Starting pelvic treatment after 4 and a half years

[webslave]

Yes, those who struggle to improve often have deep psychological issues going on. Guilt, blame, anger, even childhood abuse can all play roles.

[JuanMilo]

Yes, those who struggle to improve often have deep psychological issues going on. Guilt, blame, anger, even childhood abuse can all play roles.

That makes a lot of sense and I can definitely now see how that can play a big role in this condition.

I have a question if that’s alright webslave. Gerard Greene recommended to do the internal stretching with the wand a couple of times a week for two weeks, then move onto using the large end of the EZ magic wand internally for some trigger pointing where it feels tender. Does this sound reasonable to you? One thing I’m bothered about is the size of the end of that wand, it’s very similar to the size of the ends on a Theracane. The internal stretching actually seems to really help me though.

I’m doing a lot better than I was and definitely heading in the right direction, but this episode has left me with a decent amount of discomfort (usually burning) in my abs, which is entirely new. I’ve only experienced this as a side effect of over stretching when I very first tried to treat this condition. It’s mainly in my lower abs. But yeah, I think it’s clear my abs are big source of CPP for me. Lying down can bring this discomfort on too. It seems anything I do that alleviates the condition in general helps the pain In my abs - internal stretching helps it a lot, which was a nice surprise. The discomfort in my abs has been improving overall, so I’m trying to not get too hung up on it.

[webslave]

I presume Greene's thinking is that the wand will stretch the anal canal to the point where a large implement can be used. If there is no pain, it's probably okay.

[JuanMilo]

Hi webslave, I did some internal trigger pointing the day before yesterday. I found some internal spots that referred pain, mainly to my hip. I did have a little discomfort afterwards, but in the night after that I felt some relief.

I have a couple of quick questions if that’s okay - Gerard said to find tender points and press on them, but the video he supplied me from the woman who taught him said only to bother with spots that refer pain. Also, how far in should I go while looking for trigger points?

I’ll leave the page with the video on here just in case it’s of some use:

https://www.harbornephysio.co.uk/physio ... siotherapy

[webslave]

Trigger points typically do refer pain, but not always. I presume he is encouraging treating only points that refer pain to play it safe and ensure you are not pressing on a place you shouldn't be.

How far in to go? Look at some illustrations of the hammock of muscle that makes up the pelvic floor. That's a good guide.

[JuanMilo]

Thank you webslave. I did some internal work and I feel like it’s going okay. However I’ve been researching the external trigger pointing from A HEADACHE IN THE PELVIS and I feel like I have no clue what I’m doing. I had a try and I just feel like I’m painfully rolling around on a tennis ball. I may see a physio and ask them to look at the muscle groups in the book and the ones Tim Sawyer mentioned. I’m feeling a bit clueless here even though I’ve put a document together and watched videos about the different muscle groups. Do you have any recommendations?

[webslave]

Have you reached out to David Wise? He's very approachable by phone.

[JuanMilo]

Have you reached out to David Wise? He's very approachable by phone.

Yep we spoke on the phone, which was great of him. The only thing is I don’t have the money to do the online clinic and he doesn’t recommend anyone in the UK. I could potentially put myself into (more) debt, but I’m apprehensive. I have a very small income as I’m not able to work fulltime with my health issues and I’m already in an amount of debt that will take a while for me to pay off.

I’m assuming there must be people here who’ve either had success treating this themselves and learning as they go along, or using other physiotherapists to help guide them?

I’m improving from this flare with the methods I’ve been using, albeit a bit slowly but I’m feeling a decent bit better. This feels like a bit of a stumbling block though.

[webslave]

There are people in the UK who know about treating CPPS trigger points (though none I am prepared to recommend). Also the clinic across in Holland. Have you thought about finding a local physio?

[JuanMilo]

Perhaps I’ll discuss it with Gerard, although I’m not sure how in depth he goes with it all. He seems quite knowledgeable about the pelvis and as a physio in general, but I’m not sure if he just has a few tools in his locker for pelvic pain. I’ll run the muscle groups Tim told me about by him and book in for another online appointment if he thinks he can advise me on how to treat these. Also, looking through the Isa Herrera book, there seems to be some more hands on directions for self treatment. I’ll stick at it and form a plan. I felt a bit dejected before after realising I had no clue what to do, I rolled onto the ball I was using for trigger pointing and bloody sat on it. That’s left me sore . Oh well nothing permanent I keep telling myself.

Thanks again Webslave. I’ll keep you up to date!

[JuanMilo]

Okay an update for whoever may want to read! I think I’m making progress. A few days ago I did what I deem as my first solid session of internal trigger point release, three sessions in. I did focus on tender spots as well as spots that refer. I don’t tend to find solid referral that lasts a long time, but twinges elsewhere when I press in certain spots.

I followed the advice in the video Gerard sent me and I was able to get some decent leverage with the wand and press into the muscles. This left me a bit symptomatic afterward when I’d been feeling good that day.

I’m still struggling with some compulsive behaviour and at the risk of TMI I woke up in the middle of the night with an unusually hard erection and masturbated. I think treating the pelvic floor must have caused that. As I should have known, that wasn’t a good idea and I had quite bad pain after ejaculating. The thing was that the pain was also in the rectum in what felt to me to be the muscles I treated earlier. To me, that gives me confidence this is the pelvic floor causing the symptoms.

Despite that, the days after I have been doing really quite well. Some feelings of normality in the area, my penis not feeling as sore, looking more normal including the usual bulbous veins being much less bulbous and less sore (I’m not obsessing over that, I just noticed it). No pain after ejaculation two separate times, although I’m still doing that slightly too much and addressing this will be a key part of my recovery I’m sure. Nowhere near as bad as I was, but still.

I’ve also found some incredibly effective tools on the curable app. The most effective is reframing the pain - often I’m not even calling it pain at all and I’m trying to use that word much less. I might say ‘this sensation isn’t as cool as I would like’ if I feel burning, or replacing ‘cool’ with ‘comfortable’ if things feel uncomfortable. Those sensations have even vanished within moments of employing that technique. It’s actually hard to believe.

Flaring a bit today but I’m just staying relaxed and not catastrophising. I’m feeling really quite positive.

The only thing that’s stuck around is the burning pains in my abs, but I think that’s improving too.

Admin comment: Interesting stuff about the Curable app!

[JuanMilo]

There are people in the UK who know about treating CPPS trigger points (though none I am prepared to recommend). Also the clinic across in Holland. Have you thought about finding a local physio?

Hey Webslave, what do you think the mechanism is for PE In this condition? I was doing quite a lot better overall but I’ve still had PE and it’s worse when my urethra is more irritated. I’ve never suffered with PE before apart from one single isolated incident when things were quite irritated. Now I feel I have some degree of a lack of control almost every time and it can be extreme at times.

I’m sorry to be a pain in the arse and likely an incredibly frustrating case, but related to this I have to admit to using the aneros again. I foolishly thought it might be better since I’ve had glimpses of feeling so good. But needless to say, it’s heightened my pain and the PE seems to quite possibly be back where it was at the start of this flare, which is that minimal contact makes me ejaculate in very short space of time. I didn’t think using the aneros once would have that effect - I don’t feel anywhere near as bad as I did in terms of pain, but honestly I’m frustrated with myself and a bit concerned. What do you think the mechanism is for PE here? I did read it can be the result of an inflamed prostate, so that concerns me. Also, the aneros makes your pelvic floor muscles go into an auto spasm, so no doubt that’s really not good for this condition.

I’d really like to think I could use the aneros if I recover from CPPS, but I feel like I’m playing with fire. I haven’t been using it out of pure hedonism, I’ve had a deep desire to improve my sexual experience and I’ve had glimpses of something very unique/powerful with the aneros that traditionally we won’t realise is there for us men to experience. But the irony is that I’m actually messing myself up and setting myself back. It’s having the precise opposite effect of improving my experience :/

As you can probably tell, I’m quite bothered here and frustrated with myself. I have to confess to catastrophising today about the potential effect PE could have on my future love life, I’m going to use the flare function on the curable app to try and get my thoughts in order. I feel more calm for having typed this out. Again, sorry to be a pain in the arse.

[webslave]

PE is a temporary condition in all but the rarest of cases. And irritation, inflammation and allodynia can all make PE worse. Temporarily. Your anxiety and obsessiveness about everything to do with your health is also part of the condition. Until you learn to step back from yourself, look down from a height, on your own mind, your own thinking, and see it as disturbed, just like your pelvis is disturbed, you won't make good progress.

The Aneros is a sex toy and not a good way to massage the internal pelvic muscles. Get a Theracane instead.

[JuanMilo]

I know you’re right Webslave and as always I appreciate the work you do and the advice you give to all of us here.

I managed to find a database of pelvic health physiotherapists here in the UK - I’ll post that in another comment if you’d like to make that into an individual post. Turns out there’s actually a woman who treats women and men in my hometown. This was quite a surprise after having travelled to London to see Karl Monahan and Birmingham to see Gerard Greene. This woman is also doing a degree in psychosexual therapy, so I think it’ll be useful to see her and talk through things. She said she can treat trigger points if indicated but ‘tends to move away from the wand’, for self treatment I assume. I’ll have to see how it goes, it’ll could be very useful having this woman so local to me.

[JuanMilo]

Database for pelvic floor physios in the UK -

https://thepogp.co.uk/patients/physiotherapists