February 16, 2018
Written By Lauren Mallari-Snyder PT, DPT
Dysmenorrhea. This is an unnecessarily scary term for “Ughhh…period cramps”. So, please don’t let that freak you out because there are some things we can do to help! Yes, herbs, heating pads and (yes… ibuprofen) can help, but I’m going to explain how all you need to alleviate period pain is your very own body.
The Medical Stuff:
There are two types of dysmenorrhea: primary and secondary. Primary refers to the more common menstrual cramps that many of us feel during or right before our period starts and secondary is more involved and is related to other causative factors. Secondary dysmenorrhea should be talked about with your Medical Doctor first and as your Doctor of Physical Therapy, I’ll focus on the primary type.
Many of us may have felt this cramping in the front of our pelvis that can vary from feeling like your uterus is being gently squished by a very calm person playing with a stress ball… to feeling like your uterus is being crumpled up to resemble those oxygen bags that drop down from the airplane ceiling and you’re not sure just how there is, in fact, oxygen still flowing through that thing! (You know the feeling!) You may also have achy, low back pain, which is even more annoying, because you’re already dealing with enough! So, here are a few tips on how to calm or completely get rid of these pains.
But First, A Little Anatomy to put this in to Perspective:
The uterus lives in the pelvic bowl and is located just behind/above the pubic bone and behind/above the bladder. It is very soft and very mobile. I mean, imagine, it starts as centimeters big, (we’re talking about 7-8cm long by 5cm wide) and expands to hold a baby! Also, because it is so soft and mobile, its position can be changed dependent upon the fullness of the bladder and/or rectum, the pull of the muscles, fascia and ligaments holding it and all of our organs in place and can be effected by the hormonal changes we go through throughout our menstrual cycle.
My Simple bodywork TIPS to alleviate period pains:
Move! Despite your desire to curl up on the couch with a heating pad, try to get moving instead. You don’t need to go hit up the gym or take a full class, but you do need to get those muscles, fascia and ligaments moving. Go for a walk, jog, swim or whatever you like to do. You’re goal is to prevent all those soft tissues from tightening up around the uterus. Let your uterus do its thing! You’ll know you’re doing it right or long enough when your cramps go away. 🙂 You can definitely still use that heating pad, (it will for sure feel good!) but its effects just may not last as long as movement’s effects do.
Diaphragm and Pelvic Floor Breathing. Let’s take movement up a notch by adding the breath. You’ll want to ensure you’re moving all the soft tissues around and normal mobility of the pelvic floor while breathing. Many of you may already know how to diaphragmatically breathe, but let’s review, or introduce!
- Inhale, making sure to expand through the abdomen and rib cage evenly in all directions: front, back and sides.
- While inhaling, try to expand the pelvic floor muscles, filling them with air as the rest of your trunk is also filling with air. This is super important! Sometimes its helpful to butterfly the knees out while you’re doing this and easier to do this part if lying on your back with knees bent.
- Exhale, deflating the abdomen, chest and pelvic floor, encouraging a little pelvic floor contraction and elevation or “Kegel”. This way, you’re set up to do another inhale with expansion and gentle downward motion of the pelvic floor.
- Repeat for 5 minutes switching on and off between deep breathing and regular breathing to avoid hyperventilation. Try 3-5 deep diaphragmatic and pelvic floor breaths at a time, breathing normally for 30 seconds- 1 minute in between.
Core and Hip Stabilizers. Due to the fluctuation of our hormones during our menstrual cycle, we can often become a bit more lax in our ligaments. This may lead to low back or SI joint (Sacroiliac Joint) pain as our bones may move around more than normally would and put strain on the ligaments and/or joint surfaces. To help with this, focused, deep, core and hip stabilizer exercises are fantastic!
Do this exercise, called the Abdominal Series. Remember these 4 steps: push, cross, pull, push, and start lying on your back.
- Bring both knees up toward your chest, just a bit closer than a 90º angle at your hips and then flex your feet backward. Using your hands, gently push in to your thighs, creating counter pressures between hands and thighs. This effort should be done by activating your core and also trying to curl your pubic bone toward your face. Hold up to 30’’.
- Keep both knees, hips and feet in the same position but just cross your hands to opposite thighs. Now press in to your thighs but at an angle since your hands are in a different position. Hold up to 30’’.
- Put your hands behind your thighs now, on your hamstrings, and point your toes down. Pull your hands in to your legs and your legs in to you hands, with the effort coming from your hamstrings and glutes. Don’t arch your low back. Hold for 30’’.
- Finish off with the same push as in #1. 30’’.
You can do this for as many rounds as you like, working your core and your glutes to stabilize your pelvis and lumbar spine, preventing or decreasing low back pain!
So, bottom line is, managing your period pains is actually doable without additional tools — you just need you! And of course, if you have questions or need more help managing these symptoms, let me or another Physical Therapist specializing in Women’s Health know and we’ll be able to help you. Yes, Physical Therapists do that. Who knew!? You do!
About The Author: Lauren Mallari-Snyder started her career as a Doctor of Physical Therapy in 2012 in an Orthopedic setting and began including a focus on Women’s Health and Pelvic Floor issues a few months after. Currently, she is getting more involved in postpartum care and loves finding ways to meld the orthopedic, pelvic floor and postpartum worlds during her treatments. She lives in Mission Hills with her fellow Physical Therapist husband and crazy, cute French Bulldog. She’s danced her whole life, has been getting more and more in to yoga and shopping at Shop Good!
Lauren works at Body Gears Physical Therapy in Scripps Ranch https://bodygears.com/