hey guys it’s Hina Sheth here at rebalance physical therapy and wellness in Center City Philadelphia as well as on a main line in Narberth Pennsylvania and I am a pelvic floor and orthopedic physical therapist that specializes in treating the spine hip pelvic and pelvic region as well as our clinic located here and today I want to talk to any of you who might have been diagnosed and actually when I say any of you meaning you women who have been diagnosed potentially with something called vulvodynia or perhaps you stumbled upon
the word vulvodynia on all of your other google searches or perhaps in one of my other videos so vulvodynia is basically any type of symptom that involves pain swelling burning irritation achiness pain that is locating located in the valve our region and what I mean by the vulva region I’m going to show you a picture for those of you so if you look at the female anatomy over here the vulva area is basically any of this right in through here basically this pink area any pain achiness symptoms itchiness irritation burning that you’re
having that involves this area is generally called vulvodynia and it’s kind of an umbrella term because it can involve many different things but oftentimes what we see here in the physical therapy world is that the muscles in this area can actually get involved the muscles of the pelvic floor can get involved in this area and we’ll talk about that in a bit so with vulvodynia basically I already kind of talked about the symptoms of like pain and irritation and achiness and itching and burning and all this
kind of stuff that can be involved sometimes there’s no you know what is the cause basically a vulvodynia sometimes it can be a hormonal change sometimes there can be trauma perhaps from birth you know if you’ve had a tear down there or perhaps you’ve had some type of surgery that provoked this sometimes chronic yeast infections or urinary tract infection any type of an infectious process that is happening in this area can trigger this off and then other things that can cause this is actually the muscles down
in an area called your pelvic floor now for those of you that don’t know what the public floor is I have another video that actually explains what the pelvic floor is so perhaps click on that it’ll give you an idea what it is but we’ll talk about it briefly here as well so now these are not the only things that can cause vulvodynia sometimes it just comes on sporadically and there’s no reason why people have no idea why it started it may just start off as hey I’m noticing discomfort when I’m sitting and
then that discomfort gets worse and worse or perhaps intercourse becomes uncomfortable all of a sudden are using a tampon becomes uncomfortable and you’re noticing hey this is kind of strange and this is weird and perhaps it it followed by an event perhaps it was after you had your child perhaps it was after a I don’t know a sexual encounter that that was not comfortable for you so there could be many many different reasons why this comes on but those are just some of the main reasons why vulvodynia can occur so today I’m gonna
be talking more about the musculoskeletal side of why this can happen even though there might be a hormone imbalance or a urinary tract infection or something something trauma related or hormone related or perhaps the infection related that maybe have triggered this off so regardless of what triggered vulvodynia off many many many times what can happen okay is even if you end up having an a chronic infection even if you end up having trauma even if you had a tear say during delivery or this came on on its own basically what
happens is most likely the muscles of the pelvic floor at some point have also gotten involved and most of the time this is definitely part of the reason as far as what might be continuing to give you discomfort down there there could be other things but the muscles of the public floor is one big area that can cause a lot of pain in this area so what I want to do is I want to actually show you another slide here the public floor so basically you know if this area of the vulva if you kind of open this area up okay and
you take that you kind of peel this layer off what you’ll find is if you look inside the pelvis okay because this whole area is actually inside the pelvis if you look inside the pelvis and you see this right over here inside the pelvis this is where your rectal opening would be for the female and the urinary and the vaginal opening would be over here the this pink reddish everything that you see here is basically the pelvic floor these are muscles that are inside the pelvis so if you tilted this pelvis basically up this way that is
what you would see over here okay so we’re kind of looking inside of the public’s we’re looking from the top down versus from the bottom meaning underneath this paper would be where you would basically see this right over here okay so you can see that these muscles okay surround the vaginal opening so if these muscles become too tight which is typically what happens and people that have vulvodynia then anything going in or potentially coming out okay anything going in if there’s restriction and
tightness around this opening then it’s gonna be hard to have something to go into that opening so again with intercourse or with using tampons perhaps using you know devices or pleasure devices basically what can happen is that’s gonna get uncomfortable because there’s no suppleness around these muscles to allow something to enter or exit this opening so basically what can happen is that can cause you pain and then there’s also nerves in this area you know every muscle is surrounded by nerves that’s how muscles
get their function that’s how they get their sensitivity so you can imagine if there are nerves also going through okay you can’t see it here just imagine like little roots or branches kind of spreading out through this entire area nerves is what actually gives you pain so if those nerves are kind of irritated in that area as well because these muscles are so tight and not allowing proper nutrition and blood flow to get to these nerves which is what makes nerves healthy then you’re gonna have irritated nerves and when
that happens you’re gonna have pain when you try to have intercourse so the symptoms of vulvodynia okay along with pain burning and and all that kind of stuff that I talked about in the beginning functional things that people may notice is discomfort with sitting discomfort with urination okay because I said you know this opening right over here is also where you urinate out of you have your urethra that comes out of there sometimes and many times what people will say is it’s also pain with intercourse and so or pain with using a
tampon pain with sitting sometimes you can just have you know if you’re wearing clothing and the clothing rub up rubs up against that area that can be uncomfortable pain with wiping and so every time you go to the bathroom and you go to wipe you feel like oh that feels irritated and uncomfortable and so you know it can be something as simple as just like touch in that area is uncomfortable so again oftentimes what we’ll hear in our clinic is that women don’t want to wear jeans anymore they can’t wear tight pants they have to wear
you know dresses or skirts and they don’t want to wear underwear okay that’s how uncomfortable it can get and then like I said you know anything that puts pressure in that area such as sitting can cause discomfort so these are some of the functional things that most people will start talking about and there’s many other symptoms I actually have a lot of other videos on what type of symptoms pelvic floor tightness can cause but these are some of the symptoms and some of the common ones that we hear at our clinic so again
those are some of the functional things now what can we what can be done about this so basically when we have women coming into our clinic that are complaining about this one of the big things that we’re gonna look at is everything we kind of take a holistic approach at our clinic and what I mean by that is that oftentimes you know when you go to a health care provider whether regardless whether it’s a doctor a nurse practitioner whoever you might be seeing oftentimes people can Zone in on the area of where the pain is coming from
and if they don’t see anything there and oftentimes what will happen with vulvodynia is you may go and you may see your GYN and you’re worried that there might be you might have an STD or perhaps you have an infection that nobody can find maybe it’s a yeast infection but no one finds that there’s a yeast infection maybe there’s a cyst whatever it is perhaps you’ve already gone to all of your health care providers and they’re basically saying hey we don’t see anything there because
oftentimes with vulvodynia nothing actually will come up in terms of an infection or something problematic in terms of gynecology or urology so basically what ends up happening is it’s a lot of this is your musculature and the tissue in this area and so to treat this you actually need to look at not only the muscles meaning these guys which is what we evaluate okay as part of our exam but just remember these muscles are actually attached to the bones of the pelvis and into the low back as well as into the pubic bone so
not only do you have to actually do an exam of this but you actually have to look at the structure and the alignment of everything from your back your pelvis your hip and all the muscles that kind of surround that area from the outside as well as the inside so basically that’s what we do here at our clinic as we look at all of these things and we say hey why are these muscles actually spasming inside the pelvic floor and then creating all of this pain in the vulva area we also would of course look at the other things that might be
causing it such as perhaps this could be a hormonal imbalance things and we have ways that we test tests to see could this be more of a hormonal thing we also would make sure that there’s clarin that you don’t have any UTIs or East infections or other types of chronic inflammatory things that may have been the cause of why this has happened so we would be diving into that and then of course then we’re gonna do our own exam from a musculoskeletal standpoint meaning we’re going to be looking at all
of these things and saying hmm why is it that these muscles are now staying spasmed why did they stop them in the first place and so this is what our evaluative process basically looks at and then usually if a lot of these muscles are tight because there’s an imbalance and an alignment issue then we have to fix the alignment so that’s where we go in we’ll work on various areas to try and improve the alignment of your pelvis give it give those montt the muscles of the public floor a better base to be able to relax and then on top
of that work on the public floor musculature now there’s a whole lot of other things that we also do but for the purposes of this video and to kind of just give you an idea of what vulvodynia is and what treatment may consist of this is basically what we would be doing so for those of you who you know I’m sure there’s many of you that are watching this video that do not live around us and I know perhaps from my previous videos I had said hey yeah give us our give our office a call and we’ll be able to help you out but what we
found is we’re actually getting an overwhelming response of all of you out there who are suffering from these conditions and we haven’t been able to actually you know be it’s been actually impossible to contact everybody but we do want to help you in some way possible now if you live in and around this area at the no brainer give our office a call this is what we treat all the time every day all of us have anywhere you know twenty you know fifteen to twenty one to twenty two years plus of experience each
so we do this all the time give our office a call you might be I’m able to have a free phone consult with us to be able to help you figure out if this is something that will be beneficial and who the best person to see at our clinic would be if you are international or you are coming from out of town we also the out-of-town patients but we realize that some of you might not be able to make it to us for treatment so in that case we do do phone consult we do our phone consult so and I’ve helped many many people this way to kind of help you
find the right guidance the right treatment to kind of help you get to the right place whether it’s a certain physician that you need to see whether it’s a certain physical therapist that you need to see and perhaps I’ll even be able to guide you and help you find the right people in your area to see because these diagnoses are sometimes really really hard to kind of figure out what’s going on so our website is www.pevs.
com [Music] or into what the public floor is and symptoms and Yatta Yatta dog okay so have a wonderful day taker
