Health Organization for Pudendal Education

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

Tracy,
Attached is something I found to be useful/descriptive. It parallels the approach my PT is using on me post op.
RR

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

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.

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.

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.

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!

pomegranate wrote:I'm paying Stephanie Prendergast and Liz Rummer a visit in March, so I'll be sure to come back and report.

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.

Faith wrote:My PT is taking the "Demystifying Pudendal Neuralgia" course that Prendergast and team teaches in Orlando in March

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!

WooHOO!!

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

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