Connective Tissue Dysfunction

Connective tissue is self-explanatory in its name. It connects things in our body. It is one of four types of tissues in the body including skin, muscle and nerve tissue. Connective tissue (CT) is the fascia, or supportive tissue which holds us together. The connective tissue that we are referring to here is the container that wraps around the muscle. It lies between the skin and muscle layer all over our bodies.

Different studies have demonstrated that connective tissue problems (unhealthy, thickened, and stiff tissue) can result from the following:

• Wind-up of our sympathetic nervous system (fight or flight response) as a result of persistent pain. This can be caused by inflammation or infection in our organs such as our bladder, prostate, or uterus.
• Underlying joint problems (stiffness, inflammation).
• Can occur superficial to a muscle tender point.
• Can occur in the area related to an inflamed peripheral nerve (i.e. Pudendal Nerve Irritation).

Essentially, connective tissue stiffness is a very important component of the tissue problems that we see with persistent pelvic pain.

The symptoms of connective tissue dysfunction can include:

• Itching, burning, numbness and pain.
• Genital hypersensitivity.
• Clothing, underwear, sitting intolerance.
• Organ irritation or dysfunction (in other words, your connective tissue can get irritated because your bladder is infected or irritated, OR your bladder can get inflamed or irritated because your connective tissue is irritated. It is a vicious cycle).
• Poor tissue integrity, vaginal and rectal fissures, or small tears in the tissue.
• Colour changes in the skin, usually darker or blotchy.
• Sympathetic nervous system can up regulation (fight or flight response) and contributes to your sensitive nervous system.

The goal of treatment is to regain mobility of your tight tissues without increasing your pain response. Many manual techniques exist to help calm down the sensitive nervous system, and your therapist will implement them while ensuring that you’re comfortable.

The treatment for connective tissue dysfunction in the pelvic area is skin rolling of the affected areas from the knees to the rib cage, front and back, including the sides of the thighs, buttocks and abdominal wall. Skin rolling is a superficial connective tissue technique, and can be carried out by any massage therapist or Pelvic Health Physiotherapist.

A self-treatment technique is foam rolling, which can be done as a home program, or as an independent treatment technique at home. If you are not seeing a physiotherapist for this problem, then you can access Ending Female Pain or Ending Male Pelvic Pain by Isa Herrera for self-treatment techniques of the vulva and perineum.