Muscles Stimulated During Arousal

[CppsDad]

One of the most frustrating things about chronic prostatitis / chronic pelvic pain syndrome for me is that I have severe flare-ups when I get aroused or try to have sex. I'm not going to go into how debilitating this is because many of you are or have been in my situation. I'm hopeful that this will one day be behind me, but it seems to be the last "major" item on my chronic prostatitis / chronic pelvic pain syndrome to-do-list as the Stanford/Wise-Anderson Protocol is helping with most of the other symptoms but this one still remains.

When I get aroused, even slightly, I can almost immediately feel pain in my perineum and also sometimes internally. This happens even if I try to do absolutely NO tensing of muscles. Yesterday, my wife and I were watching a move on the couch, and a good scene came on, the type that would lead to some post-movie-manouvers on my part. I was extremelly relaxed on the couch, and I tried to put almost all reaction to this scene out of my mind (but after months and months of barely any sex at all due to CPPS, ANYTHING stimulating is hard to ignore). I was successful for the most part, but I still felt a pain in my perineum, and some referred pain when I woke up in the morning.

It's this type of pain that used to make me think that my prostate was the problem. What I'm trying to understand is "what is causing the pain here?" If I'm not using any muscles that I can feel, then what trigger points are involved?

So I guess my questions come down to these?
What muscles are used in arousal?
What muscles might be causing me pain with even arousing thoughts?
Has anyone else had this and do you have recommendations on where to tell my PT to check for trigger points or for muscles to stretch?
If you have had this, how long did it take for it to go away, and what stretches or massages worked best for you to tackle the problem?

Also, I'd like to know what the pain in the perineum is in this situation. It hurts directly in front of the sphincter. Has anyone had trigger points right there? What's the best way to reach them?

[webslave]

I used to have that very badly, now I have it not at all. So it can be beat.

My advice to men with post arousal pain is to consciously relax all pelvic muscles before and during orgasm/ejaculation. This avoids over-stimulating the already hyper-irritable neuromuscular system of the pelvis.

See viewtopic.php?t=627

[CppsDad]

Thanks Mark. That's good to know. I figured as much but it's still the most depressing part of the condition and the one that I have the toughest time accepting. I know there are muscles that tense even if I can't feel them, but I just don't know what those are. But these muscles must be tensing barely at all and yet are still able to send out pain messages. Grr... Do you remember any specific muscles that caused that pain after arousal? Are they around the prostate? In the perineum? And lastly, did this pain last longer than other pain as you practiced the SP?

[webslave]

I cannot name the muscles to you, but they are obviously very deep in the pelvis and not accessible via a Theracane, for starters

It may also be a purely neurological thing, something you cannot massage away. The nerves take time to heal, even when trigger points are resolved. This is my suspicion.

I had something analogous happen to me recently. I developed RSI in my hand from computer work. I changed my way of working and it went away for years. But if I chop down a tree with an axe, as I did recently, the heavy tensing of the hand muscles brought on a relapse. Go figure. Nerves are very complex entities, and the interplay with muscular exertion is still rather mysterious.

[CppsDad]

Thanks again. I just have to stay the course with the SP. This part of chronic prostatitis / chronic pelvic pain syndrome has been the worst for me. It's like a cruel joke that doesn't end. While many of my other symptoms have gotten better already, this one hasn't, and each time it comes back it reminds me of how far I still have to go. I'm committed to this as long as it takes though, and I have faith that one day that pain will be gone.

[scotsman]

This is sort of related, but I've noticed a big difference in my libido recently.

For the first 18 months of having chronic prostatitis / chronic pelvic pain syndrome my desire to ejaculate was massively reduced due to the increase in symptoms post ejaculation. The relaxing whilst/leading up to orgasm certainly helped reduce the pain but it was still pretty bad. Over time that post ejac pain has been reducing.

For the first 6 months I probably only had sex/masterbated about once every 2 weeks but then moved to once every week as I started to get some prostate leakage/pain if I went longer.

Whilst during all this time I got aroused easily I never felt the desire to either have sex or masterbate. Usually I have to remind myself it's almost a week since I last ejaculated and do the business. However, these last few weeks have seen me have the 'I fancy knocking one out' feelings most days.

Not sure what has happened to click me over like that - my pain hasn't reduced significantly. Perhaps it's just time.

Interesting none the less and I'm not complaining

Richard.

[alprost]

My only relevant experience here is of pain at the tip of my penis during intercourse, and severe pubic pain post-ejaculation. For me, these symptoms were caused by a trigger point on the central portion of my pelvic floor below my prostate, which, when pressed, re-created these symtoms exactly.

This problem has resolved 100% after having this trigger point treated.

[latte]

I've been through about 15 PT sessions in the last few months with significant relief. My sitting pain is much better but my post ejaculatory pain is still present. Unlike most men I have not been willing to give up sex, I just endure the discomfort afterwards. Perhaps my libido is higher than some but it just feels too good to give up. Interestingly, the post ejaculatory pain is more nerve related for me. It feels like the nerves are hypersensitized after sex but the sitting/muscle pain is still better if that makes sense. The nerve related pain does improve with doing an hour of Dr. Wise's tapes to relax. I can live with the pain as it is now. I rarely have a day where the pain is unbearable. As a matter of fact, my New Year's resolution is to drink more alcohol since I had to abstain for so long. A martini or a beer seems to make my pain better now.

[CppsDad]

alprost when you say your trigger point was right below the prostate, can you be more specific about which direction? Closer to the sphincter or deeper in? I assume you mean closer to the sphincter but I just wanted to make sure.

Mike

btw this thread is really helping me. thanks for all the responses.

[alprost]

alprost when you say your trigger point was right below the prostate, can you be more specific about which direction? Closer to the sphincter or deeper in? I assume you mean closer to the sphincter but I just wanted to make sure.

It is really difficult to be exact, as I was on the receiving end of the treatment

It felt like the finger wen in, and fowards towards my pubic bone. If you are looking in a downward direction to the pelvic floor I'd say it was about half way between my rectum and pubic bone, just left of centre. That obviously doesn't mean that this is exactly what is causing your problem, but it might be orth checking out - given that your pain is in the perineum, it may not be the same trigger point.

Also, from this post viewtopic.php?t=1800 by Dr Wise you can see that they typically find the symptoms I experienced are caused by a trigger point in this location:

Area of referral of pain and sensation from LEVATOR ANI:

trigger points in the levator ani can refer pain to tip of penis (usually found in the anterior(front) portion near to the prostate

trigger points in the levator ani can refer to the anterior (front) lower abdominals and to the bladder

trigger points in the levator can refer to the prostate and urethra

trigger points in the levator can refer a sense of frequency and urgency --

trigger points in the middle and posterior (back) portion can refer a sense of the golf-ball-in-the-rectum feeling

If you read this entire section, you will see that you can have internal trigger points quite close to your sphincter, and also on the sphincter itself.