Neue01's Case

[neue01]

What is the location of the Anterior Levator Ani muscle? Is it the muscle on either side of the prostate and up an inch or so? I seem to have a lot of trouble with this area only on my right side. What is the best way to release this muscle? Are there any great techniques or methods that have worked for you guys?

[webslave]

F2 and I2 are in the anterior levator.

[superuse]

Can one (or a PT) even reach these insertion points of the anterior levator ani ? It seems one's own finger would be limited to H4 or so. Perhaps the PT a bit farther.

--jjf

[Viking]

I have no problem reaching these areas myself. A PT shouldn't have any problems unless he or she has short fingers.

[neue01]

I wanted to make sure I'm following the right procedure and getting correct results after doing some self physical therapy on my pelvic floor. It would help to check these things in regards to what most people here are doing. I've found what I believe are 4 trigger points internally. These are very sore points that refer pain to my problem areas. There are two on the Levator Ani on both sides around the rectum. One on the Anterior Levator Ani on the right side next to my prostate and one in the muscle group just above my prostate. I am locating these points finding where they refer the most pain and pushing on them with my finger for 30 to 60 seconds. After this I attempt to rub them or palpate them for 10 seconds or so. I do this to each TP maybe 3 times in one session. Currently I am preforming 3 sessions a day. Is this too much? Afterward I feel pain and a slight burning for 30 mins or so and sometimes a slight relief in the area. Are you supposed to feel loosened up after or is it normal to feel pain after? I want to make sure I'm helping and not making things worse. I also seem to get a phase of muscle twitches in the pelvic floor for an hour or so after working in the area. Is this normal? I have heard people say this is the muscles releasing themselves or something of the sort. Is this true? I spend my time after this practicing some paradoxical relaxation.

Any help would be great.

[carld]

Have you seen a pelvic floor PT that went over your issues with you and helping you learn self PT

Seems like you are spot on in regards to treating yourself.

I think 3 times a day is too much. That is something you have to go over with your PT. 3 times a week seems like a reasonable approach. Maybe once a day in the evening...followed by stretches and a hot bath every other day. It's trial and error really. The fact that you re-create your symptoms for the most part is very encouraging and on the right track.


Good luck...

[neue01]

Yeah, I'm seeing a PT. It's actually Dr. Jerome Weiss here in SF. He costs a lot for a session ($220) and I want to be able to do what I can outside of his time to cut down on costs. I'm pretty aggressive about getting well though and it might be that 3 times a day is too much.

What about sensations afterward? Are these consistent with what others are getting?

[carld]

When I do PT it mimics my discomfort and feeling of having to urinate, so my simple answere is yes...

The next day if I have stress under control I have times for the most part normal...So self PT works for me.

[neue01]

I notice you also have issues eating wheat, flour, carbs, etc. What do you think the connection here is? I've never had food issues until this happened.

[carld]

I notice you also have issues eating wheat, flour, carbs, etc. What do you think the connection here is? I've never had food issues until this happened.

That's a great question and I'm not 100% sure...

What I do know is the less wheat and gluten I eat, the less head congestion I have after my meals...Does that mean a wheat and gluten intolerance?

I have cut my intake to about 85% now...I do throw in some pasta here and there etc... but my irritation in my perineum is even less than it was prior to 1/1/08 when I started the south beach diet and wheat and gluten cut back

My stools are more solid...I think I ate so much wheat growing up that it has become an irritant for me, but does it mean I have an intolerance??? I really can't tell.

Maybe I was in a wane of the condition when I started and now the wax and wane stays more on the latter now because of everything I have done. I have done so many things to get well that not 1 thing is the magic bullet for me. It's my over all protocol in my signature that is what I do to enjoy my life.

[webslave]

What I do know is the less wheat and gluten I eat, the less head congestion I have after my meals...Does that mean a wheat and gluten intolerance?

Yes, definitely. One of the classic signs of intolerance is phlegmy-ness after eating, or having to clear your throat numerous times after eating a specific food, or suddenly having a runny nose after or during eating an item, or swelling of nasal passages and getting "snuffly" after eating a food. Classic. Another classic sign is hiccups after eating a food, or difficulty swallowing the food at times (feels like you might choke and throat goes into a spasm).

[neue01]

How long does it take to get over a trigger point? Essentially once a TP has been located how long does it take to "zap" it out and how long does it take to recover with a return of normal feeling and function once it has been "zapped"? Does this tend to be a long process?

[neue01]

Does anybody know what the name of the muscle just above the prostate on the anterior side is? This is what seems to be giving me the most trouble.

[mbaker]

Around I1-I2, the muscles attach to the bone. As I reach up to that area, I move across a bony area that goes laterally across. I assume that is the beginning of the pubic/pelvic area in the diagram. Then the muscle seems to dip a bit into a shallow space and then come back up again at the attachment. I have to insert the finger completely in a far as it will go to reach, and I'm still experimenting with the purple massager. The finger is def better for control, but not quite as long.

Are the TrPs typically exactly at the attachment area on the bone, in the shallow space just below that, or along the ridge? If I press into the shallow space, I get referred pain, but I'm not sure if that's the shallow space portion of the muscle, or the fact it's pulling on the attachment. The HITP book isn't precise in it's description; it simply point to the general area.

Thoughts?

--mb

[webslave]

It's part of the levator ani.

Here is the pelvic diaphragm formed by the levator ani muscles. Levator ani muscles actively support the pelvic contents, compressing the urethra by elevating the pelvic floor, and maintaining the anorectal angle by pulling the anorectal junction forward. Relaxation of these muscles allows evacuation of the bladder and rectum. By increasing the intra-abdominal pressure even more through simultaneous contraction of the diaphragm and abdominal wall muscles, they distend the pelvic floor downward, opening its apertures.