Check out this: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5479997/"The aim of the study was to compare the efficacy of two conservative treatments, the use of anal dilators or a finger for anal dilatation, in reducing anal pressure and resolving anal fissures."

Has anyone tried this method? The study says it was used on people with acute fissures, will it work on chronic as well?

This is basically what my pelvic floor PT wants to do. I didn't handle the first session well, so I'm doing the dilators a bit longer first. We plan to restart next week.

The results of that study are very interesting. My PT says it works better because the dilator doesn't reach all of the muscles.

I'm currently doing the massage exercises as well, although not as described in the paper. Instead, as my PT directed, I use my finger to internally press on four directions for 30 seconds each. I repeat the lateral directions twice. After that I use a dilator inserted for two minutes. I don't think I could tolerate a 10 minute massage like the patients in the study, the pain would be too much.

Very interesting. Are your fissures chronic or acute? Do you have any links or more detailed instructions as to how to perform this sort of therapy?

I´ve got a fissure that is almost healed, but keeps tearing every 3-4 weeks. I´ve been thinking that I might benefit from some sort of dilation to make the lining of the anal canal more flexible so as to prevent these small relapses, but am a bit worried that I´ll tear it more that way. Any opinions on this is appreciated.

I don't know if I have a fissure anymore. Two different doctors have said it's gone. But my muscles have forgotten how to function properly, and doctors I've seen are mostly useless when it comes to quality of life issues, so PT is my last resort. I don't have any links to instructions, sorry! I would recommend gentle stretching internally if you can handle it. But it's best not to push directly on the fissure if it's raw.

My fissure has been healed for quite some time. I still have internal hemorrhoids that hurt and bleed with every BM, however. My doctor sent me to the PT because he didn't understand why I was having as much pain as I was, to the point where I could never sit down comfortably. The dilator helped almost immediately. I think the muscles got really tight during the "fissure period", and haven't settled down. I suspect that's a big reason why the hemorrhoids never improve, even with infrared coagulation treatment.

I haven't really started the massage therapy yet, so I don't really know the proper procedure. I know the PT will do something similar to what patience_and_healing said: go around in a circle and press, slowing working inward.

It's good that you're seeing some improvement with the dilator. What size are you using, if you don't mind me asking? I've started at the smallest size of 8mm, because everything is so tender internally.

I'm actually using an 18mm dilator now. I have to go slow to get it in. I started out with a 13mm. I don't have a fissure, so being more aggressive seemed ok. My PT wants me to eventually move up to a 22mm, but I'm not sure that's necessary.

What type of dilator are you using? Is it something that can be ordered online? Found a good deal here: https://shevibe.com/sinclair-select-deluxe-silicone-dilator-set.aspx

My PT gives me small vaginal dilators, actually:
https://www.cmtmedical.com/product/syra ... -dilators/