Health Organization for Pudendal Education

Hi All,
Just curious: How long are (or were) your PT session? How many time per week do (did) you go? What kind of treatment do you receive?
When I was going to PT, my visits were 30 - 45 minutes long. For me, that was enough! I went twice per week. I had internal and external myofascial release therapy, massage and she did some minor manipulations with my hips and SIJ.
Warm regards,
Karyn

Hey Karyn,

Most of mine have been 45-1 hour long. They do the same as you mentioned although my PT is just learning external myofascial release. I've also had Active release therapy, but the stretching involved is too intense for me and flares me up. They have also used ultrasound on my pelvic floor which really seems to hlep. And I have this place right along the edge of my sacrum that causes me a lot of pain and sometimes they use iontophroesis (steriod patch hooked up to something like a TENS unit). It might decrease the pain for a day or so. I did 2x a week for about 12 weeks and no I am only doing once a week. I don't seem to get any more relief from 2 days a week so why "waste" my money? I am going to go for 10 more treatments and then I may take a break from PT altogether because i seem to have plateaued. What about you guys. When do you say enough is enough? I mean I have seen 3 different PT's over the last year and I am not getting better (actually I just seem to get worse with time). It's just a lot of money in my opinion without much benefit (for me) anymore.

Faith wrote: When do you say enough is enough? I mean I have seen 3 different PT's over the last year and I am not getting better (actually I just seem to get worse with time). It's just a lot of money in my opinion without much benefit (for me) anymore.

Ha! My husband just asked me last night (as I was nursing a flare in pain brought upon by a massage therapist) why I was wasting money on PT appointments that seem to increase rather than decrease my pain. I often have a pain flare after a PT appointment. But I seem to be experiencing some progress in terms of my ability to walk (not sit). I guess I just cannot give up on walking and am trying everything I can to keep moving.

Major pain flare right now. Sitz bath and icing all day long, and extra pain meds. No fun at all. And last week I was feeling so much better.

Lernica

Mine were 45 minutes to an hour 2 times per week. I also did my PT excersises and self-massage for myofascial release every day. I am mostly replying to say that I had a different experience than everyone else who has posted so far. It was a lot of time investment but I felt better after sessions and it kept me functional and able to do the basics like drive my kids to school and back very day.
I did that PT (myofacsial and excerise PT) for about 4 month before she gave up on aligning my pelvis and referred me for manual therapy PT. manual therapy improved me dramatically in a total of 2 sessions, the 1st 2 hours and the 2nd one hour. After that I felt much better and while I did go back to the other PT a few times I no longer felt I was getting further benefit out of it and stopped going.
I really get the impression that if somebody is going to benefit from PT, they will know it within a week or two. I knew it was helping from the outset. I do recommend everyone try it but not that they keep at it if it makes them flare.

I go to the physiotherapist once a week for one hour. We have been doing strictly external work since internal work is currently too painful. We've been working on my walking mostly. Hip strengthening exercises. Reverse kegels. Manual manipulation of legs and hips. Stretches (piriformis and psoas). Trigger point pressure on piriformis. IT band massage. At home I self-massage with small hard rubber ball and an IT band roller. Results after four visits have been good. My pelvis is loosening up and I'm walking better.

PT is anxious to start doing internal work. We started a bit last week. Major ouchiness! After just a few minutes of trigger point pressure, my whole pelvic floor was burning. Then my anxiety builds. Then my head burns. Not pleasant. But PT thinks that without internal work I won't progress.

Lots of money for more pain. Ughh.

Lernica,

I'm sorry you are in a pain flare. Me too... the pits.

What extra meds do you take when you are in a pain flare?

Do you get increased bladder symptoms such as frequency or hesitation with your flare ups?

A's Mommy

Faith:

I'd say give up on PT for now. From the sounds of it, you are going down the same route I did before my first surgery. I'm worried that continued PT on you is just going to make you worse. My heart goes out to you.

AM

A's Mommy asked:

1. What extra meds do you take when you are in a pain flare?

2. Do you get increased bladder symptoms such as frequency or hesitation with your flare ups?

Response:

1. For the first two days of the flare, I was taking 2 extra-strength Tylenol twice a day in addition to the meds listed below. But I continued with my normal activities. Now for days 3 and 4 I am taking one Tylenol 3 twice a day. Plus I am staying at home. This is the first time the flare is getting worse rather than better. I think my massage therapist (not PT) went too deep yesterday when she worked on my piriformis and psoas muscles. Sigh. Live and learn.

2. No increased frequency or hesitation with bladder. But major internal burning AFTER emptying the bladder in the middle of the night. Don't quite understand this.

Lernica

Karyn,
When I saw Liz Rummer once a week, it was 1 hour exactly. For $210 out of pocket, I guess she figured I was due the full 60 minutes. She was definitely a hard worker - did skin rolling, myofascial release. 40 minutes external, 20 minutes internal. She certainly seemed to know what she was doing but after 5 sessions there was no change so I discontinued further treatment. If I save my money, maybe I can see her post-op.

AM,
When I hurt worse, urinary frequency and hesitation both increase. I take extra oxycodone to take the edge off. Makes me groggy but worth it. Sorry you are having a tough time. Here's hoping that tomorrow is a better day.

Don

I'm on my third PT stint. I went for 2 months for 2 times a week the first time and really felt no improvement and stopped. The second time I went twice a week and was feeling some relief and continued until the PT thought I needed internal work for my coccyx and she wasn't qualified so she referred me to my current PT. I started seeing her once a week and then every two weeks. I think it REALLY depends on the PT. I have much more confidence in my current PT than I did in my first one. The first PT seemed very knowledgeable but I NEVER felt any better after seeing her.

Faith wrote: When do you say enough is enough? I mean I have seen 3 different PT's over the last year and I am not getting better (actually I just seem to get worse with time). It's just a lot of money in my opinion without much benefit (for me) anymore.

I had a similar experience. I tried PT for years and saw some of the apparent best pelvic floor PTs. I do not know of anyone cured by PT and I stayed in touch with quite a few other patients I met when seeing these PTs. I think PT is definitely worth trying, maybe it works for some people. I also think though that people should be aware that there is not a single randomized or controlled study that can show myofascial PT is effective in resolving pelvic pain. I think PT for pelvic pain is often discussed as if it is an evidence based treatment. It is not, it is an alternative therapy i.e unproven.