A leading cause of chronic pelvic pain is bad posture, contributing to 85% of chronic pelvic pain cases. The human musculature and skeleton is reliant on each of its components to support and move your body. This means that if you have poor posture, some parts are overworked to compensate for others. This muscular unbalance creates areas of tension, often concentrated in the lower back and pelvic floor. This tension can be quite painful, and this starts a cycle where to reduce the pain you alter the way you stand and sit, creating further tension and pain. In addition, the muscles that are not worked, become weak and less able to support your skeleton and internal organs correctly.
Your risk of suffering from poor posture and related pelvic pain is higher if you are pregnant, as the change in weight affects your spine and pelvis. If you have an office job, you may slump in your chair, or crane your neck to look at a screen which is too low. If you are unfit, you can be carrying around excess weight and the muscles around your spine may be weak.
If you visit your GP complaining of pelvic pain, they will likely discuss your posture and look to see whether it is the cause. If you have poor posture it will be obvious to most medical professionals with a few tests. They will examine the muscles in your pelvis, alongside those of your abdomen and legs. They will be looking for any areas of tenderness, limited flexibility, and weakness.
As well as the impact pelvic pain has on your life, if left untreated you will be stuck in a painful cycle of your pelvic pain leading to further poor posture, leading to worse pelvic pain. If you suffer for a long time, your reduced mobility can lead to pelvic floor disorders (such as a pelvic organ prolapse), arthritis and osteoporosis (weak bones). Both arthritis and osteoporosis are related to an increased risk of developing cardiovascular disease, highlighting the importance of treating your pelvic pain early.
What are the Symptoms of Poor Posture?
Pelvic pain associated with poor posture can be constant or intermittent. It is often triggered by activities such as prolonged sitting, a long walk, menstruation in women, defecation or intercourse - the list goes on!
The pain can be:
- A vague ache over a wide area - Spreading over the abdomen, hips, pelvic floor, buttocks, lower back and lower legs.
- A sharp stabbing in a specific localised area - These trigger points are often in the pelvis.
- An ache along the spine - From the neck to the buttocks.
- Worse during and after sex (dyspareunia)
Other symptoms are a result of the damage to the pelvic floor:
- Urge incontinence - Triggered by muscle spasms in the pelvis.
- Pain during and after defecation
- Incomplete emptying of bladder and/or bowel
What Causes Pelvic Pain from Poor Posture?
The position of your body has a huge impact on the activity of your pelvic floor muscles. For example, your pelvic floor muscles are used more when sitting than lying, and standing more than sitting. This is a normal range of motion and, as long as your pelvic floor muscles are strong, you should have no discomfort.
However, if you have poor posture it can lead to changes in the position of your bones, tendons and muscles as they are used unequally:
- The iliac bone in the pelvis can begin to lean forward. This gives the sacrum bone an increased mobility to rock and sway.
- Your spine can suffer from lumbar lordosis when the pelvis tilts forwards. This appears as your buttock pushed out backwards, and your stomach pushed forwards.
- Your knees can hyper-extend, moving beyond their normal range of motion in front of the kneecap (anterior displacement) in relation to the pelvis and lower limbs.
- Having a shortened ano-rectal angle, when on the toilet, makes evacuating your bowels difficult or painful.
Myofascial pain is common in overworked skeletal muscles that have become weak and tight, often as a result of chronic poor posture. Strained muscles often have reduced circulation, and are deficient in oxygen and blood supply.
Myofascial pain is characterised by small, very local points of extreme sensitivity in the muscles, which cause sharp, stabbing pains when put under pressure. These areas usually have restricted mobility and may even have physical bumps on the surface of the muscle. Tense muscles can develop myofascial trigger points which are more sensitive than others. They can create a sharp stabbing pain when under pressure, rather than the dull ache often associated with overworked muscles.
The pain can occur suddenly from a trigger event, after years of poor posture. This trigger is often stress as your muscles are more tense, but can be a stretch or sudden movement. Trigger points in the abdomen, hips and thighs can all cause pain in the pelvis. If you have trigger points in the levator ani muscle, it can cause pain in the lower abdomen.
To read about other causes of pelvic pain, visit the Causes and Diagnosis of Pelvic Pain page.
How to Treat Pelvic Pain Caused by Poor Posture
Your GP may refer you to a Physical Therapist to support you in your treatment. Physical Therapists are experts in treating musculoskeletal disorders, such as those that are a result of consistently poor posture. Removing trigger points to reduce pain in the pelvic area.
- Kegel (pelvic floor) exercises - Exercising your pelvic floor is essential to strengthen these muscles and gain control over your pelvic organs. If they weaken, or are strengthened inconsistently across the muscle, you can experience pain and lose control over your pelvic organs. Using an electronic pelvic toner with neuromuscular electrical stimulation can result in even quicker improvements in the strength of your pelvic floor, as they are 90% effective in comparison to 40% effective for manual Kegel exercises alone. As well as strengthening your pelvic floor muscles, the Kegel8 Ultra 20 Electronic Pelvic Toner comes with a specific programme to relieve pelvic pain.
- Biofeedback techniques - To test the strength of your pelvic floor, a vaginal probe can be inserted which you squeeze against. This can be used to check you are doing Kegel exercises correctly, and are making progress in toning these muscles. Biofeedback machines can be purchased for home use.
- Pain medications - Orally or through injections as required.
- Muscle strengthening and flexibility exercises - With support from your Physical Therapist, you can learn exercises which improve your flexibility and the strength of your muscles. All aimed to improve posture and the strength of the muscles in the pelvis and along the spine.
- Breathing techniques and relaxation - Learning how to relax and proper breathing techniques, can help reduce the sensation of the pain. Both mental and emotional stress can increase physical pain.
- Myofascial release techniques - To release the pressure on the trigger points and taut bands within your muscles, a Physical Therapist can provide a gentle and sustained pressure on the muscle tension. Contracting and relaxing these muscles, followed by a long stretch, can release the tension.
- Vaginal dilators - Can be used to release trigger points.
- Review your diet - To improve bowel and bladder regimens.
- Relief with heat and ice - Heat and ice are often used as muscle relaxants, as part of a massage or sauna / ice room experience.
How to Prevent Pelvic Pain Caused by Poor Posture
- Proper posture- Sitting and standing tall with our shoulders back.
Use a toilet stool - Using a toilet stool can you put you in the best posture to evacuate your bowels. Giving you the optimum ano-rectal angle.
Adjust the angle of your monitors - If the monitors for your computer are too high, you may crane your neck and lift your chin up to use them. If they are too low, you might find yourself slumping. Read the NHS guide on sitting correctly.
- Exercise throughout the week - If you have a low activity job, and save your energy for long walks and exercise only at the weekend, then your back and abdominal muscles are likely to be not strong enough to support the spine.
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