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Generally, pelvic floor muscles (like any other muscle group in the body) can have hypotonic or hypertonic tendencies. Our nervous system plays a major role in managing muscle tone. If a client is living in a constant state of anxiety and stress or they find sex stressful, it’s likely their pelvic floor muscles will have a difficult time coordinating with the system.  Regulating the pelvic floor will be especially difficult during sex.  

Here are 3 suggestions to activate the parasympathetic nervous system and give the pelvic floor the needed messaging to relax:

Diaphragmatic Breathing: As we inhale, the diaphragm pushes down into the system to create room for the lungs to expand. As the diaphragm relaxes down, the pelvic floor muscles adjust accordingly to the intra-abdominal pressure within the system, and these muscles “drop” and lengthen as well. As we exhale, the pressure leaves the body and both the diaphragm and pelvic floor muscles...

Our pelvic floor muscles form the base of our spine and deep core. They wear many hats:  bladder and bowel elimination, sexual activity, support and stability, pressure management, and shock absorption. I often refer to this group of muscles as Grand Central Station: there are a million convoluted routes to take! There is a TON going on down there. Not only are there about 16-20 muscles, but numerous ligaments, tendons, nerves, and fascial connections that help us complete ADLs/IADLs without the very embarrassing occurrence of urinary or bowel leakage and passing gas uncontrollably. Carter et al. (2015) found that a strong and coordinated pelvic floor leads to enhanced sexual function and higher levels of sexual activity. To me, this is reason enough to learn about the backstage crew. 

Let’s talk about what roles these pelvic floor muscles & organs play in our favorite occupation - sex!

Before we start, we’ll get into the nitty-gritty with a quick...

Welcome to the second part of our three-part series on addressing sexuality and intimacy after spinal cord injury (SCI). Today, we’ll delve deeper into the crucial role that Occupational Therapists (OTs) play in supporting individuals with SCI in this aspect of their lives. With their expertise and unique perspective, OTs can provide invaluable guidance and interventions to empower SCI patients and promote a positive and fulfilling sexual experience. The OT can be the shining light of comfort and advocacy! OTs are perfectly situated to lead these efforts in a clinical setting both for their patients and for the interdisciplinary team. Let's continue our exploration of the strategies and approaches that OTs employ in this domain.

Education and Understanding:

One of the primary responsibilities of OTs is to educate SCI patients about the impact of their injury on sexual health. By providing comprehensive education, OTs help individuals understand the changes in their...

When I first started addressing sexuality with clients and making recommendations for sex toys I went through the steps of printing out a screen shot of a vibrator on a work computer, folding it in half, and slyly giving it to my client in front of their families.  

But now, thanks to the folks at Direct-Rec App, OT clinicians can share sexual wellness products directly and privately with their clients.  Dang… where was this 10 years ago!?   

Ok, so what is Direct-Rec? 

Direct-Rec is a new app that can help clinicians share equipment and product recommendations quickly and securely with patients. The folks at Direct-Rec teamed up with the OT educators at the OT After Dark Podcast to create a category of sexual wellness products with information on how the products can be helpful to specific patients based on their specific challenges, sexual goals, or interests.  This might be a vibrator with an extended reach, slings and supports to...

I have often thought about the lack of discussion around pleasure and conversely the prioritization of discussing sexual risk and pathology in sexual dialogues – to include academic dialogues, professional dialogues, and even familial or personal dialogues.   

Dr. Jones (2019) reviewed 300 articles from the Journal of Sex Research that were published between 2010-2015 and found disease and pathology were the main focuses of the articles. 

The articles had little discussion of the role pleasure plays in both enhancing quality of life and motivating high-risk behaviors. 

The researcher also highlighted the heteronormativity and lack of inclusivity pervasive in the articles.  They used a feminist and queer lens to challenge White Supremacy and heteronormative ideology pervasive in the articles which investigates very few social factors related to sex and sexuality.

For example, among many, the researcher found most of the articles related...