title: Chronic pelvic floor dysfunction.
abstract: The successful treatment of women with vestibulodynia and its associated chronic pelvic floor dysfunctions requires interventions that address a broad field of possible pain contributors. Pelvic floor muscle hypertonicity was implicated in the mid-1990s as a trigger of major chronic vulvar pain. Painful bladder syndrome, irritable bowel syndrome, fibromyalgia, and temporomandibular jaw disorder are known common comorbidities that can cause a host of associated muscular, visceral, bony, and fascial dysfunctions. It appears that normalizing all of those disorders plays a pivotal role in reducing complaints of chronic vulvar pain and sexual dysfunction. Though the studies have yet to prove a specific protocol, physical therapists trained in pelvic dysfunction are reporting success with restoring tissue normalcy and reducing vulvar and sexual pain. A review of pelvic anatomy and common findings are presented along with suggested physical therapy management.
authors.affiliation: Dee Hartmann Physical Therapy, 1417 West Grand Avenue, Chicago, IL 60642, USA. Electronic address: healthyexp@gmail.com.
authors.forename: Dee
authors.initials: D
authors.lastname: Hartmann
authors.affiliation: Sarton Physical Therapy, 13891 Newport Avenue, Suite 285, Tustin, CA 92780, USA. Electronic address: julie@pelvichealing.com.
authors.forename: Julie
authors.initials: J
authors.lastname: Sarton
mesh_terms: D005260:Female; D006801:Humans; D059408:Pain Management / Q000379:methods*; D017773:Pelvic Floor / Q000503:physiopathology*; D026741:Physical Therapy Modalities; D011788:Quality of Life; D012735:Sexual Dysfunction, Physiological / Q000503:physiopathology / Q000628:therapy; D056650:Vulvodynia / Q000503:physiopathology* / Q000628:therapy
keywords: manual therapy; organ system dysfunction; pelvic floor muscle dysfunction; sexual dysfunction; vulvar pain; women's health physical therapy