Progress but improvement stalled

[Ranzzar]

Thanks MajorSky1, Noll and all
That's really helpful feedback

As I have not done any internal work really, I guess it's worth a go to see if I can get some further improvement with this. So I am definitely going to see the PT's in Bondi Junction, thanks Noll for that tip, to get some professional input.

In the meantime, I have also started to try do some internal work myself, at least to get familiar with what's going on there. I just used a finger and I was really not sure, should I be able to feel trigger points as "tight" areas?.....i could feel the prostate as a small bulge but the rest all felt pretty non descript really. There was one area when i pressed it sent a feeling down my leg, not actually pain, just a sensation (I do get leg and feet tingling when i have a flare). Is that likely to be a trigger point i am touching ? (it didn't feel "tight" though)

I take your point though MajorSky1 about not neglecting with the psychological issues (I am a stressed kinda person, with a very stressful job and other stuff) and I know I am mostly unconsciously stressed much of the time. Only now am I starting to become aware this happens and appreciate the signs... this has been happening most of my life and only realized it since developing PT and now and learning to relax my pelvis and breathing).

Anyway, onwards and upwards

[Noll]

Best of luck Ranzzar. Definitely go and see one of the girls at the Junction - they'll put your mind at ease, if you're worried about the internal work (as I was). Ange's normally pretty well booked, so might be tough to get in, but I can't recommend her enough. I held off on the internal stuff for a while as I couldn't get past the thought of it. She couldn't be more professional or understanding, and see's loads of guys with these problems. I think she said something like 40% of her clients are guys now.

With the self internal work, I've tried this too, and for some reason I can't replicate the work the physio does. When I do I barely feel any pain, and make no progress loosening up tight spots, as I just can't feel them. I'm not really sure why. I've tried a therawand too, and I find that fairly useless too. There's something to be said for a skilled PTs work.

I also get the feet and lower limb tingling and tightness too.

[Noll]

Also, following MajorSky1's point - interestingly I saw the PT for about 12 sessions back in 2015 and made zero progress. I was working a very stressful job, also working a lot of nights, which I've now found is awful for your nervous system.

Second time around this year, I decided to quit my job and really focus on hitting this from all angles. I made a tonne of progress in the first 12 sessions this year because of it. If you aren't actively doing things to down-regulate your nervous system, chances of making progress are slim, from my experience.

[Ranzzar]

thanks Noll, I would be interested to know how it goes for you with the intensive programme; keep us posted hey?. I got my first PT appointment set up :)

[MajorSky1]

Definitely down-regulate the nervous system. It's key. The hardest part of this condition is that it's inherently set up like a see-saw. Stress/anxiety causes pain <> Pain causes stress/anxiety. In the beginning you MUST work on both simultaneously. Get the tightness under control and ease into some psychotherapy to talk out your stress/trauma, or really face what's been bothering you that you may have been belittling. Maybe your job is just too damn stressful - which might sound like saying "you're weak if you can't handle a little stress" But it's not "a little stress" for a little while, or a lot of stress for a little while. Some jobs can be MAJOR stress for a LONG time - that inescapable, trapping a prisoner kind of stress. And THAT is NOT healthy for any living being because there is never a resolution to it - no foreseeable end. That takes a huge toll, and bosses berate you and make you feel less self-worth in the process. Don't do that to yourself. There are better ways to live and make a living!

[Ranzzar]

Yes MajorSky1 I agree. I have a very stressful job and always thought I could handle it. But I think the effects of chronic stress will out somewhere, somehow in the end. In my case with CPPS. I have started to acknowledge the reality of my work/life stress situation in my life and to take measures to daily minimise this stress. I am also looking to transition to other career avenues. It's certainly an important consideration in the overall management I feel.

[Noll]

Ranzzar, how did you go with the PT?

[Ranzzar]

Hi Noll, its going pretty well thanks.
I have had about 4 sessions so far. It's really uncomfortable when she massages internally (and I don't look forward to it at all) but overall I think it is helping. I find the flares after ejaculation are not lasting as long and are less severe. Also, I am becoming more aware of my pelvic floor muscles; when they are tight and when relaxed. If they are tight, I now have an idea how to relax them (previously, I had no idea and was even totally unaware they were tensed).

[Noll]

Good to hear Ranzzar.

I know what you mean - I used to dread going there at the start, but I just knew it was needed, so stuck with it. It took me 5 or 6 sessions till I noticed any difference, so sounds like you're doing well.

Keep us in the loop on your progress.

[HCR123]

Hi everyone,
I'm glad I found this thread. Looking at the comments from major and ranzzar, this is the phase I am now facing. A spasm from my levator after masturbation or oral sex. I think the pain lasts about a week or ten days and is awful. Before I wasn't getting this pain at all after sex or masturbation. Now I ask my PT to help work the levator. Do any of you also have this spasm? I seem to have a quivering or trembling in that area even when I have no pain or it's just slightly sore. I get the feeling it's what major has described as part of the psychological distress of anxiety manifested as tension. I know the job is part of what brought the symptoms on along with personal things with family. I've wanted to leave for awhile but can't quit. Been trying to get interviews. Going to do a mindfulness meditation course in January and incorporate this daily to help long term.

Anyway I have a pelviwand now and will try the 3 ball side. That's the one my PT recommended as well. Will aim for 11 and 1 o'clock sides. And sounds like I have to mentally will myself to feel like psychologically it's ok to have sex or masturbate. Major is right, I now have a slight fear of the pain returning. But there's no way we should live life this way. But Should I not have sex for a certain amount of time while working my levator before engaging again? I've only been at this for about 6 months, so I'm a young pup lol. I'm starting to accept that this is a marathon and I won't heal this overnight. But I'll apply a lot of the knowledge and techniques here. This forum has helped a lot.
H

[Ranzzar]

Hi HCR123, thanks for sharing your comments. I don't think I can pin point my pain to a particular muscle...its an overall kinda ache in the pelvic area (along with tingling in toes and lumbar ache)....and everyone seems to be a bit different.

The PT says everything is tight in my pelvis; so I guess that's not surprising. I try to do the relaxed orgasms webmaster has talked about. That, along with PT, and making a real effort to relax the pelvic muscles post ejaculation has allowed me to get back to an every other day, occasionally consecutive days, ejaculation routine (which is an improvement to 6 months ago) but not where i would have been normally be pre-condition. Also if i do get a bad flare up, i do tend to have a rest for a few days at least until things settle. Having a break does help. I hope it continues to improve as it has been and you as well!

[HCR123]

Thanks so much for the response Ranzzar!
Sounds like just making an effort in the ways described here will help, and the distress will go away on its own.
Be well and have a great Thanksgiving.

[MajorSky1]

MCR,
Chronic pain gets started from pain neurons being "on" too long. The pathways get worn in where they shouldn't be. It takes time and retraining. So, masturbating/orgasms at any point isn't going to cause death or any kind of damage. It's more a matter of comfort. If you flare up bad enough after an orgasm, then take it easy for a while, and keep trying to get the pelvic floor tissues retrained to relax. This involves relaxing/mediation techniques as well as PT if the trigger points are chronic enough. The pain is not from just one factor. It's a combo of muscles, fascia, nerves, dorsal horn, brainstem, and pain center of the brain, and of course emotional stress/trauma. Working on down regulating all of these factors will help. Attitude toward the pain helps too - which is probably the biggest challenge because the type of pain that it is, causes a panic feeling, and that can be really difficult to work around. This is where a commitment to rituals and habits of mediation, relaxation, and calming your mind come in.
Remember, it takes time. It will go away.
How it gets so easily started, no one is quite sure. But it WILL resolve over time - and knowing and believing that in itself should help expedite the process a little.

[HCR123]

Thanks Major.
I'm trying CBT and meditation now. It's tough now that I developed a bout of tinnitus. This is all nerve related imo.

[MajorSky1]

(Sorry, I accidentally typed MCR, but meant to type HCR). Good luck! Keep us posted!