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By Isa Herrera, MSPT, CSCS
Many of my patients complain about pain right above the pubic bone. When I started to investigate this area over time I discovered that many of my patients would experience bladder pain, urgency and referral pain to the urethra and pelvic floor muscles. The bladder and more of the main pelvic floor muscles the PC muscle (Pubcoccygeus) live underneath the pubic bone and it makes sense that if there is a dysfunction in the bladder or the pelvic floor muscles that the top of the pubic bone and the lower abdominal area will be painful and filled with trigger points. We must remember that there is also fascial connections from the abdominal area into the bladder and pelvic floor muscles that travel above and below the pubic bone therefore the suprapubic area can become loaded with trigger points because of its anatomical relationships. Suprapubic Trigger Point therapy brings about amazing results and can help reduce urinary urgency, bladder pain, urethral pain and pelvic pain.
Many times trigger points in the suprapubic area refer pain to the bladder and it is necessary to address them to get the pain relief associated with the bladder. Suprapubic trigger points in this area also can cause extreme urgency. Many times men and women can only tolerate soft pressure in the suprapubic area because the sense of urgency and pain is extremely high and unbearable. At first I recommend that the trigger point therapy in this area be gentle but as the symptoms release press a little deeper into the triggerpoint. This is called “Chasing Your Urge Points” and I find that when women and perform the suprapubic trigger point therapy they get a lot of relief and their urgency and pain starts to diminished . This is one of my go-to techniques for women and men suffering from bladder conditions.

WHAT TO DO:
1. Start your investigation by pressing along the top of the pubic bone and your lower abdominal muscle area. Take note of where the pain is and what symptoms you feel when you press into these areas.
2. Make yourself a simple map. Note pain level from 0 to 10 (0 = no pain, 10 = worst pain) and symptoms produced.
3. Hold the trigger point for 90 seconds, making sure to release the trigger point slowly. Repeat as many times as necessary until the pain level is reduced by 50 percent or you feel relief from the symptoms.
4. CAUTION: Do not press into an area that has a pulse. If you feel a pulse, move to a different area.
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Isa Herrera, MSPT, CSCS is a licensed physical therapist, international best-selling author, and a leading pelvic floor and women's health specialist.
She holds a BA in Psychology and Biology from Fordham University and a Master of Science in Physical Therapy from Hunter College.
Over the course of her career, Isa has helped more than 21,000 women heal from pelvic floor dysfunction, vaginal pain, incontinence, and intimacy challenges.
She pioneered integrative modalities including Maya Abdominal Massage, Low Level Laser Therapy, Sound Healing, and Andean Energy Techniques at Renew Physical Therapy, her NYC-based healing center, where she has practiced since 2005.
Isa is the author of five books on pelvic health, including the international best seller Female Pelvic Alchemy and Ending Female Pain: A Woman's Manual.
She is the founder of PelvicPainRelief.com, an online school dedicated to helping women and health professionals access evence-based pelvic floor education.
