Physical Therapy – Post Procedure
February 2, 2014 at 1:23 pm #9106KarenKParticipant
Hi all – I thought I would write a quick post about PT post-procedure in case it may be helpful for someone else. Before my procedure with Dr. Pacik, I was seeing a PT once a week for almost 2 and a half years. I was using the white silicon dilators on my own, and with my PT, I was doing several exercises to release tone in my pelvic floor muscles. My PT was also using her fingers to manually stretch the inside of my vagina and used lidocaine to “numb” the PC entry muscles. During our sessions, my muscle spasms would eventually relax enough to let her do her “thing” but I would still feel initial pain upon entry. Over time the pain would go away quicker, but the initial pain upon entry was still there. I am happy to report that after this procedure, my PT appointments are SO much easier and there is absolutely zero pain upon entry. The lidocaine is not even used anymore (just lube), and I have absolutely no issues whatsoever. Everything is just so much easier, and my PT can tell this as well. She did notice some tone on the right side still but she thought that the right side could be overcompensating for the left side – as my left side was always way worse in terms of spasm and tone over the span of the 2 and a half years I saw her. Either way, the tone has decreased drastically, my PT has absolutely no issue at all getting past the PC muscles, and I can experience the whole appointment pain-free now. I never thought in a million years I would get to this point. If you are like me and feel like you need an extra push to get you over the hump after a few years of PT, I greatly, greatly encourage you to have Dr. Pacik’s procedure. You will never regret this decision, I promise.February 5, 2014 at 12:13 am #12475NakitalabParticipant
I am so happy for you KarenK! Thank you for sharing!February 8, 2014 at 9:35 pm #12492Heather34Moderator
This is an excellent post Karen!!!! It is so interesting to read of the significant changes that your PT sees from pre-procedure to post-procedure in terms of your entry muscles. This was always what prevented both my hubby and I from being able to insert anything at all (i.e. the blocked / wall of resistance feeling). Post-procedure, it went away and we were able to use all of the sized dilators as well as have pain-free intercourse as we were not fighting to get past the wall. Excellent, excellent post!!!!!July 20, 2016 at 4:12 pm #19529Heather34Moderator
This is an interesting post. To the Maze team, for someone who may need further help with dilation, either before Botox or after Botox, could you share about Pelvic Floor PT?November 15, 2016 at 5:25 pm #19980mazemelissaModerator
Physical Therapy can be an extremely helpful tool in overcoming vaginimsus. I often refer to Physical therapy for my patients who continue to struggle through dilation, or still find that intercourse is painful even after being able to insert all the dilators.
With vaginismus the pelvic floor muscles become short and tight, and create a much smaller tighter vaginal opening. Dilation, passing the dilators through the vaginal entrance over and over, will help stretch the muscles, relax the muscles and lengthen the mucles, which will create more blood flow and oxygen to the area, and make the area less painful. As one continues to dilate, the muscles further and further relax.
However, for some patients, dilation alone is not enough. The muscles are so tight, or in such spasm, traditional dilation will not bring the patient to a pain free state.
It is at this time that I usually will recommend the Botox procedure and or physical therapy. Not everyone is ready to make the commitment to the Botox procedure, either for financial reasons, or family commitments, and Physical therapy can be a great alternative. Many can find PTs in their area, and some even accept insurance.
Physical therapy after the botox procedure can also be very helpful for patients struggling to do the dilation on their own. PTs can work with you with the dilators.
A quick google search for pelvic floor physical therapy in your area might be a great place to start to help get treatment.April 19, 2017 at 5:09 pm #20837Helen Leff, LCSWModerator
I recently got a call from one of our patients who was working on dilation and found herself getting stuck – physical therapy was suggested. She called to say that she and her husband of several months just had successful pain free intercourse for the first time. Physical therapy was key for her and it may be for you too!
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