Saturday, June 28, 2014

Seeing a Pelvic Floor Physiotherapist - The 2nd Appointment & Progress

The second appointment with the pelvic floor therapist was much shorter than my first encounter as we already covered the large set of introductory questions. We started off with some questions on my progress and how I was finding my exercise routine.

We did another internal examination of the pelvic floor muscles and I was instructed to contract and release to measure my ability to hold a relaxed state. I did notice a definite improvement in my ability to consciously relax the pelvic floor so I was very happy about that. The exercises were definitely helping.

I was still finding some issues when sitting down , my pelvic floor muscles would feel tight often accompanied by a burning sensation or dull ache and sometimes the classic golf ball syndrome.

Probably the most important take away was the fact that I am very tense throughout he day and really need to learn how to relax in general. I bought a relaxation cd that was directly targeted for chronic pelvic pain and have been using since my 2nd appointment and it is frankly amazing for the pelvic floor as well as calming an overactive mind.

Important Take Aways

Lumbar Support

The Lumbar support for the chair helps maintain the natural curve of the lower spine while maintaining a good sitting posture with the sitting bones taking the the weight of the body and avoiding tucking the tailbone.

A good way to determine if you are sitting correctly is by paying attention to your breathing, Are you able to take a nice deep belly breath down into your pelvic floor. Then you are sitting correctly and the pelvic floor is able to relax.

Relaxation CD

The pelvic floor relaxation CD is probably one of the most important tools for people suffering pelvic floor dysfunction and pelvic pain. For those of us with pelvic issues we really need to learn how to relax and a relaxation CD teaches you how to relax again .

there seem to be a few audio books available online to download for pelvic floor relaxation or you can visit a pelvic floor physio in order to get one but it is very similar to other relaxation cd and goes something like this

-> Start relaxing each body part starting from your face and working your way down to your toes.
-> To better feel the feeling of a relax limb or joint , first lightly tense the muscle then relax
-> Jaw tension has been closely associated with pelvic floor tension , always check in with face and jaw tension.
-> Do the same for the pelvic floor, lightly contract and draw in the pelvic floor and breath out and release the pelvic floor muscles.
-> It helps to cover your eyes with a towel or hankerchief to block out light so you can fully focus on the relaxation.

I shall be back with appointment number 3 if anyone is interested, we used an ultrasound on the pelvic floor muscles to help me visual the relaxing and contracting of the pelvic floor muscles.

I will also hopefully publish a post regarding levator ani syndrome, and what has helped for me as this must be one of the most frustrating disorders I have come across, full of uncertainty and miss diagnosis. Hang in there all the best :)

Saturday, May 24, 2014

Seeing a Pelvic Floor Physiotherapist - The 1st Appointment & Experiences

Hello all its been a while since my last post , I finally had a chance to see a pelvic floor therapist / specialist / physiotherapist so I thought I would share my experiences to see if it would be something that may benefit others. After all to be honest it wasn't exactly cheap and if I can spread some free information and help others that would be great :)

The 1st Appointment

So I was a little nervous going into the 1st appointment after all I knew it would involve an internal pelvic floor examination. But for me enough was enough it was time to get a professional diagnosis of the health of my pelvic floor.

It seemed like most of the other clients at the pelvic floor therapists were women but I was told by my physiotherapist that they are seeing more and more men lately (apparently male pelvic floor physio's are one in a million because of the fact that they practice on each other during their training which may make it quite awkward for a man, well that's my thinking anyway). The first thing we went through was a series of questions to determine whether tightness/pain was my issue or whether it was incontinence and a weak pelvic floor.

Some of the questions I was asked were.

- Do I experience any pain or discomfort, when and where?
- Sexual Orientation
- Any history of sexual abuse ( unfortunately very common for people with pelvic floor disorders)
- Ease of bowel movements
- Any leakage either urine or from the anal
- Do I experience any other pain be it backs, hips, neck

She also showed me a very disturbing image of different types of poo :P and asked me to tell her which ones I experience on a daily basis , I felt like I was choosing items off a very unappetizing menu

a necessary discussion of bowel movements

My physiotherapist then walked me through the basics of pelvic floor anatomy with the help of a pelvic floor anatomy model.
She discussed the fact that the pelvic floor muscles resemble a muscular bowl with the job of holding all internal organs in their correct positions. She showed me on the model the deeper layers of the pelvic floor such as the levator ani which can often hold painful trigger points which can be healed through massage or relaxation exercises.

Pelvic Floor Internal Examination

We then moved onto the pelvic floor examination (just what I was dreading :P ). My physiotherapist had my lie on my back with my knee's bent and did a quick external examination to check for pain or muscle tightness around the perineum (between the anus and testicles) , around the thighs and buttock area. For me I felt no pain what so ever but she did notice that I had very tight abductors and hips. (very common for people with office jobs or sitting for long peroids of time)

We then moved to the internal examination , I positioned myself on my side with my knees drawn up towards my chest so that the anal canal is more easily accessible.  The physio was very gentle and I did not feel any pain or discomfort during the examination which had me worried because my number one goal of visiting the physio was to find the trigger points that I knew must be the cause of my pelvic floor issues. 

The physio continued to lightly press on different muscle fibers of the pelvic floor and FINALLY I felt what I would describe as a slight twinge of pain which was most definitely a trigger point. Something that I had never been able to find when performing internal massage by myself. The Physio then lightly pressed down on the trigger point while she instructed me to do semi contractions of the pelvic floor and I did feel almost instant relief. ( Can't tell you how happy I was that I now had proof I had trigger points in my pelvic floor :) ).

After a couple more minutes or internal massage , I was given a pelvic floor exercise routine which looked like this

10 x Pelvic Floor Squeezes

1. Breath in
2. Breath out and contract the pelvic Floor
3. Breath in and maintain the pelvic floor contraction
4. Breath Out and release the pelvic floor
5. Breath in and out without contracting , on the exhale try and relax pelvic floor further

This procedure was also recommended for constipation to train my body to know the difference between a contracted and relaxed pelvic floor. I know you may think that prescribing pelvic floor exercises can be counter productive for people with pelvic pain and tightness but its really about training yourself to relax by first feeling what a contraction feels like. You will eventually reach a higher level of pelvic floor relaxation.

Also price wise the first consultation was not cheap, just under $200 for a 1 hour appointment. My health insurance did pay a little but I wouldn't be scheduling appointments too often I am going to get the most out of it and heal myself hopefully :)

So that's about it for the 1st appointment, feel free to ask me questions and I will create another post for appointment 2 with the progress I have made (which I have by the way :) ) Also on a side note I was given a diagram on proper defecation posture which involved placing a short stool under my feet to put me into a squat position to straighten out the anal canal and allow for easier bowel movements.
Similar to the squatty potty , which I have ordered recently :) can't wait for it to arrive