Physical therapists' theories book "Pelvic Pain Explained"

[Luxemburger1977]

I had an ankle injury 13 years ago and my whole body got out of balance. This soon appeared to be the main aggravating factor for (mostly one-sided) CPPS symptoms with further symptoms of myofascial pain in my (left) quadriceps. While I am in pain and expect some understanding from all doctors that I have seen, I was the one who actually had to show understanding and explain the whole story ever again because most of them have no clue.

I am sick and tired of doctors (and psychologists) wanting to teach me, in the most patronising way, how to 'relax' through a mental process which is not helping in any way. I know what's been helping me, namely PT, dry needling and stretching, but doctors (and psychologists) do not give a shit what I say and all mean I should just 'relax' as if it were all in my head. No need to say I will have a hard time ever trusting a doctor ever again after this!

[Luxemburger1977]

PS: in case this is any relevant, I have not had a single bout of anxiety or stress ever since I have been on the right treatment path, but no single doctor ever showed any willingness to simply listen to what I knew about myself (so much better than they did) and to give my body and mucles the time they needed to recover from this condition.

[webslave]

I have not had a single bout of anxiety or stress

I've lost count of the number of members who only get around to disclosing their deep tensions after months and sometimes years of posting here about symptoms. Others never do, and maintain that they are free from stress completely. Often those same men are quite aggressive in their posting style, so the tension is clearly there.

[Luxemburger1977]

Aggression is obviously geared towards doctors and above all quite a number of urologists I have to say, because many of them do not bother educating themselves and still send you home with antibiotics and Flomax. In case there is no major improvement, they let you know 'treatment has failed for you', as they did with me. In 2016, this is a real shame. I knew I was in good hands when I found the right PT and then a second one for dry needling.

I have now recovered up to 80% or more with urinary symptoms resolving early on and no ED at any single point since it all started for me. The rest is a very long list of trigger points producing pain in left plant, quadriceps and glutes as well as in their counterparts in right iliopsoas, quadratus luborum, obliquii and serratus. PFD had been building up over years, symptoms (post-voiding dribble) had appeared 2 to 3 years before 'prostatitis'. I also realised the right side of my pelvis was lifted up and my right shoulder pulled down because of shortened right iliopsoas, quadratus luborum, obliquii and serratus, my right ribs were 'glued' together just in between. Pelvic floor and surrounding muscles had to work hard for many years to compensate for that. Still, diagnosis would be, for urologists who do not bother carrying out a proper physical evaluation, 'prostatitis'!

In the past, they used to blame it all on the prostate and then, with a HITP, on a stressful lifestyle. However, PT has made huge progress in understanding and treating PFD and now in 2016, Prendergast and Rummer very nicely summed it up in their book 'Pelvic pain explained':

A slew of anatomical/biomechanical abnormalities, such as having one leg that's shorter than the other, contribute to pelvic pain.

Despite huge progress made, the first sentence of the introduction to their book brings it to the point and reads as follows:

Anyone with persistent pelvic pain knows that getting on the right treatment path is often half the battle.

Aggression and frustration obviously builds up when you realise you often have to fight that battle more against doctors than with their help!

This is meant to help all those who have drastically changed their lifestyle and have much lower levels of stress, but are still in pain despite all efforts! Make sure you see a knowledgeable PT and have all possible factors, including anatomical/biomechanical abnormalities, checked thoroughly.

[carbonevo]

Glad you are doing better luxembuger.

There's one thing I don't get...I posted that on the other prostatitis forum as well. How on Earth do those really fat people not suffer from CPPS? Also those who have major structural issues, like one leg much shorter than the other, and they use cane to walk, or even those completely paralysed and sitting their entire life on a wheel chair... yet no CPPS.

Also if you take a look on one match of American football or even soccer... those players get smashed daily.. every single structure in their bodies must a complete mess. Yet again the majority of those players never heard of CPPS.

Frankly; those diagnoses such as rotated pelvis, one leg shorter than other, pudendal nerve entrapment, seem to me pure sci-fi when docs do not know how to treat this disorder.. from experience chiros and PTs will tell every single human on earth that enters their door that their body is a mess, sore muscles, bad posture and blablah.

Not much different than those idiot doctors who keep givin u Cipro...

If CPPS is a result of unconscious tension no Cipro, chiro or PT will solve this tension. The PTs will only give you a temporary relief as their massages will relax you, you calm down and hence the brain chatter as well.

[Luxemburger1977]

Doctors of physical therapy do more than just 'only give you a temporary relief as their massages will relax you'. In the US, they study a whole 7 years to tell you more than blabla. They should know exactly which muscles cause dysfunction and pain in each and every single case. Each and every single case will also be different. If you want to educate yourself and get to know more, I suggest the following: http://www.apta.org/Vision/

In the meantime, (pelvic floor) PT is recommended by 'enlightened' urologists, like Dr Shoskes, as a first-line treatment of the Tenderness (U-P-O-I-N-T) component of CPPS when trigger points can be identified and reproduce pain:

Nobody knows how many American football or even soccer players have CPPS because they would not tell I suppose. On the whole, we have no idea of many people suffer from CPPS. Millions of people with CPPS are not open about it and won't let everyone know about their condition.

While I do acknowledge that CPPS may be due mainly to psychological factors in quite a few cases, I do expect from those in that situation that they, in return, acknowledge that CPPS may be due mainly to biomechanical abnormalities. Unless the message here should be: 'just relax and the tension in your left Rectus femoris and Vastus intermedius (both pulling the left side of your pelvis down) will get better', which is absolute nonsense. All those who experience constant pain that does not just come and go in waves like stress would surely be thankful to find more answers out there than just 'relax'!

[webslave]

In the meantime, (pelvic floor) PT is recommended by 'enlightened' urologists, like Dr Shoskes, as a first-line treatment

And has been at this forum too, for many years.

But treating trigger points is only part of the story. Unless you look at the base cause of the trigger points, they come back.

[Luxemburger1977]

Indeed, all biomechanical abnormalities to be thoroughly checked and treated. This is how I was treated from foot plant to pelvis for the left part of my body and from pelvis to shoulder for the right part of my body. Otherwise indeed, trigger points could come back again. In my case, so far, they have not but I might be a bad example if you mean to say that it all comes from stress. Strangely enough, it all started for me last year at the end of a pleasant 5-week holiday with no obvious reason and no stress at all. Anxiety started the moment I realised that I would have to wait for long before getting answers but went away the moment I found proper treatment.

[webslave]

This is how I was treated from foot plant to pelvis for the left part of my body and from pelvis to shoulder for the right part of my body. Otherwise indeed, trigger points could come back again

Publish or perish, my friend. A theory concocted by PTs is not enough. You can blather on about "out of balance", "too many situps", "one leg shorter", "ribs glued together", "shoulder pulled down", "shortened muscles", "lifted pelvis" etc on and on, but this is the equivalent of PT mumbo jumbo, highly subjective interpretive stuff that only appears believable because the treatment (relax pelvic floor, treat trigger points) just happens to be correct.

Let's see the studies. Until we can see clear and replicable proof that any of the abovementioned cause CPPS, it borders on quackery.

I do wish PTs would just stick to treating trigger points and drop the theorising about etiology.

(This thread continues here viewtopic.php?f=7&t=8626 )