Is Pelvic PT the Missing Link in your Treatment?

BY DR. MEL WALDRON

Pelvic Venous Disorders (PeVD) occur when there is obstruction or reflux of one or more of the veins that return blood from the legs, pelvis and abdomen. PeVD can include diagnoses such as Pelvic Congestion Syndrome, May-Thurner’s Syndrome and Nutcracker Syndrome and are named after which veins are involved, however, they often don’t occur in isolation. Most individuals are familiar with what a varicose vein is and how they look in the legs, but did you know they can occur within the pelvis and abdomen as well? Read on to find out if this could be the missing link in treating your pelvic pain!

Symptoms of PeVD may include: 

• Abdominal and/or pelvic pain
• Bloating
• Pelvic heaviness or aching
• Urinary urgency
• Varicose veins on the labia in females and varicoceles in males
• Varicose veins in the lower extremities
• Pelvic pain/aching/pressure following intercourse
• Hemorrhoids
• Vulvar itching
• Neuropathy in the lower extremities

Symptoms typically worsen with prolonged standing, walking, sitting, exercise, sexual intercourse and during your menstrual cycle.

Symptoms typically improve with positions of inversion, use of compressive garments, PT interventions focusing on improving posture for optimal ribcage expansion during diaphragmatic breathing and pelvic alignment.

Some of the greatest risk factors include:

• Pregnancy (especially multiple and in those with lower BMI and higher birth weight babies)
• Hormonal fluctuations due to their vasodilatory effects
• Venous Hypertension due to genetics and lifestyle factors

So where does pelvic PT come in?

Pelvic PT can help restore your “Sump Pump”. The “Sump Pump” highly relies on the respiratory diaphragm within the ribcage and its apposition to the pelvis/pelvic floor to pump blood and lymph out of the legs and pelvis and then back up to the heart. This is accomplished through specific hands on techniques provided by your PT as well as exercises to strengthen the postural muscles and mobility exercises to improve expansion of the ribcage and pelvis. Recommendations for specific compression garments will also be made when appropriate.

Your pelvic PT will also refer you to the appropriate specialists for imaging and medical intervention as well as guide you following intervention for a comprehensive, team approach.

If you’re finding your symptoms are not improving with standard PT or you have had varicose veins previously treated but were unresponsive or returned following medical intervention, you may be experiencing symptoms associated with a pelvic venous disorder and would benefit from seeking out pelvic floor PT and a referral to the appropriate MDs.