Quite honestly I've been afraid to ask this question...What do they do in Physical Therapy to help with the Pudendal pain? I've been reading the posts but not quite sure what is invovled in the PT sessions. Can anyone fill me in? It's one of the items on my list to ask my dr about in March.
Tracy
What Type of PT
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- Posts: 196
- Joined: Mon Sep 27, 2010 3:42 am
- Location: Vail, Arizona
What Type of PT
Have been dealing with burning pain since Jan 2010.
No sitting since April 2010.
Seen the following dr's: DO, GYN, Dermatologist, Accupuncturist,
URO GYN (his RN is the one who suggested the pain could be PN), Neurologist
Had ECG and MRI both inconclusive, only the SSEP said Pudendal reaction was abnormal and they lost that test result.
Saw Dr. Castellanos April 6, 2011. Next steps, MRI and botox. Having PT while waiting.-Botox denied, appealing to Insurance company now.
No sitting since April 2010.
Seen the following dr's: DO, GYN, Dermatologist, Accupuncturist,
URO GYN (his RN is the one who suggested the pain could be PN), Neurologist
Had ECG and MRI both inconclusive, only the SSEP said Pudendal reaction was abnormal and they lost that test result.
Saw Dr. Castellanos April 6, 2011. Next steps, MRI and botox. Having PT while waiting.-Botox denied, appealing to Insurance company now.
Re: What Type of PT
Tracy,
Attached is something I found to be useful/descriptive. It parallels the approach my PT is using on me post op.
RR
Attached is something I found to be useful/descriptive. It parallels the approach my PT is using on me post op.
RR
- Attachments
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- ElizabethRummerpt.pdf
- (1.44 MiB) Downloaded 474 times
Cyclist till perineal pain onset R side (Apr'08). Dx with PN (Aug'09). Lyrica gave 30% pain reduction. Potter MRI (Oct'10) validated at surgery with Dr Hibner (Nov'10) - found nerve attached to scarred STL. Now sitting 10 hrs/day vs 1 hr/day pre-op. Surgery video = http://www.youtube.com/watch?v=6FDwana6SQU
Deep neuropathic burning pain flares have been gone since surgery...Grateful to Dr Hibner.
Deep neuropathic burning pain flares have been gone since surgery...Grateful to Dr Hibner.
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- Posts: 157
- Joined: Sat Sep 18, 2010 3:12 am
- Location: Oklahoma
Re: What Type of PT
What helps me in PT:
Ultrasound of the perineum and inner buttocks
Internal trigger point work and stretching, specifically targeting the obturator internus and levator ani muscles
Internal adhesion work--basically, she tries to mobilize my endometriosis and scar tissue adhesions she feels on my bladder, bowels, and muscles
Abdominal massage, often targeting again adhesions or the psoas muscle
By the way, internal work for me has included both rectal and vaginal.
A good physical therapy visit can buy me a couple of days of near complete pain relief. Unfortunately, the physical therapist I was seeing also believes in a pelvic floor strengthening component, which does not help my pain. Therefore, I've quit going due to our differences in opinion regarding my pain and needs.
I'm paying Stephanie Prendergast and Liz Rummer a visit in March, so I'll be sure to come back and report.
Lauren
Ultrasound of the perineum and inner buttocks
Internal trigger point work and stretching, specifically targeting the obturator internus and levator ani muscles
Internal adhesion work--basically, she tries to mobilize my endometriosis and scar tissue adhesions she feels on my bladder, bowels, and muscles
Abdominal massage, often targeting again adhesions or the psoas muscle
By the way, internal work for me has included both rectal and vaginal.
A good physical therapy visit can buy me a couple of days of near complete pain relief. Unfortunately, the physical therapist I was seeing also believes in a pelvic floor strengthening component, which does not help my pain. Therefore, I've quit going due to our differences in opinion regarding my pain and needs.
I'm paying Stephanie Prendergast and Liz Rummer a visit in March, so I'll be sure to come back and report.
Lauren
2008: mild pelvic pain and PFD began
2009: true PN/PFD pain, two PN blocks, normal PNMLT
2010: PT and conservative management with moderate improvement in PN/PFD symptoms
2011: surgery for extensive endometriosis; arthroscopic hip surgery to repair labral tear and FAI (right hip)
2012: C-section delivery of first child
2014: arthroscopic hip surgery to repair labral tear and FAI (left hip); C-section delivery of second child
Ongoing physical therapy since 2010 for both pelvic floor and hips.
2009: true PN/PFD pain, two PN blocks, normal PNMLT
2010: PT and conservative management with moderate improvement in PN/PFD symptoms
2011: surgery for extensive endometriosis; arthroscopic hip surgery to repair labral tear and FAI (right hip)
2012: C-section delivery of first child
2014: arthroscopic hip surgery to repair labral tear and FAI (left hip); C-section delivery of second child
Ongoing physical therapy since 2010 for both pelvic floor and hips.
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- Posts: 196
- Joined: Mon Sep 27, 2010 3:42 am
- Location: Vail, Arizona
Re: What Type of PT
Thank you both!! Any suggestions on how to find a good PT? I am so afraid of causing a flare by going to someone who isn't familiar with PN.
Have been dealing with burning pain since Jan 2010.
No sitting since April 2010.
Seen the following dr's: DO, GYN, Dermatologist, Accupuncturist,
URO GYN (his RN is the one who suggested the pain could be PN), Neurologist
Had ECG and MRI both inconclusive, only the SSEP said Pudendal reaction was abnormal and they lost that test result.
Saw Dr. Castellanos April 6, 2011. Next steps, MRI and botox. Having PT while waiting.-Botox denied, appealing to Insurance company now.
No sitting since April 2010.
Seen the following dr's: DO, GYN, Dermatologist, Accupuncturist,
URO GYN (his RN is the one who suggested the pain could be PN), Neurologist
Had ECG and MRI both inconclusive, only the SSEP said Pudendal reaction was abnormal and they lost that test result.
Saw Dr. Castellanos April 6, 2011. Next steps, MRI and botox. Having PT while waiting.-Botox denied, appealing to Insurance company now.
Re: What Type of PT
I see you live in Vail, AZ so you are only a couple hours from Phoenix? Maybe you could contact Loretta Robertson, Dr. Hibner's PT. Here's her website http://www.desertpt.com/. I have never been to her, but those on here who have been to her seem to talk highly of her. I really like what I read on her website. She doesn't take insurance so I was told the initial visit would be $275 (crazy I know), but maybe you could either see her once just for a good overall eval or call their office and ask for other PT's closer to you who specialize in pelvic floor PT and who take insurance Did I remember you are scheduled to see Dr. C (Hibner's associate) in March? I think they will mostly likely want you to try PT before any other treatment options (that's my understanding at least). So it might be good to do that before your appointment.TracyB7777 wrote:Thank you both!! Any suggestions on how to find a good PT? I am so afraid of causing a flare by going to someone who isn't familiar with PN.
Don't be scared of PT (and that's coming from someone who's sitting pain started with PT) just be careful if they want to manipulate your pelvis a lot, especially if they do any high velocity manipulations where you are on your side and you wrap your legs around the PT and they push as you resist. This is how my sitting pain began. I think that technique can overstrain the pelvic ligaments if not done correctly and since you already have PN pain, you don't need that! I agree with Lauren. Ultrasound has helped me a good deal and usually after I go to PT I feel pretty good that day and maybe the next if I am lucky (it doesn't take my pain away by any means though). Be sure to ice afterwards! The first couple treatments can flare you up. Just be sure to tell the PT if they are being too aggressive!
-11/08 vulvodynia began around conception of first & only pregnancy
-3/10 sacral/sitting pain began after SIJD manipulation
-Progressive widespread pain- central sensitization
-PT, meds, injections, botox, ESWT = debilitated.
-5/12 Potter MRI - scarring of left ST, coccygeous & posterior alcock
-12/12 - left FAI/labral hip tear surgery
2014-2019 managed w/ gabapentin, massage, and lifestyle mod
2020 - big flare up
www.thepurposeofpain.blogspot.com
-3/10 sacral/sitting pain began after SIJD manipulation
-Progressive widespread pain- central sensitization
-PT, meds, injections, botox, ESWT = debilitated.
-5/12 Potter MRI - scarring of left ST, coccygeous & posterior alcock
-12/12 - left FAI/labral hip tear surgery
2014-2019 managed w/ gabapentin, massage, and lifestyle mod
2020 - big flare up
www.thepurposeofpain.blogspot.com
Re: What Type of PT
Excited to hear what they say! My PT is taking the "Demystifying Pudendal Neuralgia" course that Prendergast and team teaches in Orlando in March so I am excited and hopeful that maybe she will will be able to do some connective tissue mobilization on me. I think I would benefit from that.pomegranate wrote:I'm paying Stephanie Prendergast and Liz Rummer a visit in March, so I'll be sure to come back and report.
-11/08 vulvodynia began around conception of first & only pregnancy
-3/10 sacral/sitting pain began after SIJD manipulation
-Progressive widespread pain- central sensitization
-PT, meds, injections, botox, ESWT = debilitated.
-5/12 Potter MRI - scarring of left ST, coccygeous & posterior alcock
-12/12 - left FAI/labral hip tear surgery
2014-2019 managed w/ gabapentin, massage, and lifestyle mod
2020 - big flare up
www.thepurposeofpain.blogspot.com
-3/10 sacral/sitting pain began after SIJD manipulation
-Progressive widespread pain- central sensitization
-PT, meds, injections, botox, ESWT = debilitated.
-5/12 Potter MRI - scarring of left ST, coccygeous & posterior alcock
-12/12 - left FAI/labral hip tear surgery
2014-2019 managed w/ gabapentin, massage, and lifestyle mod
2020 - big flare up
www.thepurposeofpain.blogspot.com
Re: What Type of PT
Very neat! My new physical therapist is actually hosting this event in Orlando. I'm very excited about this, because although she is already PN aware, it means more PN aware PT's will be in the area!Faith wrote:My PT is taking the "Demystifying Pudendal Neuralgia" course that Prendergast and team teaches in Orlando in March
WooHOO!!
Pain started suddenly April 2010.
3T MRI w/ Dr. Potter, January 2011 shows bilateral impingement of the dorsal nerve of the clitoris.
Unsure what to do next because my pelvis is a mess.
3T MRI w/ Dr. Potter, January 2011 shows bilateral impingement of the dorsal nerve of the clitoris.
Unsure what to do next because my pelvis is a mess.
Re: What Type of PT
Tracy, you can also search on the American PT Association website, http://www.apta.org under Women's Health. This site allows you to search by zip code for a PT close to your home.
Hope you can find one to help you. Jeanie
Hope you can find one to help you. Jeanie
Diagnosed with left side PN by Dr Renney, March 2010, after over 2 years of searching for help
Left TG Surgery, Dr Ansell, August 2010, failed to relieve pain
Left TG Surgery, Dr Ansell, August 2010, failed to relieve pain
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- Posts: 196
- Joined: Mon Sep 27, 2010 3:42 am
- Location: Vail, Arizona
Re: What Type of PT
Ok, so I've realized my brain really isn't functioning well. While I thought to call Hibner's office, I never once thought to call Loretta's. Sure would like my normal brain back...someday I hope.
Thank you all for the suggestions. I'll get to work on them tomorrow.
tracy
Thank you all for the suggestions. I'll get to work on them tomorrow.
tracy
Have been dealing with burning pain since Jan 2010.
No sitting since April 2010.
Seen the following dr's: DO, GYN, Dermatologist, Accupuncturist,
URO GYN (his RN is the one who suggested the pain could be PN), Neurologist
Had ECG and MRI both inconclusive, only the SSEP said Pudendal reaction was abnormal and they lost that test result.
Saw Dr. Castellanos April 6, 2011. Next steps, MRI and botox. Having PT while waiting.-Botox denied, appealing to Insurance company now.
No sitting since April 2010.
Seen the following dr's: DO, GYN, Dermatologist, Accupuncturist,
URO GYN (his RN is the one who suggested the pain could be PN), Neurologist
Had ECG and MRI both inconclusive, only the SSEP said Pudendal reaction was abnormal and they lost that test result.
Saw Dr. Castellanos April 6, 2011. Next steps, MRI and botox. Having PT while waiting.-Botox denied, appealing to Insurance company now.