Health Organization for Pudendal Education

Here is a test you can do to feel the restriction in the pudendal nerve pathway.

First we must get you to be able to visualize your anatomy a bit so you understand what is under the skin. Visualization is key.

I want you to visualize your whole body as a web of fascia vs individual muscles. The goal here is to find where the web is restricted.

To understand fascia please youtube: "Thomas Myers Fascia 101", this 6:59 video will give you an idea of what fascia is. This may take some time to digest! The realization could hit you a week or two later where you truly understand.
Some may get it right off the bat but usually it takes some time.



^ Here is a view of the fascia web you just heard Thomas Myers break down in that video.



^ Here is a representation of fascia as you can see a pull in one area affects the surrounding area.



^ Here is how we will visualize this web running through our whole body.



^ The red line going from the bottom side of the foot to the knee to the groin then in through the pelvis to the sacrum is the line which the pudendal nerve runs on. So restriction in the pudendal nerve pathway can affect all the way down to the foot possibly, vice versa. Usually it is the restriction in the pelvis pudendal nerve pathway that is the one affecting the foot.



Now we're going to get specific to the issue at hand, visualize the TRP2 points in your body at the back of the leg right where the adductor magnus area at the back of your leg connects to your ischial tuberosity sit bone.



From there you will see it connects to the obturator internus area which will connect to the pelvic floor that is the empty space there to the sacrum.

Let me reiterate you see there are these connections by fascia they are not individual so tension in one area of the chain can effect the rest.

The specific area we need to keep in mind for this issue is the TRP2 adductors area connecting to the obturator internus area area. That's the part of the web we will really be feeling out, putting our awareness there will
reveal the rest(pelvic floor and sacrum).

You see i refer to this as "area" and not muscle because we are visualizing the body as a web not individual muscles. You must keep this in mind. You will be able to find where the restrictions are very easy this way as well.

I'd recommend you to go through the above about 10 times until you can comfortably understand and visualize the area as a web. Visualization is key! Once you are ready then you can proceed to your test!

https://www.youtube.com/watch?v=Ux4RxV2Hd6M

^

here is a link, now you do need a soft ball your leg can sink into like in the video. I'm sure you can find such a ball at a shop near you. Also don't do the foot positioning stuff he says just keep your foot sideways comfortable. You can mute the video so there is no confusion. I'm sorry I have not made a video myself I will at some point. So now the purpose of the video is just to show you the position to get in, that's all we need to see. As you can see lying on your side comfortably with the tested leg straight on the ball and the other knee laying in 90 degrees.

1st step We will relax the area by letting it lie on the ball and this whole time your awareness is around the sitbone adductor magnus/obturator internus area.(Putting your awareness on the web in this area will reveal the rest)

2nd step We will strain the area to exhaust it so lift your leg up just a little bit off the ball and hold it. During this time you're continuously keeping your awareness on the area and feeling it out.

3rd step We will release the area as your awareness is still on the sitbone adductor magnus/obturator internus area you slowly bend your knee in towards you at a 45 degree angle(diagonal) while you continue to just really feel the area out.

Do this calmly and depending how you feel it's up to you how you proceed from one step to the next. Try to spend some time on each step whatever you feel is comfortable.

Report back what you feel on both sides.

Your awareness is key in all this.

This is an evaluation test to see if there is restriction in the pudendal nerve pathway.

Hello Mr. PK. You appear to have studied this out very carefully. Do you have some special training in this area or are you a chronic pelvic pain patient?

Violet

Violet M wrote:Hello Mr. PK. You appear to have studied this out very carefully. Do you have some special training in this area or are you a chronic pelvic pain patient?

Violet

Hi Violet going through the experience and curing yourself of a condition is the best training there is! I've been through the experience and cured myself with the help of others. It has taken a lot of tireless extensive hours researching. Below is my MRN report from Dr. Filler about 2 years ago, he recommended to release the whole nerve via surgery and remove my tailbone after taking a look at the imaging. However I have cured myself without any of that and I'm just looking to share my knowledge!


"INDICATION: This is a 22-year-old gentleman suffering from pelvic neurologic symptoms.
FINDINGS: These images demonstrate the course and caliber of the lumbosacral plexus and the pudendal nerves using multiplanar reformat techniques to provide an overview.
The general course, caliber, and contour of the pudendal nerve elements on the left is abnormal in that there is a distortion of the course and hyperintensity change just at the level of the ischial spine and no comparable findings on the right side. There is some hyperintensity in the S2 and S3 spinal nerves as they traverse the area of the sciatic notch and some distal hyperintensity change in some branches of the pudendal nerve.
IMPRESSION: evidence of impingement of the left pudendal nerve at the level of the ischial spine on the left side with some abnormalities of the S2 and S3 spinal nerves at the level of the piriformis muscle and affecting the distal branches in the ischiorectal fossa. Overall the degree of abnormality at the level of the ischial spine is strongly suggestive of a clinically significant pelvic pudendal entrapment."
Signed:
Aaron Filler, MD, PhD
Neurography Institute Medical Associates

Thanks for sharing the info, MrPK. Do you know what started your PN problems? I think that would be relevant to the forum readers since there are so many possible causes. Someone with a similar experience might especially benefit from what you have posted.

Thanks,

Violet

Violet M wrote:Thanks for sharing the info, MrPK. Do you know what started your PN problems? I think that would be relevant to the forum readers since there are so many possible causes. Someone with a similar experience might especially benefit from what you have posted.

Thanks,

Violet

Hi Violet, this test is simply for people to identify restriction in the pelvis. The causes of how the restrictions happen varies. Once restriction is identified a person can utilize various therapies to get through it. I utilized a full body approach to start, I wanted to get the rest of my body free before working specifically with the pelvis just so I could make sure nothing else was a factor. Some insight into the treatment I utilized: Full body deep tissue oil friction massage is the first therapy I had. The therapist mainly utilized his elbows and forearms to get deep into the tissues. The pressure massages the tissues while the friction caused by it results in heat that goes deep in the tissues to relieve restriction and the oil goes in to hydrate the tissue and make the area soft and supple, the oil has a heating property as well, after that a hot towel would be administered on the area to send heat even deeper through the tissues. That was the guys' philosophy, and pretty soon majority of my body which was full of restrictions became soft and supple free of restriction except the areas he could not reach which were the Obturator Internus(One of the biggest offenders and trickiest to treat) and Pelvic Floor. I used other therapies to treat those areas. The test I posted is one of the awareness techniques I used to find and release restriction the others I'm trying to find a way to explain, I'm working towards that. I'm also working to put a full body restoration treatment plan together that would involve diet, lifestyle and treatments that I will also post here to help people.

Well, I certainly wouldn't turn down a full body deep tissue oil massage. Sounds really relaxing! Is there any chance insurance pays for this type of treatment?

I would be interested to hear how you are treating the OI muscle. I found a TENS unit to be really helpful with that muscle.

Violet

Violet M wrote:Well, I certainly wouldn't turn down a full body deep tissue oil massage. Sounds really relaxing! Is there any chance insurance pays for this type of treatment?

I would be interested to hear how you are treating the OI muscle. I found a TENS unit to be really helpful with that muscle.

Violet

Hey the massage was great once I got through the first 2-3 sessions and the tissues became soft and supple. It was a bit tough before that lol. It took care of the piriformis area entrapment. I am not sure if insurance pays for massage treatment. The best treatment for the Obturator Internus area would involve you in the same position used for the test I posted. From there a knowledgeable Rolfer or other myofascial release specialist could dig deep into the area and find tender areas to release. If you have any irritation in the genitalia it is likely to be caused by restriction in the Obturator Internus area affecting the pudendal nerve and can be reproduced with deep external palpation by a skilled practitioner. Graston/FAKTR is perfect to give a deep tissue friction massage to the Obturator Internus as they have tools to reach that area along with Active Release Technique to the Obturator Internus, that is a killer combo. You can't really get your elbow in there for a deep tissue friction massage haha so the Graston/FAKTR tools are literally tailor made to deal with it. A TENS machine will likely only give temporary relief, we want a complete resolution!

True but over time the TENS unit helped calm down the OI after the nerve was released via PNE surgery. I could not tolerate a TENS before surgery -- nor internal release like myofascial release. I would have an extreme flare-up for a week afterward. The piriformis was always fine with deep massage but not the OI! So I know what you mean about it being a killer.

Anyway, I think all of your suggestions are great and worth trying.

Violet

Violet M wrote:True but over time the TENS unit helped calm down the OI after the nerve was released via PNE surgery. I could not tolerate a TENS before surgery -- nor internal release like myofascial release. I would have an extreme flare-up for a week afterward. The piriformis was always fine with deep massage but not the OI! So I know what you mean about it being a killer.

Anyway, I think all of your suggestions are great and worth trying.

Violet

Hey Violet do you have your whole experience written in some post? I'd like to read it from start to finish!

MrPK, you can read my story on the website at http://www.pudendalhope.info/node/65
I just added an update.

I would be interested in hearing your story too.

Violet