Guest guest Posted August 25, 2007 Report Share Posted August 25, 2007 One of our members is an accomplished Physical Therapist (Hi, Tom) and I have put his name in the SUBJECT so that he can hopefully answer your question. Also, Tom could you comment on the fact that squatting exercises can lead to Pudendal Neuralgia as mentioned at: http://www.spuninfo.org/index_files/WhatIsPN.htm Ora >Its been 2 weeks since physical therapy (my physical therapist was on >vacation last week) after the second pt appointment with her, I was in complete >agony, I had to schedule an appointment with my gynecologist and he put me on a >low dose of elavil now. I have intermittent burning when I urinate but >today is fairly a good day so far. Yesterday I had a fist feeling in my rectum >and a burning sensation. I emailed Dr Conway and he wrote back to me and said >that it sounds like I have a lot of PNe symptoms and I am going to do a >phone consult with him. I am so confused, I am due to go to PT again Thursday >this week, and am not sure what to do? I am not sure why this burning pain is >coming and going like it is. Since the start of the elavil, I have had >burning sensations only in my rectal area- but the pain when I touch the muscles >at the top of my legs are still there. If a nerve is entrapped would the pain >come and go? My gyne originally said I had vestibulits/levator ani >syndrome, just recently when I went to him, he said neuralgia (pudendal) - is pt >different for both cases? Or are they still just working on the levator muscles >?? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 26, 2007 Report Share Posted August 26, 2007 Hi Ora, Carolyn and all. Ora, I cannot understand why squating is necesarily a trigger for LA syndrome or neuritis of the peudendal nerve. Unless it was straining while you were squating. That could irritate the pelvic floor like haveing a difficuult BM. When you squat, the lumbar spine moves into slight flexion and the sacrum has to move slightly backwards at it's base aka slight extenion. That slight extension at the base would actually move the tailbone forward whcih would take preasure off of the levator ani and thus releive preasure on those structures...so I cant understand why they would claim the acto of squating would in and of itself cause increased symptoms. Now to Carolyn, that agonsing fist feeling in the rectum is classic Levaror Ani spasm. If you remember to think of the levator ani not as a Left and Right muscle that join at the tailbone but rather, a single muscle that loops around the rectum. When in spasm, you will get that feeling like a fist in the rectum or some have described it as a golf ball in the rectum. Try to find a PT who knows or will look up the "counter strain release" position for the levator ani muscle. It is so easy an simple to do and can give great releif. But!!!! if the pelvis and sacrum are not symmetrical, that can trigger the spasm, so the release for the muscle will sometimes be temporary. As far as the different diagnosis the doc are giving you...they are guessing... they don't understand the mechanics of the pelvis and how the muscles react with spasm. Muscles don't go into spasm for no good reason. When the pelvis and the sacrum on not in proper alignment / symmetrical, the muscles can spasm. You can stretch them( recatally ) till the cows come home but untill you get to the cause...it can be quite futile and uncomfortable. So if you PT is targeting the levator ani muscles and does not understand how to check for and properly diagnose and balance the pelvis and sacrum, your in for a rough ride. I am currently in discussion with a PT who wants me to put together and teach a course that focuses on Women's pelvic issues. Since NO male PTs ever work on this area ( other than myself) I have pre-named the course No Man's Land because you rarely need to do internal work if you can get the pelvis and sacrum back to "factory setttings." That is my winter project... I'll keep you all posted.. K. Ockler P.T. www.tomocklerpt.com taurusrc@... wrote: One of our members is an accomplished Physical Therapist (Hi, Tom) and I have put his name in the SUBJECT so that he can hopefully answer your question. Also, Tom could you comment on the fact that squatting exercises can lead to Pudendal Neuralgia as mentioned at: http://www.spuninfo.org/index_files/WhatIsPN.htm Ora On Sat, 25 Aug 2007 11:53:20 EDT, Carolyn52192 (AT) aol (DOT) com wrote: >Its been 2 weeks since physical therapy (my physical therapist was on >vacation last week) after the second pt appointment with her, I was in complete >agony, I had to schedule an appointment with my gynecologist and he put me on a >low dose of elavil now. I have intermittent burning when I urinate but >today is fairly a good day so far. Yesterday I had a fist feeling in my rectum >and a burning sensation. I emailed Dr Conway and he wrote back to me and said >that it sounds like I have a lot of PNe symptoms and I am going to do a >phone consult with him. I am so confused, I am due to go to PT again Thursday >this week, and am not sure what to do? I am not sure why this burning pain is >coming and going like it is. Since the start of the elavil, I have had >burning sensations only in my rectal area- but the pain when I touch the muscles >at the top of my legs are still there. If a nerve is entrapped would the pain >come and go? My gyne originally said I had vestibulits/levator ani >syndrome, just recently when I went to him, he said neuralgia (pudendal) - is pt >different for both cases? Or are they still just working on the levator muscles >?? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 26, 2007 Report Share Posted August 26, 2007 Tom who can diagnose the sacrum and pelvis? I don't feel any of the pts I am dealing with are that knowledgeable unfortunately. Can a physician/chiropractor do this????? I just started running and was building up to 5 miles a day, my one leg is longer than the other, I am wondering if this could effect the sacrum/pelvis???? thanks! CarolGet a sneak peek of the all-new AOL.com. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 26, 2007 Report Share Posted August 26, 2007 Tom, I've read on this list and in a local health magazine that sitting to use the toilet aggravates pelvic problems and squatting remedies or at least prevents some of these problems. Have you heard of this? Lindsey > > > > >Its been 2 weeks since physical therapy (my physical therapist was on > > >vacation last week) after the second pt appointment with her, I was > > in complete > > >agony, I had to schedule an appointment with my gynecologist and he > > put me on a > > >low dose of elavil now. I have intermittent burning when I urinate but > > >today is fairly a good day so far. Yesterday I had a fist feeling in > > my rectum > > >and a burning sensation. I emailed Dr Conway and he wrote back to me > > and said > > >that it sounds like I have a lot of PNe symptoms and I am going to do a > > >phone consult with him. I am so confused, I am due to go to PT again > > Thursday > > >this week, and am not sure what to do? I am not sure why this burning > > pain is > > >coming and going like it is. Since the start of the elavil, I have had > > >burning sensations only in my rectal area- but the pain when I touch > > the muscles > > >at the top of my legs are still there. If a nerve is entrapped would > > the pain > > >come and go? My gyne originally said I had vestibulits/levator ani > > >syndrome, just recently when I went to him, he said neuralgia > > (pudendal) - is pt > > >different for both cases? Or are they still just working on the > > levator muscles > > >?? > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 26, 2007 Report Share Posted August 26, 2007 They did not say that squatting would trigger it but they said " squatting exercises " . I am particularly interested to learn more about the possibility that cycling or squatting exercises can lead to PN. I am presently going to a PT who has me doing squatting exercises and I did one session of cycling. I don't do the cycling stuff because the seat is very uncomfortable. I think if the seat was more comfortable it would benefit me because of the rhythm involved. My purpose in going to Physical Therapy is because I recently had a meniscus repair and my surgeon recommended PT as a follow-up to the surgery. However since I have pelvic problems (vulvodynia) I do not want to make it worse. Your explanation makes a lot of sense and my exercise is not extreme, so I am not worried about that any more. Ora Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 27, 2007 Report Share Posted August 27, 2007 Carolyn, A highly skilled Osteopathic Doctor or a PT who has special training in manual therapy can identify the problem and correct it easily. AVoid chirowankers like the plague....THey take your money and put you in danger, they can actually cause these problems...No regular western medicine doctor can identify or correct the exact problem.. there aren't stupid , they just arn't trained to look for it or fix it. MY new book, The Case For Alternative Health Care will be in book stores in a month but you can get a copy at a reduced price right from the publisher www.authorhouse.com It should be ready for distribution by mid September. I devote an entire chapter to EFT and an entire chapter to the dangers of manipulations... TKO Carolyn52192@... wrote: Tom who can diagnose the sacrum and pelvis? I don't feel any of the pts I am dealing with are that knowledgeable unfortunately. Can a physician/chiropractor do this????? I just started running and was building up to 5 miles a day, my one leg is longer than the other, I am wondering if this could effect the sacrum/pelvis???? thanks! Carol Get a sneak peek of the all-new AOL.com. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 27, 2007 Report Share Posted August 27, 2007 Lindsey, I would have to agree... Sitting on the john compresses the piriformis and can aggravate the pudendal nerve. Squatting can release tension on the Levator Ani. TKO Lindsey wrote: Tom, I've read on this list and in a local health magazine that sitting to use the toilet aggravates pelvic problems and squatting remedies or at least prevents some of these problems. Have you heard of this? Lindsey > > > > >Its been 2 weeks since physical therapy (my physical therapist was on > > >vacation last week) after the second pt appointment with her, I was > > in complete > > >agony, I had to schedule an appointment with my gynecologist and he > > put me on a > > >low dose of elavil now. I have intermittent burning when I urinate but > > >today is fairly a good day so far. Yesterday I had a fist feeling in > > my rectum > > >and a burning sensation. I emailed Dr Conway and he wrote back to me > > and said > > >that it sounds like I have a lot of PNe symptoms and I am going to do a > > >phone consult with him. I am so confused, I am due to go to PT again > > Thursday > > >this week, and am not sure what to do? I am not sure why this burning > > pain is > > >coming and going like it is. Since the start of the elavil, I have had > > >burning sensations only in my rectal area- but the pain when I touch > > the muscles > > >at the top of my legs are still there. If a nerve is entrapped would > > the pain > > >come and go? My gyne originally said I had vestibulits/levator ani > > >syndrome, just recently when I went to him, he said neuralgia > > (pudendal) - is pt > > >different for both cases? Or are they still just working on the > > levator muscles > > >?? > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 27, 2007 Report Share Posted August 27, 2007 Ora, I think the bike seat would be the culprit. INterestingly enough, down hill skiing gives significant relief from PF symptoms due to the co-contractions of the adducotrs and abductors especially for beginners who do the snow plow or pizza slice technique when just learning..... TKO taurusrc@... wrote: They did not say that squatting would trigger it but they said "squatting exercises". I am particularly interested to learn more about the possibility that cycling or squatting exercises can lead to PN. I am presently going to a PT who has me doing squatting exercises and I did one session of cycling. I don't do the cycling stuff because the seat is very uncomfortable. I think if the seat was more comfortable it would benefit me because of the rhythm involved. My purpose in going to Physical Therapy is because I recently had a meniscus repair and my surgeon recommended PT as a follow-up to the surgery. However since I have pelvic problems (vulvodynia) I do not want to make it worse. Your explanation makes a lot of sense and my exercise is not extreme, so I am not worried about that any more. Ora Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 27, 2007 Report Share Posted August 27, 2007 I am currently in discussion with a PT who wants me to put together and teach a course that focuses on Women's pelvic issues. Since NO male PTs ever work on this area ( other than myself) I have pre-named the course No Man's Land because you rarely need to do internal work if you can get the pelvis and sacrum back to "factory setttings." That is my winter project... I'll keep you all posted.. Tom, I find this comment regarding rarely needing to do internal work fascinating. I recently had an evaluation with a pelvic PT, a Fletcher, who does a lot of trainings and who, unlike a lot of other pelvic PT's, focuses largely on the bio-mechanical stuff rather than internal work, which she adds only after she feels that the nerves are able to fire properly. This is in sharp contrast to leading pelvic PT's like Pendergrast and Liz Rummer in SF, who, if it's possible, like to get inside from the get-go. . . . Hollis Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 27, 2007 Report Share Posted August 27, 2007 Hi Hollis, I agree completely. My theory has always been that if you line up the structures and get rid of the increased tone, you rarely have to do internal work. In fact, the only times I did internal work successfully was after I got all the other work done. I realize I'm a bit of a rouge with my theory but it is the same theory that is accepted and works beautifully everywhere else in the body. So why should we need a completely different theory for the muscles of the pelvic floor??? I don't think we do!!! Learning Muscle Energy and Counter strain technique are challenging but well worth it. Tell your PT I agree big time and if she wants to contact me please feel free to give her my e-mail.. Thanks for letting me know i'm not the only mutant out there!!! TKO > In a message dated 8/25/2007 11:03:18 PM Eastern Daylight Time, > ihcs@... > writes: > > >> I am currently in discussion with a PT who wants me to put together and >> teach a course that focuses on Women's pelvic issues. Since NO male PTs >> ever >> work on this area ( other than myself) I have pre-named the course No >> Man's Land >> because you rarely need to do internal work if you can get the pelvis >> and >> sacrum back to " factory setttings. " That is my winter project... >> I'll keep you all posted.. >> >> > > Tom, > > I find this comment regarding rarely needing to do internal work > fascinating. > > I recently had an evaluation with a pelvic PT, a Fletcher, who does a > lot > of trainings and who, unlike a lot of other pelvic PT's, focuses largely > on > the > bio-mechanical stuff rather than internal work, which she adds only after > she feels that the nerves are able to fire properly. This is in sharp > contrast > to leading pelvic PT's like Pendergrast and Liz Rummer in SF, > who, if it's possible, like to get inside from the get-go. . . . > > Hollis </HTML> > Quote Link to comment Share on other sites More sharing options...
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