Acupressure in Holistic Pelvic Health

As physical therapists who specialize in treating all genders and all conditions related to the niche practice of pelvic health, it has been a privilege for us to deliver whole-person care, emphasizing self-healing, nervous system regulation, and mind-body integration. We often see patients who are under high stress and anxiety, and even more so when they have no other options except surgical intervention.

One such case was a 71-year-old patient who came in with a rectal prolapse. She had experienced a 10 cm rectal prolapse post-defecation, and it had taken prolonged bed rest for half a day for spontaneous reduction to occur. This happened after every bowel movement. She was told there were no other options except surgery. She was afraid to undergo rectal surgery and was willing to try anything to avoid it. Over the course of the first visit, I also learned that she had a family member who was very ill, and she rated her stress and anxiety levels beyond 10/10.

Rectal prolapse is full thickness protrusion of the rectum through the anal canal. It can occur in both sexes, but is 6 times more likely in women. Overall, about 13% of women will undergo surgery for some form of pelvic prolapse at some point in their lives. The incidence of pelvic prolapse also increases with age, peaking in those over 70 years^1,2. Rectal prolapse can present in a variety of forms and is associated with a range of symptoms including pain, incomplete evacuation, mucous rectal discharge, and fecal incontinence or constipation^2,3,4,5,6.

It is associated with lifestyle-limiting symptoms for the patient and frequently co-exists with other types of pelvic prolapse, making multidisciplinary management key, as it is primarily managed with surgical reconstruction². Multiple surgical approaches exist within the two broad categories of perineal and abdominal. Perineal approaches are considered less physiologically taxing but are associated with higher recurrence rates. Anterior mesh rectopexy appears to balance the best functional outcomes with the lowest risk of recurrence².

There is currently limited evidence to support non-surgical rehabilitation options for this condition. Complementary and Alternative Medicine (CAM) techniques, such as Acupressure, have shown promise in pelvic health, yet are largely underexplored in the context of rectal prolapse.

Given this patient’s high anxiety and impaired bowel function that required prolonged bed rest post-defecation, I decided to use a novel multimodal rehabilitation approach. This approach integrated Acupressure, pelvic floor muscle training (PFMT), manual therapy, breathing and mindfulness techniques, and postural and functional retraining. The goal was to address her symptoms, improve activity tolerance and function, and improve her quality of life.

Acupressure was introduced at the first visit. Over the course of 7 visits, this patient progressed through a gentle pelvic floor strengthening program and had a 90% improvement in her rectal prolapse symptoms. She was also trained to use pelvic floor Acupressure at the Governing Vessel 1 (GV 1) Acupoint to effectively and quickly reduce her rectal prolapse after every bowel movement.

The patient was also taught an Acupressure nervous system self-regulation program that consisted of Acupressure points to help her improve mind-body awareness & connection to down-regulate her nervous system. Several Acupoints, such as Conception Vessel 17 (CV17), Governing Vessel 24.5 (Yintang point), Heart 7, and Pericardium 6, were used to help her manage and control her stress and anxiety. These points were reviewed and reinforced at each session. Her functional gains included restored ability to perform ADLs without post-bowel movement limitations. She also demonstrated improved pelvic floor muscle coordination, increased standing and walking tolerance, and was very pleased that she was able to avoid surgery. Her anxiety levels significantly improved with the daily self-regulation practice, and she felt she now had physical control over her symptoms.

Acupressure is an evidence-based practice that is rooted in Acupuncture and Traditional Chinese Medicine. In Acupressure, we use gentle finger pressure instead of needles to stimulate specific points on the body known as Acupuncture points. These energy points are known to have high electrical conductivity at the surface of the skin and are embedded within the body’s vast fascial network. Because of this, they offer a unique gateway to access and influence the nervous system.

As a Holistic pelvic health practice, Acupressure can be used to:

1. Reduce Pelvic Pain
   Potent acupoints on the abdomen, pubic bone and sacrum can help to relax pelvic floor muscles, ease menstrual cramps and pelvic pain. The Bladder meridian points along the sacral spine (B27–B34) — are for back pain, pelvic tension, and reproductive organ support.
2. Enhance Blood Flow & Energy (Qi)
   Certain acupoints stimulate blood and lymph circulation in the pelvic region, supporting physiological functioning of various sexual and reproductive organs. The Kidney 1 point, located on the sole of the foot — is for grounding, calming, and helps with anxiety and stress stored in the pelvic bowl.
3. Regulate Menstrual & Reproductive Health
   Acupressure can help regulate cycles, reduce PMS symptoms, and support fertility by harmonizing hormonal pathways. The Spleen 6 – Sanyinjiao point, which is located on the inner leg, above the ankle — regulates menstrual cycles, supports fertility, and soothes menstrual cramps.
4. Promote Nervous System Regulation
   Acupressure engages the parasympathetic nervous system and can help to calm the body, improve sleep, and promote relaxation. The pelvis is often a storehouse for unprocessed emotions, especially trauma. Acupressure combined with breathwork or somatic practices can help with these symptoms.
5. Support Bladder & Bowel Function
   Pressing on meridian points associated with the bladder, kidneys, spleen, or large intestine can aid with incontinence, constipation, and other bowel & bladder symptoms. Acupressure can also help with symptoms of Rectal Prolapse as noted in this patient case.

This patient case explores a multimodal rehabilitation program integrating Acupressure with traditional pelvic floor therapy, which may serve as an effective non-surgical intervention for rectal prolapse. Improvements in symptom control, functional mobility, and self-management highlight the potential of Acupressure as a conservative approach for prolapse care.

I am so humbled to share that this patient’s Case study has been accepted at the International Urogynecological Association (IUGA) & European Urogynecological Association (EUGA) joint meeting that is being held in Barcelona, Spain in June this year. This is a great step forward to explore holistic options in pelvic health, and I am grateful to be part of this patient’s journey to wellness.

To learn more about Acupressure, please join the upcoming remote course Acupressure for Optimal Pelvic Health scheduled for June 7- 8^th. The course will introduce participants to the basics of Traditional Chinese Medicine (TCM), Acupuncture & Acupressure. The course introduces the 12 major Meridians or energy channels, focusing on the Bladder, Kidney, Stomach, and Spleen meridians. The course is packed with key potent points that can help to self-regulate the nervous system and help with anxiety, insomnia, chronic pelvic pain, dysmenorrhea, infertility, constipation, urinary dysfunctions, digestive disturbances, cancer pain, and much more. The course also offers an introduction to Yin yoga and explores Yin poses within each meridian channel that can be integrated with Acupressure and mindfulness practices.

References

1. Bordeianou L, Hicks CW, Kaiser AM, Alavi K, Sudan R, Wise PE. Rectal prolapse: an overview of clinical features, diagnosis, and patient-specific management strategies.J Gastrointest Surg. 2014;18(5):1059-1069. doi:10.1007/s11605-013-2427-7
2. Romero-Morales C, Bravo-Aguilar M, Abuín-Porras V, et al. Current advances and novel research on minimal invasive techniques for musculoskeletal disorders. Dis Mon. 2021;67(10):101210. doi:10.1016/j.disamonth.2021.101210
3. Yang J, Do A, Mallory MJ, Wahner-Roedler DL, Chon TY, Bauer BA. Acupressure: An Effective and Feasible Alternative Treatment for Anxiety During the COVID-19 Pandemic.& Glob Adv Health Med. 2021;10:21649561211058076. Published 2021 Dec 12. doi:10.1177/21649561211058076
4. Wen J, Chen X, Yang Y, et al. Acupuncture Medical Therapy and Its Underlying Mechanisms: A Systematic Review. Am J Chin Med. 2021;49(1):1-23. doi:10.1142/S0192415X21500014
5. Zhou YF, Zhang GL, Sun N, et al. Acupuncture for emotional disorders in patients with inflammatory bowel disease: a systematic review protocol. BMJ Open. 2022;12(9):e058568. Published 2022 Sep 27. doi:10.1136/bmjopen-2021-058568
6. Gallo G, Martellucci J, Pellino G, et al. Consensus Statement of the Italian Society of Colorectal Surgery (SICCR): management and treatment of complete rectal prolapse. Tech Coloproctol. 2018;22(12):919-931. doi:10.1007/s10151-018-1908-9

AUTHOR BIO
Rachna Mehta PT, DPT, CIMT, OCS, PRPC, RYT 200

Rachna Mehta PT, DPT, CIMT, OCS, PRPC, RYT 200 (she/her) graduated from Columbia University, New York with a Doctor of Physical Therapy degree. Rachna has since been working in outpatient hospital and private practice settings with a dual focus on Orthopedics and Pelvic Health. She was instrumental in starting one of the first Women’s Health Programs in an outpatient orthopedic clinic setting in Mercer county in New Jersey in 2009. She has authored articles on pelvic health for many publications. She is a Certified Integrated Manual Therapist through Great Lakes Seminars, is Board-certified in Orthopedics, is a certified Pelvic Rehab Practitioner and is also a registered yoga teacher through Yoga Alliance. Rachna has trained in both Hatha Yoga and Yin Yoga traditions and brings the essence of Yoga to her clinical practice.

Rachna currently practices in an outpatient setting. Her clinical practice has focused on an Integrative physical therapy approach blending traditional physical therapy methods with holistic practices that address the whole person - physically, mentally, emotionally, and spiritually. She specializes in working with pelvic health patients who have bowel & bladder issues with high pelvic pain which sparked her interest in Eastern holistic healing traditions and complementary medicine. She has spent many hours training in holistic healing workshops with teachers based worldwide. She is a member of the American Physical Therapy Association and a member of APTA’s Academy of Orthopaedic Physical Therapy and Academy of Pelvic Health Physical Therapy.

Rachna also owns TeachPhysio, a PT education and management consulting company. Her course Acupressure for Optimal Pelvic Health brings a unique evidence-based approach and explores complementary medicine as a powerful tool for holistic management of the individual as a whole focusing on the physical, emotional, and energy body.