International Journal of Physiotherapy and Research

Welcome to International Journal of Physiotherapy and Research



Type of Article : Case Study

Year: 2016 | Volume 4 | Issue 4 | Page No. 1589-1592

Date of Publication: 11-08-2016

DOI: 10.16965/ijpr.2016.143


Mayuri Sharma.

Assistant Professor. Shri U.S.B. College of Physiotherapy, Rajasthan, India.

Corresponding author: Dr. Mayuri Sharma, PT., Assistant Professor. Shri U.S.B. College of Physiotherapy, Rajasthan, India.


Background and Purpose: The purpose of this case report is to describe the physiotherapy management of a patient with overactivity of the pelvic-floor muscles with a limited number of visits and a focus on self-management strategies. Electrogalvanic stimulation (EGS) has been established as a safe and effective treatment for the management of levator ani syndrome (LAS). There is a paucity of recent literature regarding this treatment modality. So the aim is to review recent experience with EGS along with stretching of piriformis & myofascial release techniques.  in the treatment of levator ani syndrome.
Case description: This case involved a 40-year-old married woman with levator ani muscle overactivity  that was 5 month  in duration.
Intervention:  Therapist instructed the patient on how to control the levator ani muscles, and instructed her on relaxation techniques along with electrical stimulation,sitz bath  and myofascial release.
Outcomes: the patient attended 15 physical therapy sessions over a period of 4 weeks then once in a week over period of next 4 week. She performed relaxation exercises at home. She rated pain during intercourse as 0/10 on verbal rating scale & had no remaining tenderness in the levator ani muscle at discharge.
Discussion: Some women with levator ani syndrome may improve with an intervention that emphasizes education and vaginal self-dilation techniques. Future research should compare home-based and clinic-based treatments.
Musculoskeletal dysfunction , specifically muscle pain & overactivity of levator ani muscle is the cause of levator ani syndrome ,overactivity of the  levator ani muscle is a condition in which these muscle do not relax completly & pain itself may cause spasm of levator ani muscle.
The goal of physical therapy intervention for LAS is to reduce vaginal and anal pain by reducing overactivity of pelvic floor muscle, improving the patient ability to control these muscle & increasing the ability of vaginal tissue to tolerate stretch.
Physical therapist interventions for LAS include the use of manual therap, exercise, relaxation exercises,hot pack and galvanic stimulation.
KEY WORDS: Electrical Stimulation, Levator ani syndrome.


  1. Whitehead WE, Wald A, Diamant NE, Enck P, Pemberton JH, Rao SSC. Functional disorders of the anus and rectum. In: Drossman DA, Corazziari E, Talley NJ, Thompson WG, Whitehead WE, editors. Rome II: The Functional Gastrointestinal Disorders. 2. McLean, VA: Degnon Associates; 2000. pp. 483-501.
  2. Wald A, Bharucha AE, Enck P, Rao SSC. Functional  anorectal disorders. In: Drossman DA, Corazziari E, Delvaux M, Spiller RC, Talley NJ, Thompson WG, Whitehead WE, editors. Rome III: The Functional Gastrointestinal Disorders. 3 rd. McLean, Virginia: Degnon Associates; 2006. pp. 639-685.
  3. Hull TL. Unexplained anal/rectal pain. In: Cameron JL, editor. Current surgical therapy. 7th edn. St. Louis: Mosby, 2001;307-9.
  4. Sohn N, Weinstein MA, Robbins RD: The levator syndrome and its treatment with high voltage electrogalvanic stimulation. Am J Surg 144:580- 582, 1982
  5. Ng CL. Levator ani syndrome-a case study and literature review. Australian family physician. 2007 Jun;36(6):449-52.
  6. Kleeman S. Clinical evaluation and diagnostic tests for urinary incontinence. Journal of Pelvic Medicine and Surgery. 2004;10:93-107.
  7. Bourcier A, Juras J, Villet R. Office evaluation and physical examination. In: Bourcier A, McGuire E, Abrams P, eds. Pelvic Floor Disorders. Philadelphia, Pa: Elsevier Saunders; 2004:133-148.
  8. Bø K, Sherburn M. Evaluation of female pelvic-floor muscle function and strength. Phys Ther.2005;85:269-282
  9. Shelley B, Dunbar A. Clinical commentary: palpation and assessment of the pelvic floor muscles using depth and positional measurements. Journal of the Section on Women's Health. 2004;28(1):19-24.
  10. Weiss JM. Pelvic floor myofascial trigger points: manual therapy for interstitial cystitis and the urgency-frequency syndrome. J Urol. 2001;166:2226-2231.
  11. Salvati EP. The levator syndrome and its variant. Gastroenterol Clin North Am 1987;16:71-8.
  12. Dodi G, Bogoni F, Infantino A, et al. Hot or cold in anal  pain? A study of the changes in internal anal sphincter pressures profiles. Dis Colon Rectum 1986;29:248-51.
  13. Nicosia JF, Abcarian H. Levator syndrome: a treatment that works. Dis Colon Rectum 1985;28:406-8.
  14. Oliver GC, Rubin RJ, Salvati EP, et al. Electrogalvanic stimulation in the treatment of levator syndrome. DisColon Rectum 1985;28:662-3.


Mayuri Sharma. LEVATOR ANI SYNDROME: A CASE STUDY. Int J Physiother Res 2016;4(4):1589-1592. DOI: 10.16965/ijpr.2016.143




Volume 1 (2013)

Volume 2 (2014)

Volume 3 (2015)

Volume 4 (2016)

Submit Manuscript