UCPPS - Prostatitis, Interstitial Cystitis Forum

You guys are right. I just need to convince myself that its ok. Maybe I can compensate by helping my wife out with some of her work. I realize it isn't necessary, but it might help me get used to the idea. I know she wants to help me, she said as much. She even went and bought lubricant surgical gloves. I just haven't let her do it.

The other big problem is that my wife has small hands, and my worst spots are in the upper levitar ani, past the prostate, up on either side of the rectal wall. I don't think she can reach that, or it will be comical to watch her try.

Anyway, I just saw my new doctor (moved away from NYC last year). She's a D.O. and open to new ideas. She set me up for an appointement with a PT at the local hospital who does the usual pelvic treatment for women, but is also interested in male pelvic pain. I will go in with some literature, see what she thinks, and see how that goes.

I'll let her know about the SP, and how it has some specific recommendations. But I am also curious to see what she suggests.

Larger fingers definitely help, but even medium fingers can get in there if she pushes just right. You'll never know until she tries, though.

And as far as compensating by doing stuff for her, just offer her an equal slot of time for her own massage every week. I'm sure she'll like that, and it will be fun for you too.

Mike

I found out about the Stanford/Wise-Anderson Protocol theory of pelvic pain on about April 1 2003. Yet my experience with the initial PT's I saw was not helpful. I went to Marilyn Freidman who was far away from me in Great neck, long Island. Her scedule was not flexible so I had to take days off. She was often on vacation or off. And in spite of offering discounts she was expensive. I could not have realistically gone for any extended period of time. She was also totally disinterested in insurance issues.

Then in Nov 2003 I went to EMH Phys Therapy on 3 av in NY. They were only a little cheaper and the young therapists, while pleasant (and attractive) were NOT very good. I often felt worse after going there.

Finally a year later Dr David Kaufman sent me to Duffy and Bracken on Maiden Lane in NY. Ann Duffy followed up on the insurance issues which made it possible to keep going. This has lead to clear progress.

I hope this specific feedback is helpful to all.

Robert Pagen

### ###-#### [PHONE NUMBER REMOVED]

This is helpful. Your experience seems to confirm that people can find competent PT's and that regularly scheduled frequent treatments are critical to success.

In my conversations with Dr.Wise he did say this about finding a qualified PT to treat pelvic floor dysfunction though trigger point release therapy: you must find a PT who is willing to hurt you. I took this to mean that myofascial trigger point release, performed properly, is bound to be painful if you do indeed have trigger points. In short, if the PT you're getting is absolutely comfortable (no discomfort) then something is up.

There is a high uncomfortability factor in PT, even if you aren't pressing on a trigger point. What we really need is some asymptomatic adults who are willing to be guinea pigs for PT's to learn what is normal pain and what isn't. I think there are some places that when pressed right, will just hurt (your funny bone is an example), so experience really helps out.

By the way Robert, I have edited your post and removed your phone number, for your own protection. There are just enough crazy people out there to make posting your phone number inadvisable. If you want it in your post, you can add it back in.

Michael

Yesterday my PT completed the first training session with my wife. Prior to the training, I had advised my PT that my wife has small hands, and the PT said that in my case that would not be a problem. I'm not sure if this was because I have a relatively small pelvic area for a male or if all of my trigger points and affected muscles are easily reachable.

In any case, I think the training went well. The PT brought pictures and diagrams of the pelvic floor. She demonstrated techniques to my wife by stretching and palpatating muscles on my wife's forearm to give here a sense of appropriate pressure and stretching tension. Then the PT administered my normal treatment, explaining things to my wife as she went along, using the positions of the clock to denote the locations she was treating. In the end, my wife tried it just from an orientation perspective, and I'm sure her fingers reached everywhere they were supposed to; she actually found trigger points.

Next week my wife will administer the the treatment under the guidance of the PT. This combination treatment/training session lasted about 90 minutes.

All of this, I think, adds one more item to the list of qualities of a good PT: a willingness to teach and communicate.

It's good that you'r stressting the importance of HOW to do the PT, and with WHOM. I am sure there is a lot of skill to that.
I do not know if people with normal life and no health/prostate problems, tend to have trigger points too. But I am sure while it is good to treat all the trigger points there are the ones which are more problematic and for that it takes a good PT to find them and massage them.

Do you guys have any recommendations for a PT in Los Angeles ?

Anyone had experience with Debbie Martin ? Mary Cox ? Angela Spruill ?

I would love to hear your comments if you have any.

Harring it sounds like you had a good session. It will take your wife a few times to get it right, but you'll have enough experience now to help her through it.

Good luck!

Mike

CppsDad, et al, I have found at least one of the guinea pigs you were hoping for. In my last PT session, my therapist told me that when she was going through training for myofascial trigger point release therapy of the pelvic floor, the therapists worked on each other. Therefore, she has evaluated a "normal" pelvic floor. What's more, during her training she convinced her husband to act as a patient. He had no trigger points or tight muscle bands. He did not, during her treatment, exhibit high pain levels. However, she said the next day he had some pain due to the muscle stretching exercises she performed on him.

I guess the conclusion here is that if you have trigger points and tight muscle bands, and a PT who knows how to treat them, you will know it by the pain levels during treatment.

My wife went through her final training session yesterday, and my PT is gone to Greece for a month. We shall see.

Makes sense to me. Good luck with your home treatments! I'm sure they will eventually be better than going to the PT. Just be patient, and remember, your wife is learning. And she WANTS to help. That's more than most doctors...

Mike

I heard some of you use the Theracane .
I feel it looks perfect for back and shoulders pain. but do you use it for also abdominal, thigh, and groin pain ?
what about the electric massagers ?

I think the Theracane is one of the best tools for abdominal massage. That's my MAIN usage. I also use it on my perienum quite heavily. So yes, I think it can work for you.

Mike

L-O-N-G FINGERS really help!

Going back to the original question, "How do you know you've got a good PT?" based on the comments on this thread and recommendations I've received from Dr. Wise, I think the following would be a good checklist to determine if you are receiving effective PT ( This is assuming, of course, that you are in fact suffering from pelvic floor dysfunction):

1. The PT is thoroughly trained in myofascial trigger point release therapy for the pelvic floor.

2. The PT conducts a thorough evaluation, checking for pelvic mobility, external trigger points, internal trigger points, tight muscle bands, hamstring tension, etc.

3. Treatments are administered per the Stanford/Wise-Anderson Protocol as described in Dr. Wise's essay on PT.

4. The initial treatments are quite painful; the PT constantly monitors your pain levels to locate points of treatment and insure the treatment is tolerable.

5. The PT works with you and communicates with you in locating and treating trigger points and tight muscle bands.

6. The PT schedules regular, relatively frequent sessions, at least two per week--each 30-90 minutes in duration.

7. The PT does an adequate amount of internal work--at least 20-45 minutes per session.

8. The PT is open to learning and to teaching techniques to a willing partner.

9. The PT's fingers are long enough and strong enough to administer the treatment.

10. You suffer from increased pain levels immediately after the treatment and often into the next day.

Anyone willing to add to this list or possibly subtract from it, please have at it.