Pelvic pain can take a variety of forms. It often originates in the muscles of the pelvic floor and may be brought on or worsened by certain activities, such as sexual intercourse. Itching and burning in the pelvic area may result from infection. Diffuse pain may be associated with endometriosis, and stress fractures to the ilium and other hip bones, while less common, can cause debilitating pain. Distance runners often experience pain in the posterior pelvis because of injury to the muscles surrounding the sciatic nerve.
Kegel exercises--originally developed to protect the muscles of the pelvic floor against the trauma of childbirth--target the pubococcygeus, or PC, muscle and now have a variety of applications. These isolate the PC from extrinsic muscles, such as those in the groin and abdomen, and involve sequential contractions of the PC--the muscle controlling urinary flow--that are held for about five to 10 seconds and repeated five to 10 times. They can be done while sitting, standing or lying down, and noticeable improvements are usually seen after four to six weeks.
Combined Abdominal and Pelvic Exercises
Engaging the muscles of the inner abdomen in addition to those of the pelvic floor can be useful in alleviating certain types of pelvic pain. Classic "crunch" exercises are not recommended. Relaxing the relevant muscles as you inhale and contracting them as you exhale is vital. Lying on your back with your knees bent, your feet slightly apart and your arms by your sides, inhale and let your stomach and pelvis relax. As you exhale, contract your pelvic floor and abdominal muscles and curl your upper body slightly. Hold for a moment and return to the starting position. Do this four to six times once or twice a day. Since pelvic pain tends to tighten the muscles in the area, stretching the hip flexors after every session is beneficial.
SI Joint Exercises
The sacroiliac, or SI, joint--one of two joints connecting the sacrum, or tailbone, to the ilium, the largest hip bone--is a frequent site of pelvic-pain origin. Because of its limited range of motion and its propensity for tightening with age, exercising the joint is important. SI joint pain is normally caused either by wear and tear on the joint cartilage or from tightening secondary to underuse. Single-knee-to-chest stretches done lying down--eight to 10 times on each side, held for two seconds--and "knee sways"--lying down with the knees together and bent and moving them side to side, four to eight times in each direction--keep the SI joint fully mobile and strong.