Pelvic Pain and Levator Ani Syndrome Explained

[@genebrenner855]

So glad to see a male doctor give this talk. I have this condition and 99% of PT talk on You Tube is female oriented. I'm going to see a specialist for internal trigger point and stretching, hopefully just like this kindly doctor described. I was going to do this myself but couldn't get up the courage. Hopefully after a few successful sessions, I'll get over my fear and do it at home. This is truly a miserable condition.

[@Nielasher]

Thank you for your feedback 🙏

[@joannesuzieburlison7128]

I was in a pain workshop just for this, most of the people there were men, my doctor was a man who had it. I think it will work. I had it for 30 years without help, I know what you mean. Good luck!

[@vinificent]

This guy is saying a finger put where ?

[@kxrsuperstar]

Gene I’m interested to see if it has helped you. I am currently making an appointment to have this done

[@donniemoder1466]

I have chronic pelvic pain syndrome and the female physical therapists usually are much better than the men. There are tons of male gynecologists and OBGYN's, yet women seem to find them knowledgeable and acceptable. Maybe you should do the same with professional well trained female PTs.

[@earnmyturns6305]

This was enlightening, it would be even better with a combination of props. Showing all skeleton and we are talking muscles, there are props that show both.

[@ashleyceaser547]

Great explanation and attention to this sensitive topic...especially its relevance to females

[@DebbieHollandNZ]

I have frequent Pelvic floor pain and in the absence of a qualified Physiotherapist I use a Trigger Point ball and place it on the inferior rami of the ischium ( between the Pubis and the Ishial tuberosity). I move the ball around until I find areas of tenderness and then sit there until it eases. My pain is caused by hypertonic Aductors, Pectineus and Obturators. It always helps. It is very painful at first so maybe choose a soft ball to begin with.

[@davannisj.donaldson5539]

Wow! I have very similar but still under diagnosis. Does it hurt while sitting and watching for the release? I’ve heard that I should do that but I’m confused why I need to do it on a sore muscle😓

[@DebbieHollandNZ]

@@davannisj.donaldson5539 If you can find the sore points you will be on the Trigger Points x this is the quickest and most effective way to release the overtightened muscles x another effective release is to sit on a yoga block I a squat position x either in its high position or its lower position for up to 5 minutes x it will relax the adductors ( inner thighs) which will ease pelvic floor tightness and pain x

[@ghenkhoash2440]

I used to have this nasty attack once a week or two. I think I kind of found the treatment which works for me. everyday I reach my butt cheeks with my hands and try to open them apart as much as I can for around 20-30 sec. I do this in the shower. It has been more than 6 month since I started this exercise and it has never come back.

[@chenzen000]

I just massage my tailbone with my knuckles and gives quick relief

[@glynrowson]

what was your symptoms please reply thank you so much

[@ghenkhoash2440]

@@glynrowson It was a very sharp and unbearable pain around my anus. Around few centimeters deep. It was starting at random times (even during my sleep) from one side (left or right) and usually was moving to other side after a while.

[@BloodSavedMe]

Did it feel like nerve pain like a knife stabbing?

[@Chorkymom]

@@BloodSavedMe yes, it does. I’m dealing with this now, searching comments for ideas so I can get some relief at home. Did you get a physical therapist?

[@BuckRogers007]

Had this thing for 25 years. I think its the same. It feels like an intense charlie horse eight inside my rectum that sometimes would go up into my pelvis. Its difficult with work because standing and walking makes it worse. I have to sit on the toilet for sometimes up to 45 minutes! Usually only 20. When i wax younger it used to be so intense it would nearly bring a tear to my eye. Sometimes it will lighten up and i think i can go back to work but as soon as i begin walking back it returns so i have to return to the bathroom so it can run its course. It happens anywhere from every 2 weeks to a month or so. I found that pounding my fist just under my tailbone to just under the top of my crack seems to lower the pain level from a full blown 10 to maybe a 7 or 8.

[@lisa__rcs]

This sounds like it could be Proctalgia fugax!

[@pwph8361]

Hi Neil, thank you for your video. I would like to ask what your thoughts are on self treatments...... oh no hang on, you just answered me!! I was toward the end of your video and tapping this message out, when you touched on the very subject I was about to broach, albeit for a moment. I was going to ask your thoughts on using the Thera-wand or ones own digit. I am not talking about someone just diving in and going for it. I had quite a bit of pelvic floor physiotherapy in the past, post CES, and I have since replicated techniques myself either digitally or with a wand. I have not done for a while, as it felt that the last time I did, it kind of stirred things up. I particularly appreciate your mention of mobilising the tail bone, and I found it particularly helpful to get into those soft tissues just to either side of the tailbone - in fact, just writing about them now has made them feel as though they have broadened and open out, like eagles wings. As a person who suffers from PFD post CES, all information is of particular interest to me, because I don't just want to work it out to make a buck, I want to work it out to save myself. But I stop here because I will just rant endlessly, so to sharpen my closing thought, I will just ask, what are your thoughts on providing indirect fascial release to the internal trigger points from external areas such as the inner thighs, the abdominals, the gluteals/piriformis and the QL's??Thank you

[@jordanbanda4744]

THANK YOU for this video - until your perfect analysis of the "Bowl" self release WORKED 3.5 years 5 drs / specials / PT /

[@Nielasher]

Thank you for your feedback 🙏

[@Flashbax]

Wow. My GP did a routine digital rectal exam and I nearly jumped through the roof when he touched a reportedly tender nodule! He couldn't explain it. Following up with lots of tests which were normal, it ended with a urologist where he couldn't find anything wrong and I wasn't in pain with his exam. He couldn't explain why the GP felt a nodule or why I was in pain with the GPs exam either. Now to find a physio who can do this. I don't like my chances. Thank you!

[@Nielasher]

Thank you for your feedback. Good luck 👍

[@peterobrien2537]

hi Flashbax how r u now? any luck with getting better with this levator ani pain?

[@Flashbax]

@@peterobrien2537 Hi. I don't have the pain any more. I really think the rectal exam sparked it off. Nothing really fixed it but time. Also keeping away from the computer which causes bad posture. Sorry not much help. With these physio issues, I find it's always time that heals me.

[@peterobrien2537]

@@Flashbax very glad to know you’re doing fine this gives me hope too :) thanks for the reply

[@Irrelevant402]

Alright more ASMR! Love his voice...and he talks about interesting stuff of course.

[@Weeflowerofscotland]

I have severe bladder and urethra pain that emanates deep in my pelvis as a burning/stabbing unbearable pain ( when it flares) I also have pain with sex or any penetration from tampons etc. my pain gets really bad when trigger points are touched! This severe pain lasts for 3-4 days. Could my pelvic floor be responsible? All tests show normal organs etc.

[@Nielasher]

Hi Shari, Yes it could be, but other factors need to be ruled out by a professional. For more information or to find a therapist please visit our website www.nielasher.com

[@joshlockie9285]

What’s the root cause though? How long does relief from treatment last?

[@vinificent]

Good question

[@Flashbax]

I bet like most reasons why muscles act up, it is due to poor posture and too much sitting at a computer.

[@MsMesem]

@@Flashbax Sound like a doctor who does not wish to think. Therapist caused massive sacro iliac joint trauma and now nothing is as it should be!

[@KoolAidDinkyTV]

I haven’t been diagnosed yet but I been suffering with Frequent urination, urine dribbling afteurinating, weak urine stream sometimes or sometimes it starts like so strong but after 10 seconds it starts to decrease and the line becomes thin then it stops. But if I strain a little or push more urine comes out. I also don’t have pain but have twitches in penile area and my penis sometimes feel like tight like if it was being squeezed. I also get twitching sometimes in area between anus and testicles. Sometimes mild left testicle pain but It doesn’t last a lot. I had been also experiencing problems with ejaculation. When I ejaculate it doesn’t shoot with force. Just like a drop comes out and the rest stays stuck in urethra then it slowly comes out.

[@lisa__rcs]

Very often it’s chronic clenching or similar activities that put pressure on the pelvic floor, like a lot of sitting. Doing this trigger point release + reducing/eliminating the cause should cause permanent relief! Been on this journey for a few years and finally getting relief.

[@jackieburns5257]

Can this be caused by doing deadlifts?

[@Rachel-jf8bu]

I think that's what caused mine !

[@moon-ud8tq]

Glad to see this informational video 👍👍👍 wonder what doctor I go to to talk about treatment/ consultation.

[@Nielasher]

Thank you for your feedback!

[@loricarver3245]

I have been having pelvic pain since 2010😭. I fractured my pelvis in a car wreck in 2009.

[@michaelhorn9114]

I hope that you get better!

[@michaelhorn9114]

I hope that you are doing better!

[@catdavis3567]

What if you find that one side has atrophied? My therapist advised my left side levator (which has a trigger) is intact but atrophied. The right side musculature is much noticeably thicker. Can we strengthen or build this muscle after releasing and stretching it?

[@Nielasher]

Hi Cat, Yes you can undertake a routine that emphasises the atrophied area. For more information or to find a therapist please visit our website www.nielasher.com

[@carmelhardy7690]

Is it safe to exercise with this problem ? Lifting weights ?

[@johnathanabrams8434]

Why is lifting weights a priority when you have a chronic pain condition ? Fix the pain condition and then get back to your life

[@patron9981]

hello doctor thanks for the video it's complicated for me it probably started with a urinary tract infection got 6 different antibiotics the pain has spread more and more from the lower abdomen to the testicles to the prostate and now my lower back is also feeling extremely tense from the pain oppressive pulling burning I have pain between testicles and leg penis root lower back in the lower abdomen I sometimes get sone stitches and sometimes a foreign body sensation in the rectum I went to a doctor who felt the two penis nerves N. Pudendus clearly caused pain. so could it just be pudendal neuralgia? what kind of treatment can you recommend me? Thank you!

[@monicatowns5559]

Have very rare issue with rectocele post delivery of second child plus now in menopause have a leaning and folded uterus and both push on a nerve causing so many issues and pain for 30 yrs. Several doctors don’t know what to do with me and this is the first time I’ve heard this. I am going to try to get physio help with this. Do u think it will help?

[@MsMesem]

Remove uterus

[@mr.collins7210]

What kind dr I hv to go to

[@julzyboy8960]

I held my bowels for years without knowing it was wrong, now I have pain and other symptoms in my front and back private areas, I'm trying to figure out if I have this condition.

[@nicecook12]

Could someone figure out what it is?

[@jackieburns5257]

I read that could be a cause

[@MsMesem]

?

[@tobiwalker7145]

The British pronunciation of Levator Ani is marvelous.

[@Nielasher]

Thank you for your feedback 🙏

[@camus6525]

In my case i feel inflamation in the anococcygeal ligament. No trgger points. I think it's possible the cause that everybody has been looking for for this problem... Probably the ligaments are the key...

[@SevenPikachu]

Have you solved this issue?

[@Nielasher]

Hi Camus, Thank you very much for your feedback🙌🏻 For more information or to find a therapist please visit our website nielasher.com/

[@davidless57]

WOW great info!!

[@Nielasher]

Hi David, Thank you very much for your feedback🙌🏻
 Please make sure to subscribe or for more information please visit our website nielasher.com/blogs/video-blog

[@Al-vh1vl]

I have pain in the head of the penis. Long history of prostate pain burning during urination etc but never pain in the head of the penis all the time. I've had two BPH surgery's. Is there anyone in the Dallas area that does what you do?

[@garyjohnson5869]

Love love this. Information you just gave me. I have Pudenaul Nerve Pain At tip of penis I tried. Surgery May 2020 Did nothing. Just found a local PT. Pelvic floor Tech. Hope she can help me And they will take. Medicare 🙏. Saw her once already She doesn’t feel is Pudenaul nerve. Problem. What’s your thoughts The Dr. said He. Reconstructed the. Nerve. I don know. But didn’t work still. Hurts Specially. At night when I go to bed. Any thoughts on that. Pain. And. Why. Thank you. Your very. Kind Dr.

[@Nielasher]

We are sorry to hear about your ongoing pain. Pelvic floor PT can be very effective. It's good that you're seeking multiple opinions. Night pain could be related to muscle tension or nerve sensitivity. Keep working with your PT and doctor for the best outcome. 🙏

[@bobbob-dt2bg]

I was told by a specialist that I probably have prostatitis. Antibiotics didn't work. I don't have pain in pelvic area but the tip of my penis can sometimes feel icy cold, numb or it aches on the underside near the tip. This sometimes makes me frequently pee which relieves symptoms but it soon returns. Sometimes I don't pee much as well. Also I feel like I'm holding urine in and might leak if I exert myself. Do you think this could be muscle tightness or tension in the pelvic area and internal massage would help me? I'm at a loss to what to do. Any advice would be appreciated

[@THEORYLOOPS]

I had a hemorrhoidectomy. Never fully recovered anus is still very tight. I’m a body builder. Can’t go to the gym for even 3 30 minute sessions a week. Gets so tight that it’s hard to have bowel movement. I’m not constipated I’ve tried everything but this. Do you think I may have ani Levator syndrome? If so could this help me? I’m so desperate to get back in the gym and have my life back. I’ve lost so much weight and haven’t had a dating life in over a year because of how much this has wrecked my confidence and joy of life. What do I do?

[@Nielasher]

Thanks for sharing your situation, and we're sorry to hear about your struggles. It's possible Levator Ani Syndrome could be contributing to your symptoms, but it's crucial to consult with a healthcare provider for a proper diagnosis and personalized treatment plan. They can offer the best advice tailored to your specific needs. Wishing you strength and hope on your journey to recovery. 🙏🏼

[@tenminutetokyo2643]

What about Ankylosing Spondylitis which fuses the sacroiliac joints.

[@alshimaaeleffish3205]

I had plvic floor dysfunction with alot of pain 2 years ago after falling down on my butt on a setting position I did not know exactly what was going on with my plvic floor until last April since then I started physical therapy but I still have trigger point in my left side which caused pain in my vigina and after urination .can I ever get well and this pain can go away and for how long I should have my pt 😪 please 🙏 help

[@Nielasher]

Hi Al Shimaa El Effish, This is one of those questions where you really need to consult the professional treating you. You leave yourself open to problems without a proper in depth assessment. Thank you very much for your feedback. For more information or to find a therapist please visit our website www.nielasher.com

[@robertschrum5496]

Are there textbooks w introductory concepts suitable for career searching teenage minds 13-19? Are trigger points site specific? Can more than one (1) trigger point affect an area?

[@Nielasher]

Hi Robert, Yes many areas can be affected by more than one Trigger point. If you are talking about areas or zones of pain there is often considerable overlap of pain referral patterns from trigger points from different muscles. Quadratus lumborum and Gluteus Maximus are one of many examples. that is why good clinical reasoning of all structures is important. Please make sure to subscribe or for more information please visit our website www.nielasher.com/blog

[@grahamnolan8688]

ive had cpps for 25 years its returned after 12year of mild symptoms now severe hard to live with where can i find someone to work on trigger points in uk

[@Nielasher]

Hello Graham … thank you for your feedback. To find a therapist in the UK try using www.therapyfinder.com … Hope this helps!

[@peterobrien2537]

how r u doing now grahamnolan8688?

[@jabohonu]

It's proper to treat the elevator ani syndrome doing a massage with a finger inside the anus (done by a professional) ? My kinesiologist advice me that

[@jabohonu]

Or maybe the correct translation it's"stretch" instead of massage in the anus, and by the way im male

[@tombrown9992]

Has anyone expiermce penile pain/ penile retraction with this.

[@prab126]

Yes

[@RussellD11]

mine goes into a very painful spasm that tries to pull my penis inward and out my bum hole (if it was mechanically possible)... but thats what it feel like!! And no MD can figure it out!

[@patriciocasillas1571]

Have you found any treatment? I’m going through the same Symptoms

[@Americancadet]

@@patriciocasillas1571 Read Headache in the Pelvis by Dr Wise, and fine a Pelvic Floor PT.

[@thenorthamericandj]

Yep

[@KoolAidDinkyTV]

I haven’t been diagnosed yet but I been suffering with Frequent urination, urine dribbling afteurinating, weak urine stream sometimes or sometimes it starts like so strong but after 10 seconds it starts to decrease and the line becomes thin then it stops. But if I strain a little or push more urine comes out. I also don’t have pain but have twitches in penile area and my penis sometimes feel like tight like if it was being squeezed. I also get twitching sometimes in area between anus and testicles. Sometimes mild left testicle pain but It doesn’t last a lot. I had been also experiencing problems with ejaculation. When I ejaculate it doesn’t shoot with force. Just like a drop comes out and the rest stays stuck in urethra then it slowly comes out.

[@Nielasher]

Thank you very much for your feedback 🙌🏻 For more information or to find a therapist please visit our website nielasher.com/

[@jabohonu]

15:40

[@vinificent]

This medic is asking people to put their finger where ?

[@Orlanzepol123]

I am having pelvic pain and am having ultra sound in a few days. I wouldn’t want to have my doctor put his finger in me and touch that area which really hurts.

[@Eduardohaztealgo]

LIE