Health Organization for Pudendal Education

Like many of you, I've had countless exams, gone to multiple specialists-uros, neuros,- and have even visited a couple of physical therapists. Sadly, none could provide me with any kind of relief for my symptoms


-golfball feeling in rectum
-frequent, urgent need to urinate
-weak urine stream
-no libido/loss of sensation in penis
-sensitivity in pelvic region


Could you all please give me some specific stretches that you've found to be helpful? Like I said, I am at a point where I do not know where else to do/what to do.


Thanks a ton.

Theres a pretty good book called "Healing Pelvic Pain" that does have lots of stretches. I do them and usually get very temporary relief but I hope that leads to something more.

Hi, I am Bill. Been there big time. I am going to advocate self education in many areas and searching further for the right PT specialist. Has anyone shown you how to do an internal massage of your rectal area? I had the golf ball feeling and it can be your pubiorectus muscle that has trigger points. It runs along the sides of your sacrum and loops around you lower colon, and presses on it. The golf ball feeling comes from it not relaxing. Look up the muscle anatomy for the pelvic floor. A pelvic floor specialist (perhaps a female one that will work with males) can assess that area for trigger points and give you a tool for doing a self message. Look for one.
Additionally, it sounds like your prostate could be bound up and not be able to move. You should be able to feel trigger points and taut muscle bands throughout the pelvic area. Get in there, gently at first, and feel. Take responsibily for your pelvic floor. Have someone teach you to do self treatment in that area. Get a Pro 2000 ultrasound from the Overstock website for $100.00 and start slowly go over your tight muscles. My doctor recommended as much as 3 minutes in one area, to release muscles. On the highest setting, you may feel some slight burning over sensative skin areas, but just lower the setting until it subsides. They will becomes less sensitive with time. Educate yourself on ultrasound.
Dry needling is an absolute necessity to release trigger points. Do a search for one in your area. You will know when the needle hits a trigger point, because you get a short burst of pain as the muscle relaxes.
Shortened fascia can hold your mucsles in spasm. It is like having your muscles it a sausage casing, and it took a long time for me to understand the role of fascia in the myofascia problem process. My dry needing PT stretches fascia as she gets the trigger points to release. I have been getting dry needling done for a long time, because I have trigger points from head to toe and just now have been able to stretch my fascia myself. You can't stretch fascia with a locked up muscle.
I just found that with a loosened, warmed up muscle, it can take 6 minutes of light stretching to stretch fascia by your self. Warming up softens the fascia so it can be stretched. While sleeping, fascia grows like a spider web over your muscles, and if it isn't stretched daily it becomes thicker and harder. A cat stretching, after a nap, is breaking up its facsia, and we need to also. Thus, when we become sedentary from pain, our fascia can cause problems in the long run. I could not exercise, and did not want to move because of the pain, which was a big mistake. I have tight fascia from head to toe, and one tight area can cause problems even on the other side or above and below it due the connectivity throughout the body. Do a seach on fascia and stetching.
Also, I am researching shockwave therapy to minimize needling and accelerate muscle release. Look up Curamedix and see if they have a doctor in your area that can treat you.
Dry needling and shockwave therapy may not be covered by insurance. I have a Physiatrist that can get reimbursed for it as long as it is the needling is done as part of another PT. I am working with him to get educated about shockwave therapy, at present. If you give me your location, I may be able to get a recommendation on a pelvic PT for you. No promises.

Hope this helps and I hope that you become a self educated, self advocate, for your recovery.

thanks for all the insight. I am located in South Florida (Miami).


I've been seeing a PT who specializes in pelvic floor dysfunction for the past 2 1/2 months, but I'd say my condition have improved marginally.



Thanks again

I just came across another avenue for pain relief, medical foods for pain, sleep, and many others. See tmedpharma.com. I am not on it yet, but I will print the website information and give it to my Primary and Physiatrist doctor since it requires a script.

I just posted a new message under " fascia stretching" using the CoAT method. See above.

I am blessed to live right next to Dr. Conway's pelvic PT person. I have been with her for probably 3 years on and off since 2010 due to surgery and medical implants.

Bill, is right on the money....

Pelvic PT can help a lot, but make sure they know pelvic PT and are trained for it. The biggest thing you need to learn is manual control of your pelvic floor and the muscles around it.

Typically, PT will want make your pelvic muscles stronger, DO NOT DO that You will only make the PN symptoms worse.

At first she focused on getting the fascia and scar tissue mobilized, she used ultrasound and laser for that.

Now my PT starts with 10 min on an elliptical runner, then I walk around and cool down for 5 min. In a private treatment room I strip from the waist down and she works the quads to get them to relax. Then she starts working out the trigger points one by one. Very much the way that Bill describes.

Only after they get all of this worked out can the real work on the pelvic floor begin.

Internal PT is in a word "intense" the PT is working on both the outside and inside through the rectum to get the deeper pelvic muscles to relax. But it helps a TON and helps you to isolate and control those deep muscles much better.

Hi,

I have done a lot of PT and it was of zero help to me. (for my condition, I don't want to discourage anyone). The nerve pain and tingling was clearly nerve pain. I just had a neurostimulator implant put in 2 days ago by Dr Richard Marvel and after 5 years trying different things including acupuncture, pelvic PT, nerve pills.. this is the first thing I think is helping. By all means, do PT if it helps.

You need to learn some pelvic exercises, food and lifestyles changes. The change will take time and follow procedure to heal slowly

Hi I am new to HOPE for pudendal education. BUT not new to pudendal neuropathy, I have had the pudendal nerve pain for three years. It started at work, while climbing into a trailer, open legs wide to climb and, bingo, pudendal nerve pain hits. I have seen five doctors in my city and all said I had a groin muscle sprain. I got injections for pain in the groin muscles, no help and it increase the pain 10 fold. I have tried Steroids, but discovered I was allergic to them. I taken all kinds of pain meds with no help. It was a doctor specialist in pain, who discovered I had pain in the illiosis muscles and pudendal neuropathy. Lyrica helped with the pain, but made me all goofy and dizzy. So I am now taking Gabapentin 300 mg. three times daily. That helps with the pain, and it gave with some other side effects after long term. So I went to a Neurologist who also prescribed Clonazepam for the pain and anxiety.
I don't like to take too many medications, but there are needed even with the side effects. So a RN nurse family member suggested I look into Pelvic Floor Therapy to see if it would help me with some pain relief. I checked with my doctors and no pelvic floor therapy available in my city. They are specialized therapist and not many around. the closes one was in the city of San Antonio, Texas as a part of the Methodist Hospital system. After getting a Doctor Script I headed to the pelvic floor therapist with some hope but trepidation also. The initial diagnostic and check up went well with a lot of poking around where there was some pain and tenderness. I was told that the muscles in the groin are tight and had some pressure points at the source of the muscle. But after four treatments in one month, I am getting some relief in pain. YES finally some light at the end of the long tunnel of pain. I do some kegles exercises, yes I know it causes some pain to some people. But I follow all the stretching and exercises that they gave me and I am able to reduce one gabapentin capsule a day since I am getting less pain.
Pelvic floor therapy worked for me, I am very happy with the reduction in pain, but I have a long way to go to eliminate all pain. But we are doing baby steps in pain reduction and reducing muscle tension in the groin which was causing pain. Do I recommend Pelvic Floor Therapy, yes I do. Will it work for you, I don't know, but you have nothing to loose but some pain. Good luck and as long as life is in us, there is hope. G. N.