What Is Somatic Pelvic Physical Therapy?
Authored by Dr. Maryssa Steffen, PT, DPT, Board Certified Pelvic Health Specialist
“The white fathers told us: I think, therefore I am. The Black mother within each of us - the poet - whispers in our dreams: I feel, therefore I can be free.” - Audre Lorde
Bodyful Physical Therapy and Wellness is a somatic pelvic physical therapy practice. We collaborate with you during your healing process and we support your self evolving material.
So, what the heck is somatics and how is it applied to physical therapy and wellness?
Somatic practices are open structured, creative, and individual-centered.
They explore the principles of interoception, exteroception, and proprioception (more on these terms below!)
Research shows somatic approaches promote self-regulation and improve self authority or agency.
What does open structured and self evolving mean?
Your subjective experience is valuable material, and once developed, can be a potent resource for regulating your nervous system, exploring your creative journey, or to simply enjoy lifting weights more!
It is much more satisfying to squat with the felt sense of your bones folding during the condensing and expanding nature of your gluteal muscles, rather than dissociating from your body and counting down 10x while watching television! If you have been guided to pay attention to your body, you will never need to ask your PT again, “how many times a day should I do this exercise?” Instead, your body will guide the answers to your questions.
When you are an expert in your own needs and capacities, you are in the driving seat! How empowering and thrilling. That is livin’!
What is interoception, exteroception, and proprioception?
These are bodily senses that shape perception and motivate movement:
Interoception is awareness of the internal body.
Exteroception is awareness of the external environment.
Proprioception is awareness of movement in space.
So what about physical therapy?
In physical therapy, distinct from, and complementary to, somatic psychotherapy, you will get a neuromusculoskeletal diagnosis and plan of care, and the treatments will include individualized movement or exercise prescriptions to support and transform your condition so you may move your body with more ease and pleasure. With a somatic focus, the emphasis is on “body awareness through reflection on movement habits, opening up movement capacity and developing self-directed or personal movement styles.”
When you practice your individualized prescribed exercises, you are embarking on your own movement education journey. You will stay present and mindful during movement. This potency is deeply restorative, healing, dynamic, and generative.
When you have a consistent practice, unique to you and repeated over a period of time, your body will become conditioned to the repetitions. Soon, you may experience spontaneous moments of pleasurable movement (“Wow, running sprints feels good!” “Twerking while in a squat releases the hip flexor muscles!”)
When you embody the joy of movement, you validate your own subjective experience. Further, sensory exploration can replace fear or doubt about how you move.
By first learning, and then eventually embodying these principles, you will pay specific attention to your internal sensations and will use this sensed information to empower yourself to make meaning. This process informs you how to act. Over time, your conditioned body-mind connection is embodiment.
What is embodiment?
Embodiment is awareness.
Awareness is a stimulus for change.
Having awareness, agency, and options is liberating. When we move with more options, we have freedom.
To anticipate your question about, “Hey, I am already too aware of my body, that is why I am in pain!”- this can be caused by cognitive-emotional sensitization. When “emotions, attention, expectations, depressive thoughts, and catastrophic thoughts each enhance a descending facilitation this in turn sustains the process” of pain. This topic is too large for this blog, and is another condition we treat as part of a multidisciplinary team at Bodyful PT and Wellness. Stay tuned for part two where how we treat complex pain is explained!
How does Polyvagal Theory influence Bodyful treatments?
In polyvagal informed physical therapy, interoception can be used as a guide to explore the relationship between the body and emotions. Interoception is the “sense of the physiological condition of the entire body that is generated through sensors located in the internal organs and soft tissues, thus receiving sensory information concerning internal, visceral body processes.”
Read here about how visceral fascia mobilization can encourage your interoceptive sense.
Research shows that developing this greater awareness of the connection between bodily sensations and emotional states, “promotes listening more often to the body for insight,” and “participants [in the study] experienced their body more often as safe and trustworthy.”
When you slow down and listen, your body will tell you when to stop, when to change, when to say “no,” and when to say “yes.”
Understandably, however, slowing down and listening to your body can be frightening, especially if you have a history of traumatic holding patterns that are stored in your tissues and nervous system. There is much evidence to support that somatic and trauma-informed healing professionals can offer containers to dose your gradual return to self, to prevent overload and overwhelm, and to give your being the space needed to metabolize your story and its energy.
A Summary of Somatics:
Interoception is the perception of your gut, your emotions, and your physiology.
Exteroception comes from receptors in your skin and connective tissue, responsible for sensing touch, including pressure, heat, cold, potential damage to tissue, and vibration.
Proprioception is from receptors found in joints, ligaments, tendons, muscles, and the inner ear. This is the sense of your body in space and how you move and stay balanced.
You can deepen the interconnectedness of these sensory systems and improve your self awareness and body awareness. By engaging with these senses more often, playing with them, and practicing with others, you enrich the neural pathways for total body integration.
Lastly, somatics is not a goal. Somatics is a process.
It is a practice, and if you are lucky to live long enough, your embodied wisdom can offer a type of “fountain of youth.”
Movement options are freedom. You can get out of a chair from any number of movement patterns you choose from. The pattern may be organized from your grounded feet, from the lightness of your lungs, or the total participation from your whole being. This organized embodiment is available to you after many, many, repetitions, practiced over the years. It is a quest of being with the layers that emerge, and the parts of you discovered.
Pelvic health clients often suffer from stress and the struggle to self regulate. The traumas, isolation, fear, shame, and dissociation are often kept for you in your pelvis, so that your mind can keep functioning and so you can keep up with the outside demands and responsibilities to others.
When you are ready, your body is always there for you. It is not a performance. There is no “correct” way to move. Your body is yours, unique to you. When you can track your felt material, and try new movement behavior, you have the capacity to self-regulate and be free.
Interested in scheduling a discovery call to see if we can support your pelvic health? Click here.
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References
Meehan E and Carter B (2021) Moving With Pain: What Principles From Somatic Practices Can Offer to People Living With Chronic Pain. Front. Psychol. 11:620381. Doi: 10.3389/fpsyg.2020.620381
Pain Physician 2012; 15:ES205-ES213 • ISSN 2150-1149
