Hi there,
Dr.
Rudell Stewart-Winoonen,
Medical Practice here.
This is some ideas for you to do on your own using the concept of graded motor imagery or GMI.
Really this is a fancy word for visualising.
So when you move a body part,
For instance perhaps doing pelvic rocking in yoga,
A movement map activates in your brain.
And in many women with pelvic pain,
Various movements of the pelvis can cause pain.
The good news is that scientists have shown we can activate the same movement map by imagining or visualising the movement.
And the great benefit of this is that you can be performing the movement in quotes with little or no pain.
And by doing this,
The movement map is refreshed and stays nice and healthy and actually helps ease pain.
You could think of it as brain physio for your pelvis.
And just like if you were doing the actual movements,
There's no need to start by doing everything at once.
Start simple,
Slowly challenge yourself.
So here are some ideas from easy to more advanced.
And as you do them,
If they cause no or very minor emotional or physical discomfort,
Then you can move on to the more advanced ones.
And if you have time,
You may like to start before you do this by doing a progressive muscular relaxation practice,
Which I have on Insight Timer or in my pelvic resources page on my website.
Or even your own favourite relaxation or meditation or just listening to some relaxing music.
Or maybe at the minimum,
Let's take several nice deep belly breaths with a big sigh out to release a little bit of tension.
Filling the belly up with a breath in and allowing to deflate and the big sigh out to release.
And again,
Just taking any position that feels comfortable to do this GMI.
So firstly,
If you feel comfortable closing your eyes,
Then do so.
Otherwise,
Just keeping them downcast.
And in your mind's eye,
Seeing the whole general area of your pelvis.
Let's do this for a few seconds.
See if you can continue to breathe and relax.
And then open your eyes.
If this has caused any significant discomfort,
Then leave it now.
Come back another time.
But if it's fine,
Then I suggest that you repeat several times.
If it causes no discomfort at all,
Certainly move on to the next task.
And if it causes some bearable physical or emotional discomfort,
Then just stick with this for a while longer.
Maybe just build up the time that you use.
Build up the repetitions.
So I'll just guide it one more time.
So closing your eyes,
Seeing the whole general area of your pelvis in your mind's eye.
Continuing to breathe.
Relax as best you can.
Maybe for somewhere between 5 and 10 seconds.
Then opening your eyes.
You can pause the recording here if you like.
Otherwise,
We'll move on to the next practice.
So now closing your eyes and in your mind's eye,
Seeing the area of your pelvis that is perhaps your difficult area.
This might be your vulva,
Vagina,
Bladder,
Bowel,
Uterus.
Continuing to breathe and relax.
Doing this for a few seconds.
And then gently opening the eyes.
So how are you going?
Again,
If this is super easy,
Then just move on.
If this is a bit challenging,
Then perhaps continuing at this level,
Trying this out for a few minutes daily for a while until you get used to them.
And if they feel like they're in that nice sweet zone,
You might like to increase the amount of time you spend visualising or increase the number of repetitions before you move on to the next exercise.
You might like to pause at this point.
Or otherwise,
We'll move on to the next exercise.
So in this exercise,
You might choose to see your pelvis in various positions.
So perhaps choosing to see your pelvis in the position of sitting in a chair,
Perhaps lying on your back,
Perhaps lying on your side,
Or perhaps standing.
So just choosing one of them for now.
And again,
Closing the eyes,
Imagining your pelvis in this posture,
Breathing and relaxing.
And after a few seconds,
Opening your eyes.
So you might want to pause the recording here and continue with the same posture or trying the other few postures.
Again,
You'll need to use your own wisdom as to whether you stay with this exercise for a while or whether you're ready to move on to the next one.
So now closing your eyes and seeing your pelvis,
This time in active movement.
So you might see your pelvis in a sitting position,
Moving from a kind of neutral resting position to tilting the pelvis as far forward as possible.
And in your mind's eye,
Holding that position for a few seconds,
Breathing,
Relaxing and slowly returning to neutral.
Perhaps you might even enjoy this movement if you feel that it's right for you to continue this.
So closing your eyes,
Seeing in your mind's eye your pelvis moving from a neutral resting position to as far forward as possible.
Breathe and relax,
Perhaps enjoy the movement and return to neutral.
You might want to try this exercise in your imagination lying down.
And again,
Using your own wisdom as to how far you persist with this one today,
Whether you go back to the last one,
Leave this for another time,
Or whether you want to stay with this one,
Build up the number of seconds,
Maybe up to about 10 seconds,
And build up the number of repetitions,
Maybe about 10 times.
So pausing the recording here if you like.
And otherwise,
Repeating this exercise but this time with the pelvis moving backward.
So closing your eyes,
Seeing your pelvis in your mind's eye,
Perhaps sitting,
Perhaps lying,
Moving from a neutral resting position to as far backward as possible.
In your mind's eye,
Holding that backward position for a few seconds,
And slowly returning to neutral.
Continuing to breathe,
Relax,
And if possible,
Enjoy the movement.
Sometimes it can be very freeing to be doing a posture in your imagination that you can sense the enjoyment in that because you're not getting pain.
And this can be very powerful in the brain.
So again,
Deciding now whether you want to repeat this a few times,
Build up the seconds,
Build up the repetitions,
Or leave it for now.
And if you'd like to,
You can pause the recording here.
And so the last exercise on this recording is going to be identifying a specific task that you'd like your pelvis to engage in.
So you might want to do a certain yoga stretch,
Or a dance position,
Or a position at the gym,
Or a sexual position.
So perhaps just pausing now to give that a little bit of thought as to what movement you would like to try this out in your imagination.
But once you've decided,
Closing your eyes and seeing your pelvis involved in this task that you've chosen.
This is causing a lot of emotional discomfort.
It's a kind,
Wise thing to do to let it go for now,
And maybe choose a task that's a little less difficult.
Or perhaps you've chosen that lovely sweet spot where in real life this might be quite challenging,
But in your imagination you might even be able to enjoy this task.
Seeing your pelvis doing the task,
Continuing to relax,
Breathe,
And open your eyes when you're ready.
And again,
Using your own wisdom going forward.
Do you like to increase the number of seconds?
Maybe build up to 10 seconds?
Do you want to increase the number of repetitions?
Maybe up to 10?
Do you want to change the task?
Pausing the recording now if you like.
And you might like to keep a written record of what you're doing and actually notice the progress that you're making.
How you may be able to stay with a task for longer,
To do it more often,
And to have it cause less discomfort,
Both physical or emotional.
So this concept is surprisingly simple.
Your brain is worried about you.
By exposing it to healthy,
Enjoyable visions of the pelvis and pelvic movement,
Your brain becomes less worried.
The pain eases,
Movement improves,
And you'll be more prepared for actual physical movements of the pelvis,
Which you might like to do with your health professional.
Another step between this and actual physical movements of the pelvis is to look at photos or pictures of pelvises.
So if you check out my website in the Pelvic Pain Resources page,
You'll find a PowerPoint of various photos of pelvises,
Both still and moving.
And you can go ahead and apply exactly the same principles to these.
So good luck with this,
And a big thank you to Adrian Lowe,
Sandra Hilton,
Carolyn Van Dyken,
Who wrote the book Why Pelvic Pain Hurts,
That I've based these exercises on.
