Vaginial pain is normalized. Periods. Birth. The first time in someone’s Honda Accord. The twentieth time in someone’s bed because their partner still doesn’t understand female anatomy. Those suffering from chronic pain in their vaginas are then shunned despite the numbers showing roughly a third of women will have a form of a pelvic floor disorder in their lifetime, including vaginismus, vulvodynia, urinary incontinence, and pelvic organ prolapse.
This is where Kristi Ayars comes in. She began as a physical therapist, as most pelvic floor therapists do. Her Northern California practice applies the skills and interventions used by physical therapists toward problems that are manifesting in the pelvic floor, bowel, or bladder. It’s all connected.
Her path began in 2003 when a patient came in for back pain and casually referenced her urinary incontinence.
Ayars recalls, “I went to my boss and asked, ‘Hey, who’s the pelvic floor physical therapist I can send this lady to?’ He goes, ‘Who?!?!’ He had never even heard of it.”
She immediately signed up for a Herman & Wallace Pelvic Rehabilitation class, whose institute has paved the way for the pelvic floor therapy community.
“I paid for it myself,” says Ayars. “I really feel a burden of responsibility to patients to do my best to help them with these issues that not enough people are talking about. I still get doctors calling me up, saying, ‘What is this patient talking about?‘What is it that you do?’”
Ayars has binders of techniques that include mobility tests, heat compresses, and biofeedback. All of her healing methods start with the same base: Respect the body’s messages and keep the patient informed every step of the way.
Biofeedback is noninvasive and provides a visual aid to the patient so they can better understand their muscles. Electrical pads are placed on the abdomen due to its proximity to the pelvic floor. Tight abs, which are often overly active, equate to the same issue in the pelvic region. A screen then shows the impact of motion and breathwork on muscle tension.
Ayars reminds patients that small steps don’t equate to a lack of progress.
“I had a patient about 40 years into a marriage who had never been able to achieve penetration. She had all sorts of weird, almost barbaric stuff done to her by practitioners and doctors. Although it was a good six months before she and her partner achieved digital penetration, they were completely comfortable with the process.”
There’s been an increase in the number of pelvic floor therapists over the past 10 years. [Herman & Wallace even provides an official accreditation rather than a small section on the women’s health portion of the physical therapy exam.] However, information is still often misconstrued. While Ayars errs on the side of caution with a diagnosis, as lots of studies demonstrate its harm on some patients, Ayars also champions the power of validation.
“Especially with certain kinds of pelvic pain, such as vaginismus, people are told it’s all in their heads or they think they have these deep-seated nerouses. And I’m able to say, ‘This is the physical manifestation. Here’s the underlying mechanism. Here’s what I can offer.’”
Kristi Ayars and pelvic floor therapists are creating safe spaces. And they’re getting flowers sent to them after someone out there gets fingered. More of this please.
