Exercises for Pudendal Neuralgia: The Pelvic Floor, Abdominal Muscles and More

In this article, we will take a close look at various exercises that can be beneficial for those with pudendal neuralgia. These exercises aim to alleviate symptoms by strengthening and relaxing the pelvic floor, and other muscles that impact the pudendal nerve
Sabrina Greco

Sabrina Greco

MSc in Anatomical Sciences at Queen’s University in Canada

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What Is Pudendal Neuralgia?

Pudendal neuralgia is a chronic condition caused by damage or irritation to the pudendal nerve. Exercises for pudendal neuralgia aim to alleviate symptoms, including pain, and improve the quality of life for individuals with the condition.

A physical therapy evaluation includes an assessment that can identify movements and patterns that contribute to symptoms. This evaluation is critical in determining which exercises are best for your symptoms and condition.

Be mindful of how your body feels during these exercises. It is important to avoid postures or movements that trigger pain. Consult with your physiotherapist or another healthcare provider before beginning any new activities or exercises.

Pelvic floor exercises for pundendal neuralgia

Physiotherapists who treat individuals with pudendal neuralgia often use and suggest pelvic floor exercises [1]. The pelvic floor muscles sit at the base of the pelvis, providing support to organs and tissues above it. These exercises aim to strengthen and relax the pelvic floor muscles, which can help alleviate symptoms.

Kegel exercises have been recommended in the treatment of pudendal neuralgia. These exercises involve repetitive contractions and relaxations of the pelvic floor muscles.

To perform Kegel exercises:

  1. Contract the muscles used to stop the flow of urine.
  2. Hold for 5 seconds.
  3. Release and relax.

Kegel exercises can improve muscle tone, reduce pelvic pain, and improve overall urinary and digestive functioning.

Stretching and strengthening exercises exercises for pundendal neuralgia

Stretching and strengthening exercises for the thighs, hips, lower back, and abdominals

Stretching and strengthening exercises can help relieve tension in muscles that support the pelvis and lower body.

Stretching the hip and thigh muscles can increase the flexibility of the lower body and reduce pressure on the pudendal nerve. Exercises that stretch and strengthen the lower back and abdominal muscles work to improve posture and alleviate pressure on the pudendal nerve. Stretching exercises may help alleviate symptoms for individuals with pudendal neuralgia.

These exercises include:

  • Heel slides.
  • Marches or toe-taps.
  • Wide leg bridges.
  • Side-lying hip abduction and extension.
  • Hip extension in the quadruped position.
  • Standing backward leg lifts.
  • Pelvic-tilt exercises.
  • Bird-dogs.
  • Arch backs.
  • Cobra pose.
  • Happy baby pose.

Maintain an elongated spine and strong posture when completing these exercises.

Limited research is currently available on the effectiveness of these exercises for pudendal neuralgia [2, 3, 4]. Consult with your healthcare provider and physiotherapist before trying any new stretches or exercises.

Breathing exercises for pundendal neuralgia

Breathing exercises can be helpful in the treatment of many conditions, including pudendal neuralgia. Breathing provides oxygen to the body, and the muscles of breathing are important in maintaining posture.

Diaphragmatic breathing can influence the compression or stretching of the pudendal nerve, by helping relax muscles of the pelvic floor.

As you inhale, your diaphragm moves downward in your abdominal cavity, and your pelvic floor shifts downward to accommodate. As you exhale, your diaphragm moves upward, and the pelvic floor returns to its normal position. Relaxing and activating the pelvic floor muscles, through diaphragmatic breathing, can provide relief of symptoms for individuals with pelvic pain [5].

Conclusion

Certain exercises can help manage symptoms and improve the quality of life for individuals with pudendal neuralgia. Every experience is different, and what works for one person may not work for another. More research is needed on these approaches and their specific effectiveness for individuals with pudendal neuralgia.

Consult with your physiotherapist or another healthcare provider before beginning new exercises to ensure that they are safe, effective, and appropriate for you and your condition.

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Sabrina Greco

Sabrina Greco

Sabrina is a pre-medical student based in Toronto, Canada. She completed her BSc in Life Sciences and her MSc in Anatomical Sciences at Queen’s University in Canada. Her recent research focused on investigating the symptoms and experiences of women who have undergone gynecologic surgery. Her research has been published in the Journal of Obstetrics and Gynecology Canada, and presented at the International Society for the Study of Women’s Sexual Health Annual Conference 2022 and 2023. Sabrina is a patient advocate dedicated to improving communication and knowledge translation practices in clinical settings.