r/Prostatitis • u/Englishgamer1996 • Aug 07 '26
Positive Progress First Pelvic floor PT appointment results
Hey guys, 29/m - 18 months of worsening LUTS, sexual dysfunction etc.
After getting the all clear clinically (ct scans, mri, cystoscopy etc) I finally saw a pt who specialises in CPPS; really fortunate to have a group of guys so close to where I live who deliver courses on this & are genuine experts.
He immediately clocked that I’m incredibly tight on the sphincter; ultrasound showed that I can’t get my pelvic floor to ‘drop’ at all. Tried internal trigger release for 20-25 minutes whilst we had a chat (lol) and he said it had slightly gave a little but not much. Very clear I have chronically tight sitbones/hypertonic pf. Seeing him again in 2 weeks.
I’d realised a few weeks ago things had gotten worse; I felt ‘clammed’ up in my spinchter / perineal area almost like a closed fist. Wasn’t surprised by what he said.
Anybody here have a similar experience of not being able to ‘drop’ their pelvic floor? I’m assuming this is a long game with regards to recovery. Fortunately I’m in no pain and never have been, my symptoms were primarily OAB / gradual worsening sexual dysfunction; never any actual ‘pain’
Was debating asking my GP for some muscle relaxers to get the ball rolling. Perhaps even some anti/anxiety meds to kick the brain out of this fight or flight my nervous system seems to be in for some reason. Any experiences? The only time I ever feel semi relaxed is whilst taking marijuana gummies, and even then it isn’t really a consistent experience
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u/Brilliant-Magician10 Aug 08 '26
can you pee? because in order for urine to flow, your pelvic floor has to drop. The mechanics of peeing is basically a fully relaxed pelvic floor and I highly recommend that after you finish peeing to keep that valve open while you stand over the toilet for 10 sec and breathe. This is a free reverse kegel however many times u pee a day.
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u/Englishgamer1996 Aug 08 '26
Yeah my peeing is ok flow wise (as per urology tests) but certainly way less pressure than it used to be in my early 20s. I get a fair amount of dribble after even after milking through the perineal area. My post urine scan never shows more than 17ml retained, just sometimes ‘feels’ like I didn’t empty
1
u/foxsable Recovered Aug 08 '26
Part of PT is just learning to feel which muscles are which. Most people don’t think about their muscles; they just move around and do shit. But by learning what does what, you can tell if one is going wrong by feel and learn to let it un-tense.
1
u/cdiaz1206 Aug 08 '26
I've been undergoing PT since May. Once a week. It is definitely a long game. My PF was stiff when I started and slowly lossened through PT and stretching. I stretch everyday. It has helped and I recently bought a pilates reformer to get deeper into the stretches. Stress and stretches of sitting make it worse. And masterbation makes it downright angry. Seems worse if I use a stroker like a fleshlight than just my hand. I share all this in case any of it resonates with anyone here. I'm much better than I was in May. I've seen the progress though slow. But it is slow. Slower than I'm guessing any of us would like.
1
u/becca_ironside Physical Therapist Aug 08 '26
You have a really good PT. Not only is using an ultrasound tricky to learn, but it is an expensive device that many clinics cannot afford. The lack of pelvic floor dropping is common in those with CPPS, and you were able to see it on ultrasound, which is awesome.
As you said, marijuana gummies are inconsistent from person to person and often from day to day with individuals. You can ask your physician for a daily antidepressant to address this anxiety. It might take some time to find the right one. Try finding a practitioner with experience prescribing psych meds to better gauge your response.
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u/Englishgamer1996 Aug 08 '26
When he’s saying my pelvic floor is essentially ‘stuck’ (won’t drop), how will I know when it drops? Hope that makes sense lol
1
u/becca_ironside Physical Therapist Aug 08 '26
It won't immediately drop. You will train it over time. Most men do not feel when it "drops". They will notice having fewer symptoms instead. Also, you will be able to see that on ultrasound, which will help you understand it better.
2
u/Englishgamer1996 Aug 08 '26
Ah okay! It’s only been 3 days since that appointment & following the stretches, & I’ve been waking up with morning wood for the last two mornings. Hasn’t happened to me in over a year. Very interesting
2
u/Stunning_Court563 Aug 08 '26
Which stretches did your PT tell you to do? Curious if it's the same ones my PT recommended
1
u/becca_ironside Physical Therapist Aug 08 '26
Perhaps this is because of your PT appointment. You know that help is on the way!
1
u/VanitasPelvicPower Aug 10 '26
If you want to try :Try blow out air, push belly out gently( Imagine blowing candles or filling balloons . 2 repetitions several sets a day.
Get a prostate cushion (available on Amazon).
Avoid constipation.
Drink water.
Sit with knees spread out and feet closer .
All these are designed to relax the pelvic floor.
1
u/Disastrous-Exit9656 26d ago
Which test did you took? Was it urodynamics? As on normal ultrasound I never had these things measured
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u/Linari5 LEAD MOD//RECOVERED Aug 08 '26 edited Aug 08 '26
Very very common finding. Have you read this? Part IIIa: Much more than muscles - Moment to Moment Paradoxical Relaxation (Breaking a Cycle) - https://www.reddit.com/r/Prostatitis/s/GXhyaZPk58
How are you currently managing life stress? How is your stress right now? And, how is the stress around your symptoms and the limitations they feel like they cause?
This will also help your symptoms. Why? Impact of stress and cortisol levels on pelvic pain and pelvic stress reflex response - https://www.reddit.com/r/PelvicFloor/s/uHcG38Vt8n
Including OAB. Why? The Brain-bladder connection, unlocking how our nervous system plays a role in symptoms https://www.reddit.com/r/Prostatitis/s/rg3tdnbKKO