Feeling tight or tearing sensation with sex? Painful? I don’t promote self- diagnosis and treatment; however here are some tools we use with patients to stretch vaginal muscles and reduce tone. think of the difference between foam rolling verses stretching your hamstrings. You require both for optimal results. So too, with pelvic floor dysfunction. I have never had a patient cure herself exclusively with dilators, it needs to be done in conjunction with manual therapy and pelvic floor muscle down training. Dilators serve as an excellent tool for a home exercise program to maintain and progress between sessions. Your pelvic floor is bowl shaped, and a straight dilator will not be able to do the job alone. At physical therapy, we customize dilator programs based on the patient, including frequency/duration, position, and instruct in stretching techniques. The dilator serves not only as a stretching tool, but is a form of desensitization, for vaginal tissue and nerves. I explain to patients, that just like I don't feel and constantly process that I am wearing glasses, so too with time the vaginal muscles will let go, relax and lengthen around the dilator. We like the Syracuse Medical Dilators. They vary in size from XS to L+. Intimate Rose is another great option, a silicone dilator set which is a softer material. Dilators are available in glass as well, which retains heat and can be soothing after warmed. Other patients prefer chilling their dilators, by leaving them in the fridge or keeping them wrapped in gel ice packs. The therawand, also coined by a patient of mine as her “magical wand”, truly works wonders. This S-curved hook, allows one to access sore spots, and perform a trigger point release both vaginally and rectally.