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Pelvic Floor Trigger Point Injections | Allyson Shrikhande MD | Pelvic Rehabilitation Medicine

A trigger point is a palpable taut band in
the muscle. There is a loss of the linear pattern of the
muscle. Quite often, you can get referred pain patterns
when you touch a trigger point to other areas of the body. And sometimes you can get something called
a twitch response. And you can have an autonomic response when
you touch a trigger point. You can get vasodilation where you can have
increased heat in the area. Overall, when the trigger point is present,
there is a restriction in the blood flow which ultimately leads to an ischemia and neurogenic
inflammation and pain in the area. So the pelvic floor musculature, which is
a sling of muscles, can have trigger points just like any other muscle in the body. It can benefit from a release of the trigger
point. Sometimes it’s myofascial release from a physical
therapist. And sometimes it can be from a trigger point
injection performed by a physician, where you would like to break up the trigger point
and release the tension ultimately increasing blood flow to the area. And blood flow is healing and provides oxygenation
and will overall make the muscles feel better. Trigger point injections to the pelvic floor
muscles are external ultrasound-guided injections. The ultrasound is what allows us to do everything
externally, the ability to visualize what we’re doing without going inside. We also do something called peripheral hydrodissection
nerve blocks. So there’s three things that we were doing:
creating space, resetting the hyperactive nerve temporarily and decreasing any inflammation
that’s around where the nerve is flowing. The treatment frequencies are either once
a week for six weeks or twice a week for three. We describe it as, for the muscles, a trip
around the pelvis where the three major muscles on the right of the sling and the three major
muscles on the left of the sling, they each get one treatment. The goal of the series of trigger point injections
is to release tension in the pelvic floor, to improve blood flow and oxygenation to the
muscles of the pelvic floor and to break up specific trigger points in the pelvic floor
and overall, create space in the muscles of the pelvic floor and lengthen the muscles
that are short and contracted. Trigger point injections are commonly done
in the sports and pain medicine world throughout the body. However, doing them externally under ultrasound
to the pelvic floor is unique to something that was created here at Pelvic Rehabilitation

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