Health Organization for Pudendal Education

Last night and this morning I've been doing pelvic floor drops. This is like urinating but not actually doing it, it's just the same muscular action. I can feel the tension in my perineum and crotch releasing when I do this. This makes me think my issues are due to a very tight pelvic floor.

I think it's going to take some physiotherapy and reeducation to resolve this. The more I learn about the possible causes of my symptoms the more hope I get. I think because my pelvic floor is so tight, it's squeezing my perineum and hence causing pain when sitting down.

I'm home with my family this weekend as well. That helps a lot as well.

Having done some more research, I believe I may have levitator ani syndrome. There is so much pressure in my perineum and rectum area. Even standing still is not good for me as I can feel the pressure in my crotch, walking and lying on my side provide most relief.
As I said earlier, massaging my sphincter muscles got rid of pain urinating and defacating. But it feels like I need a massage deeper in my rectum, but I don't want to do this myself to avoid injury.

Do pelvic floor physiotherapists provide treatment for this condition?
How deep is the levator ani muscle from the anus in terms of inches?

Will they or Dr Baranowski be able to diagnose whether I have this?

Many Thanks

Reckless,
i had levitor ani syndrone 3 times and basically it was the pelvic floor muscle spasming. Not sure if the pt treats it but they may as it seems to be that area. I did not get to pt until after I got rid of the spasms with electro galvanic stimulation EGS treatments the first 2 time and botox the last. Pt if possible may be a better option?
Janet

Thanks for the info Janet.

I can feel that there is some point deep in my back passage, that if pressed will release a lot of tension! This is pretty gross but before I go to the toilet, I am in the least amount of pain. I think this is because the faeces are pressing against some muscle and are therefore reducing tension. I cannot wait to see the doctor and physio but still have another 3 weeks until my appointments!

Still, at least I only have 8 days of work left.

Reckless,

It sounds like you would be a very good candidate for internal PT if you feel some relief with internal pressure. PT didn't work for me because I have the opposite reaction to pressure in the rectum; I find it unbearable. Good luck and please keep us informed of your progress!

Well I've seen Dr Baranowski who believes it may be pudendal neuralgia and has offered to do a nerve block.
I'm not sure about this as I feel a lot of muscle tension in my crotch area so I'm thinking it's due to some tightness. I'm thinking this nerve block won't reduce the muscle tension and hence won't really stop the pain.

I've also seen a pelvic floor physiotherapist. Both Dr Baranowski and the physiotherapist have examined me internally and found no trigger points. But the physio said I had external trigger points around the anal sphincter and hip abductors. So she's given me some stretches to perform and will do some massage at the next appointment.

I'm thinking of having a full body sports massage and seeing if that helps.

What do you guys think?

The nerve block is normally done for diagnostic purposes as well as for treatment reckless.
I know that Dr Baranowski has done many so you will be in good hands. However the only person who can decide what to do is. . . yes you've got it. It may be that whichever muscles ARE in spasm are reacting to the trapped nerve and therefore a block (in the right place) will be able to help those muscles relax.
Maybe if this block he is proposing doesn't work he will try steriod or botox into the muscles you think may be affected, I don't know, never having seen him.
Good luck with whatever you decide to do, let us know how you get on. To get in that quickly did you have a private appointment?
Take care,
Helen

Yes I had a private appointment. To see him on the NHS takes 6-8 Months!

I honestly believe that my problem is due to muscle tightness. When my bowel is full, I can sit down with no pain, because something is being stretched inside.
I think it's my sphincter muscles. I have massaged them a lot and doing the massage did eliminate the urinary and defacating pain completely. But there's still tightness around that area and the perineum. I hope the physio helps, but she didn't seem to massage that hard today.

It's quite depressing.

Can tightness in the inner buttocks cause prostatitis symptoms?

Reckless, we sound so similar.

I have all your symptoms and those include ones similar to prostatsis.

Like you, I am in the least pain just before I have a bowel movement. You may be right about something being stretched, but I think it may be more related to either of these:

1) You are in less pain, because it has been some time since your last BM so nothing has aggravated you
2) You may be less tense at this stage, because you know you are about to try and have a BM

I am having internal massage, it seems to help, but my therapist says I am so tight it is unbelievable. Apparently my pelvic floor is extremely high. A theory is that I am holding up subconsciously through some kind of anxiety.