Health Organization for Pudendal Education

Hi Beverley
I just read your recent posts and am so glad that you are feeling better! Thats great!
You mentioned a guy who showed you a technique called NKT that helped you to use your pelvic floor muscles when working out..

I believe that overuse of my pelvic floor muslses esp. in pushing to get all the pee out, for years when I did not feel empty.... this started years ago and has occurred since...may be at the root of at least some of my issues ( It may have put my pelvic floor into deep spasm that remained int effect.) I did also had at least one surgery ( a nerve surgery with Dr Dellon that is causal for my intense anal pain...we think...but along with the irritated nerves we believe there's still a muscular component.

Is the guy who does NKT the one you mentioned to me...in Manhattan? .could you pls tell me a bit more about him?

I hadn't pursued it yet as wer'e working on pain control here in NJ. ( and hubby is exhausted from shleping me to the city for PT and to many docs appmts in the past several years...we got nowhere with all this.. so I hated to ask him yet again to drive me in...( i can't sit due to pain so can't drive yet on my own )

I noticed in your signature we have had some similar issues. (hip tear and surgery with Coleman,, I had a labral tear repair as per the advice of Dr. Coady) I also have pelvic varicosities which we still wonder about, tho I had one side embolized in 2011 without relief...Yet both these things appeared on my MRI also..

I also did quite a bit of yoga in 2010 with a private instructor who said I was very limber...I made him aware of my issues and tried to be careful, but stopped when my neck got hurt...(not sure from yoga tho) I continued later with another private instructor ...extremely gentle ..I mainly did it to calm my nervous system. I enjoyed it but found my tension and anxiety with regards to my pain issue would return shortly after the yoga session.. I did it usually weekly.

Anyway would love to her more about what helped you if you have time.
My main concern is calming my severe anal pain so I can lead a normal life again but also to calm my muscles in the event that the muscle spasm in the pelvic floor is the root cause..
Ths so much in advance Beverly and so happy for your improvement!
Kathy

Yo

Hello, I just joined this forum, mainly because I have no idea if I even have PN involvement or not, but I have gone undiagnosed (MRI/radiologist missed it) with a labral tear (right hip) and a torn hamstring tendon (also right leg) since Sept. I now have extreme pelvic pain, as I can barely hold my right hip/right side of the pelvis "on" and am now having bladder and bowel issues. Went to a urogynecologist today, and he said it was pelvic floor dysfunction/spasms (ARGH>>>) due to the injuries and that nothing will be resolved until I have surgery for the labral tear. He also said the PN is firing fine, according to his reflex test and that all of my internal pain was related to the hip.

Someone here suggested I ask a few questions about labral tears specifically, and how the surgery effects/helps general pelvic health. I was in extremely good health prior to injury, very active. The doctors all want to jump to pelvic floor things because I have been diagnosed with Interstitial Cystitis for 20 years, but I have had no real issues with it at all and took no meds for it whatsoever. I'm emotionally torn up at this point, having to advocate for myself for 5 months of a sports injury that could've been DXed and fixed within a month, and long before I had any bladder/bowel issues due to it. I actually was refusing to stop walking and still walked 6 miles a day (I cut down a bit) for a month with this injury, I think sheer willpower and every muscle in my pelvis is keeping the hip up at present.

What risks do I have with the arthroscopic hip surgery, and what should I be asking? I want absolutely no resultant pain issues from this, I want it to (obviously) go back the opposite way. I've just read a few posts that seem to indicate some nerve involvement from this injury and the surgery for it.

Thanks in advance, and as I say, no proof yet of any PN involvement, but I get a pelvic EMG later this week.

Where do you live? If i were you i would do (good) pelvic floor PT before having the surgery and see where that gets you. Lots of people have labral tears without pain and it usually isn't as simple as the hip surgery cures the pain (unfortunately).

Started pelvic floor PT today, and she thinks I also have strained two of the muscles that attach to the hip as well as the inguinal ligament. Not major, and didn't show up as damaged on the MRI, but they're the sore points. The hip itself does hurt enormously, but it is very helpful to learn how to let the muscles go a bit and not make the spasming worse. My early PTs had said so much about core muscles being "off" and having to clench them and "reactivate" them that I had worked myself into much worse shape by doing that. This therapist is very, very good.

If I've got these muscles sort of messed up, I am worried about the traction for the surgery. My muscles are just SOOO messed up, and there is a warning on my doctor's site about how the nerves get stretched a bit by the surgery itself. I just honestly can't imagine being any MORE sore in this area. Did any of you experience any worsening symptoms after the surgery?

yes, the surgery made the symptoms worse and the recovery is long and hard and i am not sure that i would do it if i could do it over again. I think you should stick with this good physical therapist and give it some time before considering surgery.

Hip surgery to relieve my longstanding hip pain did not exacerbate my PN and in fact was key in resolving it. I have no regrets about having it. Hip surgery may or may not make a difference to your PN pain (if in fact you have it). But if your hip hurts, you should fix it. Having said that, Beverley is correct in warning you that recovery from hip surgery is long and difficult. In my case, it took a year.

Patience isn't really one of my virtues when it comes to this, I lost a lot of years to a nerve injury in the past and went through the wringer with the meds and the pain. I thought I was finally free from the life of being a chronic pain patient. Alas.

Appointment didn't go so well today for the pelvic EMG. The doctor dismissed everything I said, thought I was obsessing on my injuries and told me to stop thinking about it, go home and do nothing. Basically to ignore it. Literally no treatment, no EMG, he even told me to not go to PT. I was very upset, he wouldn't even acknowledge that one half of my pelvis is in the wrong place, which I've had no trouble with the other doctors and PTs noticing just from looking at me. He said that there was too much pain in my pelvis to be coming from a labral tear alone, and thought there was likely a groin strain as well to a few of the muscles there. Well, that had already been determined. Then he started asking if this was possibly gynecological, when my scans all show hip damage yet no damage whatsoever to my organs.

Luckily, I see another doctor Thursday, and he's just about the most highly recommended hip specialist in the area. How do you deal with these guys, seriously? They don't seem to see me as an injured athlete, but a malingering chronic pain patient. If I get told one more time that it's just my "perception" that is off of what's going on in my body as opposed to someone saying they'll help me I'm going to just lose it! One person says one thing, another something opposite and they all have the same scans. It's very frustrating!

I'm also confused about the healing time, they keep saying that arthroscopic surgery usually takes just a few months maximum to heal from, but they also told me that there's no way a labral tear could be this painful.

Hang in there Antonia! I was dismissed by two orthopedic docs when I started down the labral tear hip path. Not all of them know what the hell is going on, and are up to date on the research. I ended up having surgery with the doctor in NY who pretty much discovered the connection between pelvic pain and hip labral tears. It's frustrating believe me. But I am seeing progress in my case even though it is very slow. As far as recovery from arthroscopic surgery goes, my surgeon told me that my hip would be healed in 3 - 6 months, but that it takes longer for the pelvic pain to resolve which could take a year to 18 months.

I'm trying. The doctor's office I was supposed to go to on Thursday called this morning and referred me back to the doctor I saw yesterday who told me to go to a gynecologist. Again. I really fail to see how a sports injury is turning into something like this, it's bizarre. The pain is very specifically in the hip and right to the interior of the hip, it's not even in much of the pelvis except that it shoots down occasionally. It started rather suddenly. I realize that my health isn't the priority of these guys, but this is intensely frustrating!

Griff522 wrote:Hang in there Antonia! I was dismissed by two orthopedic docs when I started down the labral tear hip path. Not all of them know what the hell is going on, and are up to date on the research. I ended up having surgery with the doctor in NY who pretty much discovered the connection between pelvic pain and hip labral tears. It's frustrating believe me. But I am seeing progress in my case even though it is very slow. As far as recovery from arthroscopic surgery goes, my surgeon told me that my hip would be healed in 3 - 6 months, but that it takes longer for the pelvic pain to resolve which could take a year to 18 months.

Who is the doctor in NY, if I may ask?