Yes, these muscles and the muscles in that general area wrap up under the pubic bone and connect internally. I had pea sized nodules and things in the areas near my thighs that I could never seem to release. Often trying harder and harder would send the whole area into flare. The best way to work this area is like I mentioned above. Spend a few minutes releasing the front external areas and then immediately go internal and work them from that angle. Do this a couple of times in a session and you will notice a huge improvement. This area had a lot of influence on my general erectile response. Not sure why this is but there was definitely a direct correlation. ;)I have exactly the same issue with the pyramidalis muscles, which is what you're referring to. These are always tense and it is very difficult to break down tension. Not sure if the connect to any internal muscles but in itself they can cause a lot of discomfort.
Neue01's Case
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neue01
- Senior Veteran

- Posts: 225
- Joined: Wed Feb 06, 2008 6:17 pm
- Location: San Francisco
Re: What worked for me
Age: 33 | Onset Age: 28
Flare | Symptoms: burning after urination/defecation, post-urinary dribbling, low libido, low arousal, pelvic aches and pains.
Helped By: Physical therapy of the levator ani muscle group, Relaxation, Diet
Worsened By: Eating refined sugar and gluten, coffee, beer, stress
Flare | Symptoms: burning after urination/defecation, post-urinary dribbling, low libido, low arousal, pelvic aches and pains.
Helped By: Physical therapy of the levator ani muscle group, Relaxation, Diet
Worsened By: Eating refined sugar and gluten, coffee, beer, stress
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neue01
- Senior Veteran

- Posts: 225
- Joined: Wed Feb 06, 2008 6:17 pm
- Location: San Francisco
Re: What worked for me
BTW. This was a major area for me as well. This took the longest to work out and contributed a ton to my condition. The muscles on the back dorsal side are very strong and don't like being released all that much. It took a lot of effort and time to get them functioning properly again. They also have a tendency to resort back to being slightly congested at times. It's much easier to release them now but I can sympathize with the effort it takes to work those areas.I am getting much better as well but I noticed last night when massaging the pubic bone area that a pain shot to the top of my penis.
Age: 33 | Onset Age: 28
Flare | Symptoms: burning after urination/defecation, post-urinary dribbling, low libido, low arousal, pelvic aches and pains.
Helped By: Physical therapy of the levator ani muscle group, Relaxation, Diet
Worsened By: Eating refined sugar and gluten, coffee, beer, stress
Flare | Symptoms: burning after urination/defecation, post-urinary dribbling, low libido, low arousal, pelvic aches and pains.
Helped By: Physical therapy of the levator ani muscle group, Relaxation, Diet
Worsened By: Eating refined sugar and gluten, coffee, beer, stress
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benzo
- Senior Veteran

- Posts: 221
- Joined: Thu Jan 20, 2005 10:04 pm
Re: What worked for me
Not sure if you can release these nodules, imo you can only release trigger points. If they don't refer or cause pain, I would leave them alone...neue01 wrote:Yes, these muscles and the muscles in that general area wrap up under the pubic bone and connect internally. I had pea sized nodules and things in the areas near my thighs that I could never seem to release. Often trying harder and harder would send the whole area into flare. The best way to work this area is like I mentioned above. Spend a few minutes releasing the front external areas and then immediately go internal and work them from that angle. Do this a couple of times in a session and you will notice a huge improvement. This area had a lot of influence on my general erectile response. Not sure why this is but there was definitely a direct correlation. ;)I have exactly the same issue with the pyramidalis muscles, which is what you're referring to. These are always tense and it is very difficult to break down tension. Not sure if the connect to any internal muscles but in itself they can cause a lot of discomfort.
Age: 38 | Onset Age: 27 | Symptoms: scrotal pain, perineal pain, pubic pain, lower abdominal pain, sometimes urgency, | Helped By: sometimes excercising | Worsened By: found no real triggers
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GARYS
- Old Hand

- Posts: 303
- Joined: Thu Oct 31, 2002 12:40 am
Re: What worked for me
Neue did you ever find any tps that recreated the burning urethra after urinating? If so where at? Glad your doing well. Did the soles of your feet ever burn along with the urethra?
Thanks
Thanks
Age:33 | Onset Age: 20 | Symptoms: burning urethra after urinating, followed by rush to urinate again, rectal pain after a bowel movement sometimes, frequency. | Helped By: Pyridium and Ativan | Worsened By: stress, sitting and unknown reasons.
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neue01
- Senior Veteran

- Posts: 225
- Joined: Wed Feb 06, 2008 6:17 pm
- Location: San Francisco
Re: What worked for me
The nodules do relax if we are talking about the same areas. They are a congestion that can be felt externally but it is actually internally around the rotator cuffs that release them. Not all tightness and bunching is a trigger point. If left and continually aggravated I think these areas turn into TPs. Work your internal rotator areas and see if that helps. ;)Not sure if you can release these nodules, imo you can only release trigger points. If they don't refer or cause pain, I would leave them alone...
Age: 33 | Onset Age: 28
Flare | Symptoms: burning after urination/defecation, post-urinary dribbling, low libido, low arousal, pelvic aches and pains.
Helped By: Physical therapy of the levator ani muscle group, Relaxation, Diet
Worsened By: Eating refined sugar and gluten, coffee, beer, stress
Flare | Symptoms: burning after urination/defecation, post-urinary dribbling, low libido, low arousal, pelvic aches and pains.
Helped By: Physical therapy of the levator ani muscle group, Relaxation, Diet
Worsened By: Eating refined sugar and gluten, coffee, beer, stress
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neue01
- Senior Veteran

- Posts: 225
- Joined: Wed Feb 06, 2008 6:17 pm
- Location: San Francisco
Re: What worked for me
Absolutely. They run along the back dorsal side of the sphincter and rectal area. I could stir up the area right now and get that exact feeling if I was so inclined. It's an area that is still healing for me. This area is not easy to work out and the muscles are pretty strong over all. I did not have burning feet but I did have all sorts of other weird symptoms. Brain fog and drowsiness, muscle twitching in my legs and arms, reactions to food, aching at the base of my skull. These things all died down for me once I got the muscles worked out pretty well. On a day that I flair them up though I can get some return of those symptoms.Neue did you ever find any tps that recreated the burning urethra after urinating? If so where at? Glad your doing well. Did the soles of your feet ever burn along with the urethra?
Age: 33 | Onset Age: 28
Flare | Symptoms: burning after urination/defecation, post-urinary dribbling, low libido, low arousal, pelvic aches and pains.
Helped By: Physical therapy of the levator ani muscle group, Relaxation, Diet
Worsened By: Eating refined sugar and gluten, coffee, beer, stress
Flare | Symptoms: burning after urination/defecation, post-urinary dribbling, low libido, low arousal, pelvic aches and pains.
Helped By: Physical therapy of the levator ani muscle group, Relaxation, Diet
Worsened By: Eating refined sugar and gluten, coffee, beer, stress
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neue01
- Senior Veteran

- Posts: 225
- Joined: Wed Feb 06, 2008 6:17 pm
- Location: San Francisco
More Progress
Hey gang. So, I thought I'd post on my progress as of late and throw out some new massage techniques that have been working. Things have continued to progress nicely over the last 6 months. The muscles have begun to reach a place where they can release on their own or with less physical manipulation. I have moved toward less and less massage and even my flares after sex or masturbation are becoming less apparent. I make sure to massage things out after sex and just about every morning or evening. It just really depends on how things are feeling down there.
The most important thing to note is that I am no longer doing internal massage as the muscles and TPs are pretty worked out after the last couple of years. I notice that when I do internal massage I tend to flare things up 50% of the time as opposed to help loosen things. I have found that external massage is breaking my flares even when they are caused internally. The external muscles have a direct effect on the internal ones and I've noticed that if I work them out it actually releases any internal flare I'm having. The technique I'm using is to work out my abs, my buttocks and my thighs. I work the abs by massaging from the upper part of the body down to the penis. I also massage around the penis the inner thighs and the top of the thighs. I've noticed big effects in these areas. Lastly the most important technique I've been using is to work the buttock out during and after a session. I simply hold and pull both cheeks apart while relaxing like I'm going to go number one and two. You can literally feel the muscles realign themselves and settle back into their natural resting positions. This has been huge and even takes care of internal flares in a major way.
I figure I'm going to be working things out like this for the next 6 months. I want everyone to know that all functionality and sensation has come back on line when things are stabilized and worked out. I can still go through a flare with too much sex which has been happening with my new GF. We just go easy on things and I make sure to release the muscles afterwards. It's great to see them release so easily now. I'm still not all the way healed from this thing but there has been massively huge progress from where I was 4 years back. These methods really do help heal this condition. Keep putting in the time and effort to thoroughly work out all muscles involved. It's a struggle and things get pretty dark at times but you will make it through. :)
The most important thing to note is that I am no longer doing internal massage as the muscles and TPs are pretty worked out after the last couple of years. I notice that when I do internal massage I tend to flare things up 50% of the time as opposed to help loosen things. I have found that external massage is breaking my flares even when they are caused internally. The external muscles have a direct effect on the internal ones and I've noticed that if I work them out it actually releases any internal flare I'm having. The technique I'm using is to work out my abs, my buttocks and my thighs. I work the abs by massaging from the upper part of the body down to the penis. I also massage around the penis the inner thighs and the top of the thighs. I've noticed big effects in these areas. Lastly the most important technique I've been using is to work the buttock out during and after a session. I simply hold and pull both cheeks apart while relaxing like I'm going to go number one and two. You can literally feel the muscles realign themselves and settle back into their natural resting positions. This has been huge and even takes care of internal flares in a major way.
I figure I'm going to be working things out like this for the next 6 months. I want everyone to know that all functionality and sensation has come back on line when things are stabilized and worked out. I can still go through a flare with too much sex which has been happening with my new GF. We just go easy on things and I make sure to release the muscles afterwards. It's great to see them release so easily now. I'm still not all the way healed from this thing but there has been massively huge progress from where I was 4 years back. These methods really do help heal this condition. Keep putting in the time and effort to thoroughly work out all muscles involved. It's a struggle and things get pretty dark at times but you will make it through. :)
Age: 33 | Onset Age: 28
Flare | Symptoms: burning after urination/defecation, post-urinary dribbling, low libido, low arousal, pelvic aches and pains.
Helped By: Physical therapy of the levator ani muscle group, Relaxation, Diet
Worsened By: Eating refined sugar and gluten, coffee, beer, stress
Flare | Symptoms: burning after urination/defecation, post-urinary dribbling, low libido, low arousal, pelvic aches and pains.
Helped By: Physical therapy of the levator ani muscle group, Relaxation, Diet
Worsened By: Eating refined sugar and gluten, coffee, beer, stress
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Mike Kavo
- Moderator

- Posts: 98
- Joined: Wed Oct 30, 2002 11:42 pm
- Location: UK
Re: More Progress
Very good post! Thank you for posting it! I am following a path like this just now and would agree with all your points.
Please keep us all informed of your progress.
It is great you're feeling better!
Please keep us all informed of your progress.
It is great you're feeling better!
Age: 32 | Onset Age: 22 | Symptoms: Pain | Helped By: Sleeping, Relaxation, Exercise, Stretching, Tramadol (Bad Flare Only Generally Prefer No Chemistry), Good Diet, Quercetin, Fish Oil | Worsened By: Stress, Too Much Ejaculation, Protection Response
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neue01
- Senior Veteran

- Posts: 225
- Joined: Wed Feb 06, 2008 6:17 pm
- Location: San Francisco
Update
I thought I'd make an update and share some pretty interesting new finds. I've made a large amount of progress over the last two years and thought I'd introduce more serious exercise back into the mix. This has included running, tennis, swimming, golf and weight lifting. My focus has been to build back the pelvic muscles and strengthen things some.
In doing so I began to notice my muscles in my arms becoming knotted and sore like the muscles in the pelvic floor from all the weight lifting. One night while watching TV and releasing my forearms it hit me the something must be wrong with my system over all. I have a tendency toward muscles not being able to relax well on their own. This got me looking into magnesium. I've begun taking magnesium supplements, eating bananas and drinking muscle milk on an almost daily basis. This in conjunction with moderate exercise and less focused Physical therapy has been very impressive. The results have been drastic and very noticeable.
On the massage level I've now begun to hit a few areas every single session every other day and make sure to hold on the area for 3 counts of 100. I hit all positions on the clock internally for 3 counts of 100 and the muscles actually release completely. I keep it perfectly steady and do not follow the wave of the muscle which I used to do more of in the past. I use a tool for all internal work. Once in awhile I still go up much further to make sure everything is in check. Then I go externally on the glutes, sphincter, abs, and thighs to check to tight areas. These usually release very easily if I find them now. The last massage thing to note is I work the 6:00 position on the sphincter both internally and externally pretty heavily now. I think this has always been one of the biggest areas for me. I took a long time to totally realize this though. Once I've released all areas I avoid hunting down points and obsessing over tight spots for the entire day. This is extremely hard because this condition preys on your OCD.
I also avoid sitting like the plague now. Most of all on hard surfaces the irritate or shift the muscles on the external glutes which then irritate and tighten the internal muscles. I had to change my job to do this being that used to sit at a computer all day.
Last but not least, I want to say that I try to limit sexual activity of most sorts because this is the biggest flare and I'm convinced this is the case for all of us. I don't stress it though and usually the next morning after I've been with my girlfriend I just religiously release all areas back to normal. I try to limit sex to 2-3 times a week and do not masturbate anymore. This is really the main thing that got us into this hellish condition after all.
So, that's it so far. I stay released and limber for days on end until I have sex and things tighten up again. It's much easier to release though and not much else flares me up now except sex. I want to say that there is hope for everyone and I think there actually is a cure to this not just a situation where we have to live with it. We just won't be able to go back to activities that got us here in any real extreme way once the muscles heal. Hope this helps some of you. :)
In doing so I began to notice my muscles in my arms becoming knotted and sore like the muscles in the pelvic floor from all the weight lifting. One night while watching TV and releasing my forearms it hit me the something must be wrong with my system over all. I have a tendency toward muscles not being able to relax well on their own. This got me looking into magnesium. I've begun taking magnesium supplements, eating bananas and drinking muscle milk on an almost daily basis. This in conjunction with moderate exercise and less focused Physical therapy has been very impressive. The results have been drastic and very noticeable.
On the massage level I've now begun to hit a few areas every single session every other day and make sure to hold on the area for 3 counts of 100. I hit all positions on the clock internally for 3 counts of 100 and the muscles actually release completely. I keep it perfectly steady and do not follow the wave of the muscle which I used to do more of in the past. I use a tool for all internal work. Once in awhile I still go up much further to make sure everything is in check. Then I go externally on the glutes, sphincter, abs, and thighs to check to tight areas. These usually release very easily if I find them now. The last massage thing to note is I work the 6:00 position on the sphincter both internally and externally pretty heavily now. I think this has always been one of the biggest areas for me. I took a long time to totally realize this though. Once I've released all areas I avoid hunting down points and obsessing over tight spots for the entire day. This is extremely hard because this condition preys on your OCD.
I also avoid sitting like the plague now. Most of all on hard surfaces the irritate or shift the muscles on the external glutes which then irritate and tighten the internal muscles. I had to change my job to do this being that used to sit at a computer all day.
Last but not least, I want to say that I try to limit sexual activity of most sorts because this is the biggest flare and I'm convinced this is the case for all of us. I don't stress it though and usually the next morning after I've been with my girlfriend I just religiously release all areas back to normal. I try to limit sex to 2-3 times a week and do not masturbate anymore. This is really the main thing that got us into this hellish condition after all.
So, that's it so far. I stay released and limber for days on end until I have sex and things tighten up again. It's much easier to release though and not much else flares me up now except sex. I want to say that there is hope for everyone and I think there actually is a cure to this not just a situation where we have to live with it. We just won't be able to go back to activities that got us here in any real extreme way once the muscles heal. Hope this helps some of you. :)
Age: 33 | Onset Age: 28
Flare | Symptoms: burning after urination/defecation, post-urinary dribbling, low libido, low arousal, pelvic aches and pains.
Helped By: Physical therapy of the levator ani muscle group, Relaxation, Diet
Worsened By: Eating refined sugar and gluten, coffee, beer, stress
Flare | Symptoms: burning after urination/defecation, post-urinary dribbling, low libido, low arousal, pelvic aches and pains.
Helped By: Physical therapy of the levator ani muscle group, Relaxation, Diet
Worsened By: Eating refined sugar and gluten, coffee, beer, stress
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neue01
- Senior Veteran

- Posts: 225
- Joined: Wed Feb 06, 2008 6:17 pm
- Location: San Francisco
Trigger Point compression period
So, I thought I'd update a little with some thoughts on trigger point holding timeframes. I've noticed massive change in my internal and external trigger point release by altering the amount of time I hold or compress painful or tight areas. I know that Wise/Anderson recommend a 60-90 second timeframe. I've found this to be a contributor to flare ups in my case. This is enough time to move through a partial cycle of the muscle but usually leaves it stuck midway which then leads to a flare up of the given muscle. I've increased my compression time to 2 minutes 30 seconds respectively. I hold constant moderate pressure at a sore spot and have noticed this brings full resolution and allows the muscle to cycle all they way through to it's natural elongated resting spot. This works with almost 90% accuracy in my case and has almost created the notion of an on/off switch for any given muscle. If I flare a muscle up I let it rest for a least an hour and then try again and notice I am more likely to pull my self out of flares. I have also begun to hold stretches for the same count and have noticed similar response. I'd be interested in knowing if this works for others as well?
Also, I thought I'd add that fact that external TPs are a huge part of this condition. We tend to focus on the internal but the external often tend to be the muscles that are holding the internal muscles in awkward positions. I now focus most of my time externally on my thighs and this is very helpful in deactivating long standing trouble spots internally. Don't neglect your external massage. ;)
Also, I thought I'd add that fact that external TPs are a huge part of this condition. We tend to focus on the internal but the external often tend to be the muscles that are holding the internal muscles in awkward positions. I now focus most of my time externally on my thighs and this is very helpful in deactivating long standing trouble spots internally. Don't neglect your external massage. ;)
Age: 33 | Onset Age: 28
Flare | Symptoms: burning after urination/defecation, post-urinary dribbling, low libido, low arousal, pelvic aches and pains.
Helped By: Physical therapy of the levator ani muscle group, Relaxation, Diet
Worsened By: Eating refined sugar and gluten, coffee, beer, stress
Flare | Symptoms: burning after urination/defecation, post-urinary dribbling, low libido, low arousal, pelvic aches and pains.
Helped By: Physical therapy of the levator ani muscle group, Relaxation, Diet
Worsened By: Eating refined sugar and gluten, coffee, beer, stress
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neue01
- Senior Veteran

- Posts: 225
- Joined: Wed Feb 06, 2008 6:17 pm
- Location: San Francisco
Re: Neue01's Case
PS. This is about 3 counts to 100 at a moderate rate. ;)
Age: 33 | Onset Age: 28
Flare | Symptoms: burning after urination/defecation, post-urinary dribbling, low libido, low arousal, pelvic aches and pains.
Helped By: Physical therapy of the levator ani muscle group, Relaxation, Diet
Worsened By: Eating refined sugar and gluten, coffee, beer, stress
Flare | Symptoms: burning after urination/defecation, post-urinary dribbling, low libido, low arousal, pelvic aches and pains.
Helped By: Physical therapy of the levator ani muscle group, Relaxation, Diet
Worsened By: Eating refined sugar and gluten, coffee, beer, stress
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davyboy
- Veteran

- Posts: 172
- Joined: Tue Apr 17, 2012 6:39 pm
- Location: Vancouver, BC, Canada
Re: Neue01's Case
I, too, do exactly the same thing!
Age: 27 | Onset Age: 26| Symptoms: Occasional penis discomfort (mild), primary pain is perineum - feels like I'm sitting on a golf ball, pressure in penis, almost like a stick is in my urethra, difficulty sitting for long periods of time, urinary frequency (some), incontinence (dribbling), right testicle pain (almost gone!), hip pain, stiff hips, lower back pain. Some abdomen pain. Just general discomfort in the area, post sex discomfort. | Helped By: External and Internal PT. Hot bathes. Supplements (mag, omega 3, vitamin b and D, prosta Q). Relaxing. Breathing exercises. Anti inflammatory diet. Stretches. Yoga | Worsened By: Stress. Core exercises, too much exercise, too little exercise, strenuous exercise. Sitting. Too much Sex | Other comments: Feeling better, but still not 100% I'd say I'm 75%
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neue01
- Senior Veteran

- Posts: 225
- Joined: Wed Feb 06, 2008 6:17 pm
- Location: San Francisco
Some learnings to date
Hey everyone, just thought I'd share some current experiential findings.

- So, as I'm sure you all know our internal and external muscle systems are all connected through fascia. If you stir up or inflame one area it will affect another opposing area in your pelvic system. I have found through deep high up exploration that the opening of the anus is connected to muscles high up in the system as well as externally. If you have a flair down below its a guarantee that you need to release corresponding muscles 8 to 10 inches in. I know you all dont want to hear this and feel that putzing around 1inch in will release the entire pelvic floor. It won't and in many cases just makes the congestion up higher even worse. The area to really explore and release in conjunction with the anal opening is about 7-8 inches in.
- External muscles are as important as internal. If you're not releasing external muscles it's as bad as not exploring higher up in the rectal cavity. Theses muscles are key and often act in opposition to internal muscles.
- 1minute holding and compression time is ridiculous. For the fascia and muscle to run a whole cycle and release requires 3-5 minutes of continual solid holding time. I don't know what HITP is talking about but holding a TP for 1 minute only flares thing up more. You need to make sure you are holding these myofascial constrictions for much longer to fully release them.
- I found a spot at the small of my back that was full of scar tissue. I sort of ignored this area for years not thinking much about it. I recently noticed my GFs small of her back did not feel like mine. Mine is essentially like leather. It's not painful though to touch but it does act up. I spent the last 4 days breaking this stuff apart and got the strangest release I've had. Now the whole pelvic system seems to release more naturally. I also have had the return of sensation in the tip of my penis that I have not felt for 10 years. I suggest exploring your system for patches of scar tissue and really work them with deep release and massage.
Age: 33 | Onset Age: 28
Flare | Symptoms: burning after urination/defecation, post-urinary dribbling, low libido, low arousal, pelvic aches and pains.
Helped By: Physical therapy of the levator ani muscle group, Relaxation, Diet
Worsened By: Eating refined sugar and gluten, coffee, beer, stress
Flare | Symptoms: burning after urination/defecation, post-urinary dribbling, low libido, low arousal, pelvic aches and pains.
Helped By: Physical therapy of the levator ani muscle group, Relaxation, Diet
Worsened By: Eating refined sugar and gluten, coffee, beer, stress
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GARYS
- Old Hand

- Posts: 303
- Joined: Thu Oct 31, 2002 12:40 am
Re: Neue01's Case
Thanks for the info Neue01!! When you go up this high are you going in the 12 o'clock position at all? And did you ever have the never ending feeling in the urethra of needing to urinate? Thanks again for letting us know!! Just curious, I know I'm a lot better since seeing Dr. Wise. but you always wonder if your doing everything right.
Age:33 | Onset Age: 20 | Symptoms: burning urethra after urinating, followed by rush to urinate again, rectal pain after a bowel movement sometimes, frequency. | Helped By: Pyridium and Ativan | Worsened By: stress, sitting and unknown reasons.
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CMT23
- Senior Veteran

- Posts: 276
- Joined: Sat Dec 18, 2010 8:21 am
- Location: Bangkok, Thailand
Re: Neue01's Case
neue01, how on Earth do you go 8-10 inches in? Are you using the wand from Dr. Wise?
As for how long to hold a trigger point, the Trigger Point Manual (I believe it's called) also says 60-90 seconds. Where do you get the idea from that we need to hold each point from 3-5 minutes? I believe I was told that holding for more than 90 seconds would actually be counterproductive.
Confused now and wondering if I have been wasting my time for 14 months...
As for how long to hold a trigger point, the Trigger Point Manual (I believe it's called) also says 60-90 seconds. Where do you get the idea from that we need to hold each point from 3-5 minutes? I believe I was told that holding for more than 90 seconds would actually be counterproductive.
Confused now and wondering if I have been wasting my time for 14 months...
Age: 39 | Onset Age: 17 | Symptoms: Constant feeling of needing to urinate felt in the tip of penis. Frequency. Urgency. None of the typical pain associated with CPPS. | Helped By: Valium, Klonopin, and very hot baths, followed by lying down still/doing relaxation. Also made almost symptom free for a few seconds following a bowel movement. | Worsened By: stress, anxiety, skipping meals, lack of sleep, extended sitting, coffee, alcohol. NO other pain or discomfort although after ejaculation symptoms will usually get worse unless I lie still for 20 minutes or so. | Other comments: Symptoms began at the moment of ejaculation, disappeared after a few months and then returned a few months later and have not gone away since.
