pain
- Difficulty returning to normal activities
You do not have to wait until your pain becomes severe before asking whether pelvic rehabilitation could be appropriate. Looking to optimize your well being with pelvic floor physical therapy? Reach out to us at Pelvic Health Center in Madison, NJ to set up an evaluation and treatment! Feel free to call us at 908-443-9880 or email us at [email protected]