Maybe it's not my pelvic floor?

[londoner]

Yesterday I went some distance to see a physiotherapist who specialises in pelvic floor dysfunction in men. I don't mean she's like some of the American PTs who have been mentioned on this site. She specialises mainly in male and female urinary incontinence.

Right off she told me I ought to be on antibiotics and should go back to my urologist. She had me lie down while she pushed a finger up me and got me to squeeze and release several times as hard as I could.

On the basis of that ability-to-squeeze-and-release examination she considered that my pelvic floor was in good shape, plenty of ability to both squeeze a finger and release it.

But she didn't haver a feel round in that area so I'm wondering if she's either right and I don't have anything wrong with my pelvic floor, or she's just not the right sort of physiotherapist for this condition.

Can anyone advise please.

Thanks..

[scotsman]

How she can recommend you being on antibiotics is beyond be

Definately not the sort of physio you should be seeing for this condition if all she does is the finger up the arse and squeeze test. My first assessment by a physio lasted an hour - with another hours worth of treatment.

Richard.

[alprost]

I agree with the above - All she has done is test the strength of your pelvic floor muscles in relation to urinary incontinance - this has nothing to do with CPPS. I can tell you with confidence that she obviously knows NOTHING about CPPS.

I don't know how often I've seen this - a patient who has chronic prostatitis / chronic pelvic pain syndrome goes to a Physio without relevant training, is told that there is not a problem, and they are put off following the only course of treatment that can help them. It has actualy happened to me - I saw 2 physios who told me I had no more trigger points, and they didn't know whare my symptoms were coming from. I then went to Stanford and they found over fifteen internal and external trigger points.

With regard to antibiotics, a small proportion of men (5-7%) with recurrent prostate infections DO need to take them, but this is the exception rather than the rule - how she can advise you to take them from what she did is beyond me (Actually it isn't - she is just untrained).

For an overview of how a pelvic floor exam should be carried out for chronic prostatitis / chronic pelvic pain syndrome patients, read this excerpt from an interview with specialist Physio Rhonda Katorinos (you might want to sent it to the Physio who 'assessed' you):

The pelvic exam has two components: an internal exam and a computerized muscle assessment. The pelvic exam is focused on assessing the musculature and other pelvic tissues not the organs. The pelvic floor, also know as the levator ani, is evaluated with regards to its function. Can the patient locate the muscle and perform an isolated contraction? Or does she use other muscle groups to assist her in contracting the muscle? This is also known as substitution. Is there difference from the right side to the left? Are there trigger points in the muscles? Trigger points can be a source of pain as well as cause the muscle to not function properly. The therapist will also assess the ability of the pelvic floor to relax after a contraction. The ability of the patient to do a lengthening contraction from the resting position is also evaluated. This is also known as an eccentric contraction. An eccentric contraction is the motion that is required to initiate urination. During the internal exam the therapist will also be assessing the other tissues found within the pelvis - the connective tissue and the neural tissue specifically.

There are also other muscles inside the pelvis that are actually leg muscles. These are closely related to the pelvic floor muscle. So, if you traumatize a leg, you could set up a domino effect that could cause a pelvic floor problem. You need to monitor those muscles as well.

Besides the internal exam, there is also computer assessment. The computer assessment measures the force the pelvic floor muscle generates when it contracts and its range of motion. I utilize the computer to provide objective data to describe the pelvic floor changes as treatment progress.

You should also read this article: https://ucpps.men/chronic-prostatitis-is-a-psychoneuromuscular-condition

Getting a Physio who IS trained in chronic prostatitis / chronic pelvic pain syndrome is a big problem unfortunately.