Health Organization for Pudendal Education

Does anyone know what ligament laxity is and how it relates to PN? My MRI indicated mild ligament laxity and my pain doctor said this can't be fixed and can be a cause of PN pain. Is the ligament irritating the nerve or is the ligament laxity causing instability with the pelvis (alignment issues, muscle issues, etc.) and THAT is irritating the nerve? Or am I way off base with both these ideas?

I appreciate any input,
Stephanies

Www caringmedical.com gives an outline of ligament laxity but not related to PNE, can only surmise that may be aggravated through alignment issues but not sure. Maybe someone else has direct experience? Good luck with research

Hi Stephanies,
Very interesting. If I remember correctly, you've done lots of PT. Have you gotten any feedback from your therapists about pelvic misalignment and/or lax ligaments?
Did your MRI specify which ligament(s) is lax?

When you had your surgery with Dr. Filler in 2006, do you know if he cut any of your ligaments or transposed your PN in front of the ischial spine?

Were there any comments from Dr. Campbell in 2007 about why he cut your left SSL?

I'm sorry for all the questions (and no answers!), but I don't think you're too off base with any of your ideas.

Kind regards,
Karyn

Thank you Poppy and Karyn for the replies.

Dr. Filler did not cut any ligaments, just sectioned the SS. Dr. Campbell felt the ligaments might be a problem and cut the SS and sectioned the ST. Neither doctor (to my knowledge) transposed the nerve. Does that mean the nerve is vulnerable to entrapment in the ST ligament? I am starting with a new PT soon. My last PT didn't do much with alignment. Based on my recent evaluations, I am definitely out of alignment in multiple places.

Stephanies

Well, I think it's possible your nerve could still be irritated or impinged if it is the STL that is lax. You didn't clarify which ligament .
Typically, the PN is transposed in front of the ischial spine to avoid re-entrapment in the SSL/STL ligament grip with TG surgery.

It will be interesting to hear what your new PT's thoughts are.

stephanies wrote:My MRI indicated mild ligament laxity and my pain doctor said this can't be fixed and can be a cause of PN pain.

I'm not sure how you can hold an adjustment. Maybe prolo therapy would be helpful with strengthening the ligaments?

You are right! I forgot to mention the report does not say which ligament or even which side.

I guess I will see after my appointment how I can hold the adjustment and if being in alignment makes a difference in how I feel. Thanks again!

You're welcome, Stephanies!
A bit disappointing about the radiologist not clearly identifying which ligament is lax. I guess I'm kind of impressed they reported anything at all in that regard. I had a 3-T MRI a couple of years ago that reported that my SSL's were intact, when they were indeed severed at the time of my TG surgery.
When Dr. Conway called the radiologist to discuss the error, the radiologist then amended my report to say that my STL's weren't present. More:

Stephanie, I had very lax ligaments -- so bad, in fact, that the PT gasped when she examined my pelvis because it was so unstable. Also my chiro essentially "fired" me because my pelvis wouldn't hold an adjustment more than 5 minutes. She said I had chronic sacroiliac ligament strain. The ligament laxity contributed to pelvic misalignment with pain primarily on one side, but my ligaments were also hardened and sclerosed and impinging on the nerve. So, I don't know for sure what's going on with you but I can speak from experience that ligament issues were the primary cause of my PN. I had some prolotherapy into the SI ligaments post-PNE surgery and that has helped some.

Good luck as you get this sorted out.

Violet

Thank you for the replies.

MY new PT thinks that since my alignment does not seem to be affected by the laxity at this point, that the it is not too much of a concern right now. I have learned with this condition that it is impossible to anticipate what will happen in the future, so maybe it will need to be addressed down the road.

Sincerely,
Stephanies