Hey Scotsman - in re external TrPs

[boudreaux]

John here, from the AHIP clinic. For those of you who don't know, I used to be on this board quite a bit circa 2004-2006. You can find some of my old posts in the success stories index. I went to the AHIP clinic in June of 2004 and made a great recovery over the next few years using the protocol. After my recovery, I wrote some patient perspective essays for Dr. Wise for the new editions of the book, and help out at the clinic now when my schedule allows from a patient/home program perspective. I met Scotsman a few clinics ago.

Anyway, I only come back to the board once in a blue moon to see what themes people are talking about. I think it's an awesome board and fills a really needed support role for this condition. I saw Scotsman's posts below regarding the importance of proper, daily external trigger point work. People get obsessed with the internal work (don't get me wrong, the internal work is very important), but if you are not paying attention to the abs, psoas, iliacus, ql, adductors, etc from the external perspective, you can really be missing the boat about relieving or lessening your symptoms. As Scotsman alluded to and in my experience as well, releasing the external muscles can actually cause a visceral, systemic release of the internal pelvic floor and perineum. Releasing your external muscles before internal treatment can also help a lot with your internal releases and improvement. I'm not a doctor, of course, and can't give medical advice, but this has been my experience over the years. The Theracane is great, and I have also found that the rubber grip end of a golf club is super for abs, psoas, and iliacus external treatment. You can lay on your back and put your hands on the golf club's shaft any way you like to create the proper leverage. And the rubber grip is just perfect for honing in on the deep belly muscles and angling in on the iliacus.

In any event, I just wanted to drop a note because I haven't posted in years and was glad to see about Scotsman's progress below. I send my best to everyone and want to encourage everyone to keep going, keep doing the things that facilitate healing.

[Sherradin]

Hi John

Thanks for the reminder. I have been doing well had the best week a couple of weeks ago in years. I have been getting help with the external release from a trigger point masseuse in Sydney who is awesome. Spends over two hours with me and I feel like a jelly ball when I float out at the end.

However set backs are the killer. I stick with the protocol but get thrush badly sometimes from the bath. We females have a whole lot of other issues that come to play with our anatomy esp. post kids. Anyway having a tough week again and overdid it with the wand so butt's sore and bled a bit. So going more gently and relaxing into it. However using the wand anally has been better than vaginally as it seems to loosen the butt muscles more.

I will try harder with my externals as Tim said my outer trigger point map was just like yours. But I miss my baths. Even trying it in a spring suit bottom to get the relaxation without the water slushing about. Yes quite eccentric sounding.

I am so glad that some part of this is within my control. I had to speak to a team at our pelvic pain clinic at one of the Sydney Hospitals last week and suggested they look at a multi-disciplinary approach. I don't know how they would replicate the environment at Dr Wises clinic. It is special.

[scotsman]

Hi John - good to see you back posting again :)

Yes, the external work has been the biggest revelation for me. I never realised just how key it is. My perineum pain had gone back up from 1-2 to 3-4 and I found that my glutes were very bad again - treated those bad boys on the floor with a tennis ball and the pain was back down to 1-2.

[carld]

I have to chime in here...I couldn't agree more...example is the area over my belly button...If I stretch back and press in and up, it sends discomforting pain right through my pelvis into my perineum. So I know I have TP's in my abs and other places mentioned above as well.

Great post!!!

[Sullivot]

I was wondering, when lying on the floor, how much pressure do you guys put into the belly area with the cane, club etc. While I get some relief doing them (I just started), I don't want to damage any organs. Also how long do you press in and hold. I've been holding about 10-15 seconds. Thanks!

[scotsman]

Avoid the central vertical area - if you can feel a pulsing sensation in that central area then move away from it (arteries). As for pressure - I put a fair amount of pressure and holding for around 30 seconds. I'd be very surprised if you'd do any internal damage - though one bit of advice if to use a Theracane with a split tennis ball over the treatment end you are using as that spreads out the area of contact as it's easier on the body and reduces any trauma at the point of treatment.

A Theracane is a must buy - by far the best tool.

[Sullivot]

Thanks. I'm finding that the real relief I derive from both internal and external TP pressure & massage is the next day. I did some Thursday night after work. It had been one of the worst weeks symptom wise in years. After working the TP's I felt little immediate relief, in fact, I had to sit in a hot bath I felt so lousy. On friday morning upon arising, I thought I was in for another bad day, but lo and behold I had my BEST day in years. I actually went 4 hours without needing to urinate, despite drinking 2 cups of coffee. But the best was later on...when I didn't feel run down and actually went out with friends and enjoyed myself for once. I made the mistake of skipping any massage later that night, and on Saturday I felt not nearly as good. I did the massages again last night, and today I feel almost as good as Friday. There seems to be a delay between the TP massage and the relief. So I'm learning....even if I feel good today, I need to do the TP work so I won't regress tomorrow. I've been suffering on & off for 20 years, so these exercises may turn out to be a godsend for me. Long term, it's still too early to tell, but for the first time in years, I see a light at the end of the dark tunnel. Thanks to all here who post their stories and remedies.

[scotsman]

I have a routine of external stretching and triggerpoint work every night and I do internal work every second to third day. Note that at the Wise-Anderson clinic they are looking at doing stretching and external triggerpoint work 2-3 times per day. I find as well that doing skin rolling around the perineum makes a big difference as well plus I try and have a bath every night too.

[DMcU]

...If I stretch back and press in and up, it sends discomforting pain right through my pelvis into my perineum. So I know I have TP's in my abs and other places mentioned above as well.

Exactly what I feel as well! So do you keep pushing in and down (this gives me the urge to urinate) to stretch these ab muscles or do you think that this is simply putting pressure on the bladder which in turn could be causing a different effect upon the muscles in the perineum?

D

[DMcU]

Sullivot,

a quick question.
My symptoms have changed a little lately in regards of when I feel the urge to urinate, well 'feel' isn't the correct word - it's more physical, i.e. the muscles in my perineum tensing and spasming which also burns my urethra. Then I feel a burning sensation from my suprapubic bone up to my navel, feels as if it's in the bladder. I don't feel this pain barre when I get this urge to urinate and as I am passing urine I feel this burning towards the end of urination. It goes quickly though.
Does this sound like IC to you or just another classic case of some of the symptoms encompassed in CPPS?

Thanks.