Φυσικοθεραπεία..

[1312g]

Εφόσον εστιάζουμε(και εγώ συμφωνώ) στην νευρομυικη φυση του προβλήματος...Μήπως θα ήταν καλό να μιλήσουμε με κάποιον φυσικοθεραπευτή επι του θέματος?Εγώ το σκέφτομαι...ψάχνω κάποιο κέντρο στην Αθήνα τελοσπαντων...μήπως βρω ενα είδος άκρης με ασκήσεις κλπ κατευθείαν για το πρόβλημα..

[john]

Το οτι χρειαζόμαστε εξειδικευμένο φυσιοθεραπευτή για το πυελικό πάτωμα το έχω πει και γω εδώ και αρκετό καιρό. Δε θυμάμαι αν το έχω γράψει  αλλα σίγουρα το έχω συζητήσει με αρκετά παιδιά του forum.
Μάλιστα μου είχε δώσει και ένα τηλέφωνο ενός Φ.Θ ο markelos αλλα δεν τον πήρα ποτέ μια και δε μένω Αθήνα.

Θέλω να πιστεύω πάντως οτι αυτή η εξειδικευμένη φυσιοθεραπεία που ψάχνουμε είναι αυτό ακριβώς που κάνει το wise-anderson.

(Παίρνω αυτό που έγραψες στο chat)
(by the way πηρα τηλεφωνα σε καποια κεντρα και τους ανεφερα την συμπτωματολογια και ολοι μου ανεφεραν οτι γνωριζουν και ασχολουνται με το πυελικο εδαφος.)το θεμα ειναι να βρεθει ο πιο εξειδικευμενος...

1312g αν νομίζεις οτι μπορείς να ψάξεις να βρεις κάποιον κάνε το αλλα πρόσεξε γιατί απο λαμόγια άλλο τίποτα. 50ευρώ σε βλέπουν όλοι. 
Εχεις παλιότερη εμπειρία απο μασάζ/μαλάξεις για να μπορέσεις να κρίνεις σε ένα βαθμό το φυσιοθεραπευτή ?
Αν βρεις κάποιον και πας ενημέρωσε με πάντως.
Μπορεί να ανέβω και γω Αθήνα να δούμε τι θα μας πει και ο φυσιοθεραπευτής...

[1312g]

Ο χρόνιος πυελικός πόνος στους άνδρες συνήθως αντιμετωπίζεται μέσα από μια ουρολογική προοπτική η οποία εστιάζει στον προστάτη. Το Εθνικό Ινστιτούτο Υγείας (National Insitute of Health 1990 ) αναφέρεται σε έναν νέο τύπο ΙΙΙ της προστατίτιδας που είναι γνωστός ως μη βακτηριακός ή ως σύνδρομο χρόνιου πόνου. Άνδρες με αυτό το πρόβλημα παραπονιούνται για πόνο στη περιοχή του περινέου, στους όρχεις και για προβλήματα ούρησης και συχνά δοκιμάζουν διάφορες θεραπείες χωρίς αποτελέσματα.
Πρόσφατες δημοσιεύσεις άρχισαν να ρίχνουν φώς στην παθοφυσιολογία του χρόνιου πυελικού και να ενοχοποιούν μυοσκελετικές δομές της περιοχής.  Εκδηλώνεται επίσης ενδιαφέρον για τον ρόλο των μυών του πυελικού εδάφους, των οποίων τυχόν δυσλειτουργία εμπλέκεται τόσο
στη δημιουργία όσο και στη διατήρηση των συνδρόμων του χρόνιου πυελικού πόνου.

Φυσικοθεραπευτική προσέγγιση

Αξιολόγηση ασθενούς
Η φυσικοθεραπευτική αξιολόγηση πρέπει να είναι εκτενής και να περιλαμβάνει όλες τις πιθανές πηγές πόνου. Για να ερευνηθούν πλήρως οι εν τω βάθει πυελικοί μύες είναι απαραίτητη η εξειδικευμενη δακτυλικη πρωκτικη. αξιολογηση

Χειροπρακτική θεραπεία (manual therapy)
Πολλές μελέτες προτείνουν την χειροπρακτική θεραπεία (manual therapy) για την αποκατάσταση του χρόνιου πυελικού πόνου Η συμπίεση των εναυσματικών σημείων (Trigger point) μέσω του ορθού, καθώς και τεχνικές μαλακών ιστών (όπως μάλαξη συνδετικού ιστού και διατάσεις) μπορούν να εφαρμοστούν με πολύ καλά αποτελέσματα.

Βιοανάδραση (biofeedback)
Η χρήση της βιοανάδρασης στο υπερδραστήριο πυελικό έδαφος στοχεύει στην αντικειμενοποίηση και ποσοτικοποίηση του προβλήματος, καθώς και στην εκπαίδευση του ασθενούς στη χαλάρωση των μυών.

Στάση του σώματος
Η διόρθωση της στάσης του σώματος σε ασθενείς με χρόνιο πυελικό πόνο έχει αποδειχθεί αποτελεσματική σε πολλές μελέτες.

Επανεκπαίδευση του πυελικού εδάφους
Οι ασθενείς εκπαιδεύονται στη συνειδητοποίηση των μυών του πυελικού εδάφους και επανεκπαιδεύονται στη σωστή λειτουργία τους. Αλλάζοντας την μορφολογία των μυών έχουμε βελτίωση της νευρομυϊκής λειτουργίας.

Το Κέντρο Φυσικοθεραπείας έχοντας εξειδίκευση στην αποκατάσταση του πυελικού εδάφους αντιμετωπίζει τον χρόνιο πυελικό πόνο μέσα από ένα ολιστικό μοντέλο θεραπείας με επίκεντρο τον ασθενή εφαρμόζοντας σύγχρονες και εξειδικευμένες τεχνικές.

Εγώ από πρόχειρο search αυτό βρήκα και σκέφτομαι να το δοκιμάσω από τον επόμενο μήνα...Το αισθανομαι οτι τα συμπτώματα πηγάζουν από εκεί..Πολλές φορές όταν κάνω ασκήσεις αμέσως μετά την ούρηση και συγκρατώ τους μύς μου...κάνει να μου έρθει κατούρημα κανά 5ωρο...Τουλάχιστον φαίνεται οτι άνθρωποι με εξειδίκευση στη φυσικοθεραπεία αρχίζουν να αντιλαμβάνονται και στην Ελλάδα 2 3 πράγματα...Καλημέρες

[john]

http://www.physicenter.gr/  Σε αυτό εδώ αναφέρεσαι προφανώς.

Νόμιζα οτι είσαι απο Αθήνα, αφού είσαι απο Θεσσαλονίκη γιατί δεν πας να δεις τι λέει το wise anderson ?
Εγώ εκεί θα πήγαινα πρώτα.

[Hyper Ban]

Συμφωνω απολυtα με τον John .

[Hyper Ban]

Ο Vento στην υπογραφη του , λεει :
...''Μάλλον είχα ινομυαλγία στο παρελθόν (η διάγνωση θέλει τουλάχιστον 11 trigger points-μου βρέθηκαν 9) που μάλλον...αντιμετωπίσθηκε''.
Πως εγινες η διαγνωση;
Τι εννοει ;
VENTO Θελεις να αναφερθεις λιγο σε αυτο ,οπως σε ποιον και τι  γιατρο πηγες και πως σου εκανε αυτη την διαγνωση ;
Πως εντοπισε τα trigeer points ; Εξωτερικα στην μεση σου ας πουμε ειναι ;Που αλλου ;

[1312g]

Ρε σεις Αθηναίος είμαι....αμα ήμουν θεσσαλονικιός θα είχα πάει ήδη...Απλή αναφορά κάνω από αυτά που γράφει τοsite!

[vento]

Για την ινομυαλγία έγραψα κάποια βασικά πράγματα στο Ιστορικό που έχω ανεβάσει. Για να απαντήσω στα ερωτήματα που τέθηκαν εδώ, θέλω να προσθέσω ότι:
α) η διαγνωση γίνεται από ρευματολόγο
β) προσωπικό μου συμπέρασμα είναι ότι υπάρχουν συγκεκριμένα trigger points τα οποία "ψάχνουν" οι ρευματολόγοι, σε διάφορα σημεία του σώματος, όπου ενδεχομένως δεν έχεις νιώσει πόνο πριν την εξέταση.
γ) η εύρεση των trigger points γίνεται με δακτυλική πίεση από τον γιατρό.
δ) στην εξέταση που μου είχε γίνει, είχα εκπλαγεί από τον πόνο που ένιωθα σε  συγκεκριμένα trigger points. Δεν είχα ποτέ καταλάβει πριν την εξέταση ότι στα συγκεκριμένα σημεία πονούσα....! Π.χ. πόνεσα στο στήθος κατόπιν της δακτυλικής πίεσης, ενώ αντίθετα οι καθημερινοί μου πόνοι δεν είχαν σχέση....ήταν στην πλάτη και ιδιαίτερα στο αριστερό μέρος της μέσης....

[Trapsoul]

Male Pelvic Pain: It's Time to Treat Men Right

http://www.pelvicpainrehab.com/blog/2012/07/male-pelvic-pain-its-time-to-treat-men-right/

July 29, 2012

Posted by Stephanie Prendergast and Elizabeth RummerunderMale Pelvic Pain

Tony is one of those people who seem superhuman. In his early 30s, he's lean and athletic. When he isn't chasing after one of his three young children or helping to run a successful family business, you can find him surfing, hunting, snowboarding, golfing, swimming, or playing basketball.

It's hard to believe that at one time, this guy who has such a passion for living was all but convinced that his life was over. But there was a time, not all that long ago, when he was sure that he'd never participate in another sport that he loved, let alone be able to work or even have relations with his wife.

It was on an unseasonably warm afternoon in February  back in 2003 when Tony's full and happy life took an unexpected detour. On that day, as usual, he was in active mode, attempting to pull off the perfect handstand when all of a sudden, he felt a sharp pinching pain in his lower abs.

Three doctors later, he was diagnosed with an "abdominal strain" and prescribed core-strengthening exercises. The exercises made his pain worse, and in a matter of weeks his symptoms exploded. The sharp pain in his abs snowballed into pain with sitting, constant perineum and groin pain, and a burning pain at the tip of his penis.

Unable to find any answers from the doctors he visited, he turned to the Internet. That's when the fear and panic set in. After spending hours online, he discovered that his symptoms were a match with a disorder called "pudendal nerve entrapment"or "PNE."

After reading a litany of stories about PNE, he was convinced that he needed surgery as soon as possible to free his entrapped pudendal nerve. Otherwise, according to the information he was uncovering, his symptoms would continue to worsen. He even contacted one of the doctors mentioned in the online forums who performed the surgery. The doctor encouraged him to fly out and schedule the surgery with him right away.

"I was terrified," he recalls, "I was reading all of these horror stories, and I believed that if I didn't get surgery as soon as possible, I would end up impotent and incontinent. Even with surgery I was afraid of what my life was going to become."

However, before he signed up for surgery, he decided to see one more doctor in San Francisco. Thankfully, that doctor was one of the few in the country in the know about male pelvic pain. The doctor explained that trigger points and muscle spasms in the pelvic floor—and in Tony's case, in the abdomen—have the potential to cause all of the symptoms he was experiencing. The doctor then prescribed pelvic floor PT to treat his pain. Finally, he was getting what seemed like a reliable explanation for what was happening to him. Plus, there was a treatment option available that was much more conservative than going under the knife.

"I admit at first I didn't believe PT was going to help me," he says. "But I decided I would just do it as a final effort before I got the surgery."

After the first session with Stephanie, Tony felt a slight bit of relief. Ultimately, with regular PT sessions—at first twice weekly and then weekly—his pain and symptoms began to diminish, until eventually they were gone altogether.

"Today I have zero pain," he says. "But it didn't go away overnight," he is quick to add. "It took time, patience, and a lot of commitment. And there were times during my sessions with Steph when I would break down because I was still so anxious about all that I had read on the Internet."

Tony began PT with Stephanie in January of 2004, and by January of 2006, he was completely symptom-free. Today he is living an unrestricted, active life without pain.

Unfortunately, Tony's struggle with pelvic pain is all too common. Research shows that between 8% and 10% of the male population suffers from pelvic pain. But that number is likely higher because studies also show that 50% of men will deal with prostatitis at some point in their lives, and pelvic pain in men is consistently misdiagnosed as prostatitis.

Tony's ordeal is also common in that, because he couldn't get answers from his doctors, he turned to the Internet for information, a move that led him down a dark road of misinformation. The reality is  that men with pelvic pain have an even harder time getting a proper diagnosis and treatment than women with pelvic pain.

For one thing, the medical community systematically misdiagnosis any pelvic pain symptom in men, —whether perineal pain, post-ejaculatory pain, urinary frequency, or penile pain—as a prostatitis infection, despite the absence of virus or bacteria.

The absence of a virus or bacteria simply means a switch in diagnosis from "prostatitis infection" to "chronic nonbacterial prostatitis." Typically, from there the doctor writes out an Rx for a few months worth of antibiotics and the drug Flomax, and the patient is sent on his way.

In the beginning, because antibiotics have an analgesic effect, patients will actually feel a tiny bit better. But before long the effect wears off, and they're right back where they started; in pain with no relief.

What's so maddening about this misdiagnosis loop is that in 1995, the National Institute of Health (NIH) clearly stated that the term "chronic nonbacterial prostatitis" does not explain nor is even related to the symptoms these men suffer. To describe the symptoms they actually do suffer with, the NIH adopted the term: "chronic pelvic pain syndrome."

The symptoms the NIH listed as being those of pelvic pain are: painful urination, hesitancy, frequency, penile, scrotal, rectal, and perineal pain, as well as bowel and sexual dysfunction. (In addition, in male pelvic pain patients, it's common for them to feel as though they have a golf ball or tennis ball in their perineum.)

Despite the NIH's edict, and more than 15 years later, men with pelvic pain are still getting that diagnosis to nowhere: "chronic nonbacterial prostatitis."

Just ask Derrick.

A successful CFO, and an upbeat family man, Derrick is happily married with three children. It was in early 2002 that he began experiencing perineal pain, post-ejaculatory pain, and pain with sitting.

For nearly three years he was left to flounder in the misdiagnosis loop of chronic nonbacterial prostatitis. During that time, he endured several painful and misdirected tests and procedures at his urologist's office. At one point, he even believed he had cancer.

"I was pretty frustrated and it was psychologically pretty challenging," he says. "I was in my early 30s, but I felt very old.  It impacted my sex life and all of my relationships."

Because of the effect it was having on his life, Derrick sought help from a psychiatrist. It was his psychiatrist who referred him to a doctor in San Francisco who diagnosed him with pelvic pain and sent him to Liz for physical therapy.

"PT has been the only thing that has helped my pain and discomfort," he says. "Now it's something that I must manage through therapy every two to three months, but I'm okay with that."

As both Tony and Derrick discovered, the right PT is the best treatment for men suffering with pelvic pain.

For the most part, there are four rungs to the ladder of pelvic pain treatment whether for a man or a woman. They are: working out external trigger points, working out internal trigger points and lengthening tight  muscles, connective tissue manipulation, and correcting structural abnormalities.

For male patients, the internal trigger point release and muscle lengthening (internal work) is done via the anus because this is how the PT can gain access to the pelvic floor muscles. (Click here to read more about the right PT for pelvic pain.)

Despite the proven fact that PT is the best treatment for pelvic pain in men, it's often difficult for men to get into the door of a pelvic pain PT clinic. That's because not all pelvic floor PTs treat men. This is the second major reason men have an even harder time than women getting on the road to recovery from pelvic pain.

Today, the majority of pelvic floor PTs are women. And, many of these women are uncomfortable treating the opposite sex. For some female PTs, it simply boils down to them not being comfortable dealing with the penis and testicles. Among their qualms: What if the patient gets an erection? How do I deal with that?

Coming from a practice where 15% to 20% of our patients are men with pelvic pain, here's our advice. If a male patient does get an erection, address it with a simple: "Don't worry, it happens." And move on. The bottom line is if you're in the medical profession, you shouldn't be intimidated by human anatomy. If you're afraid to fly, don't become a pilot. If you hate the water, don't join the Navy. If you're a vegan, don't become a butcher. You get the picture!

Pelvic pain does not discriminate between sexes, and neither should those who treat it. Unfortunately even prominent organizations qualify pelvic pain as a "women's health" issue. This needs to change.

To be fair, for some female PTs, their discomfort stems from the fact that they have received little to no formal education on how to treat the male pelvic floor. Frustratingly, there is very little education available to PTs on treating the pelvic floor in general. And what education is available is typically focused on the practical treatment of the female pelvic floor. For instance, when PTs take a class they practice on other PTs. So female PTs practice on other women, and when they return to their clinics, they're not confident treating the male pelvic floor. While this is more understandable than simply not treating male patients because of a social discomfort, it's still not acceptable.

The good news is that, in general, men are actually less complicated to treat than women. For one thing, there is no vestibule to deal with. The vestibule is an organ that's full of nerves with the potential to become angry. In addition, the male pelvic floor doesn't have mucosa that's exposed to outside bacteria or other agents; therefore,  men aren't as vulnerable as women to UTIs and yeast infections, which can exacerbate the pain cycle. Lastly, male patients aren't dealing with the large fluctuations in hormones that female patients deal with.

Conversely, what male patients and female patients do have in common is that with the male pelvic floor, as with the female pelvic floor, musculoskeletal impairments such as hypertonic muscles, connective tissue restrictions, pudendal nerve irritation, and myofascial trigger points commonly cause the symptoms of pelvic pain in men.

Another commonality is that lifestyle issues contribute to male pelvic pain just as they do to female pelvic pain. For instance, in Tony's case, his activities that might have contributed to his pain included a history of doing upwards of 200 sit ups a day,  and his regular long bike rides. Plus, at a young age he was told to "pucker" or hold his pelvic floor in order to avoid getting hemorrhoids.

As for Derrick, not only did he sit for long hours every day at a desk, he also had a long commute to and from work.

"In addition to solving my pain issues, PT helped me understand how my problems might have started to begin with, and it taught me to avoid certain potential triggers," says Tony, who no longer rides a bike, does sit ups, or holds his pelvic floor. In addition, he has set up a standing work station to give him the option of not sitting at work.

For his part, Derrick has cut back on his sitting, and when he does have to sit, he takes frequent breaks to stand up and move around.

Both men are thankful they were put on the right path to pelvic floor PT, and both men have the same resounding advice for other men who are suffering from pelvic pain and are looking for relief. "Try pelvic pain PT!" they both advise. "PT saved my life," adds Tony.

[Trapsoul]

Tony's Case Study: What Pelvic Pain?! http://www.pelvicpainrehab.com/blog/patient-case-studies/

Case study: 33 year old male

29 yr old athletic male. Reported attempting to do a handstand 3 months ago and had 'pinching' pain in the lower abdominal and belly button region. The pain was brought on by sudden movements or when arching back. PCP ruled out hernia and diagnosed patient with an abdominal strain.

Patient stopped exercising for one month, no change. Went to see 2 sports medicine physician at Stanford, negative for hernias. Pt again diagnosed with abdominal strain and was instructed to begin core-strengthening exercises, which exacerbated the condition. Stopped physical therapy and returned to MD who informed him he had an entrapped nerve. Began to notice L pain when sitting at the sit bones and perineum and tip of penis, and noticed he always leans to the right when sitting. Sitting for long periods of time also caused burning at the tip of the penis. This symptom may have been there for years.

Patient also reported burning in the L groin and penis burning after physical activity.

Patient called Pudendal nerve surgeon after 4 physicians visit informed him of abdominal nerve entrapment

History of performing 200 crunches 4-5 times per week and this resulted in increased burning around penis and occasionally a sharp pain in the anus.

History of chronic constipation since childhood, hard bowel movements and history of hemorrhoids.

When active cycling, patient would notice urinary frequency for next 1-2 days and a decreased stream when voiding at night.

Patient occasionally experienced post-ejaculatory burning.

Pt has a history of LBP for 7 years and was diagnosed with L5 disc bulge per MRI. Treated with physical therapy and chiropractic care. Pt reports still experiencing a low level of pain and episodic acute flare-ups several times a year. Occasional R buttock pain.

Objective Findings

Upon examination with doctor, 2 active MTrPs were identified in the abdominal wall in the rectus abdominus muscle. These trigger points were the source of the abdominal wall burning and pinching and were likely a result  of excessive abdominal crunches over a long period of time.

Upon internal examination, doctor also found the patient to have a shortened, tight pelvic floor in all of the major muscle groups.

The pudendal nerve on the right side did not present with any tenderness to palpation. On the left side, the patient presented with severe tenderness at alcock's canal and the ischial spine. The shortened pelvic floor and inflamed pudendal nerve were the likely sources of the penile burning and shooting rectal pain.

Stephanie continued the evaluation and found the patient to have connective tissue restrictions around the ischial tuberosities, in the abdomen, gluteal muscles, LB and lower extremities.  The left psoas, iliacus, and rectus abdominus were tighter than the right and palpation reproduced penile and abdominal burning. The patient also presented with sacroiliac dysfunction and pelvic obliquity.

Diagnosis

We diagnosed this patient with pudendal neuralgia and myofascial pelvic pain, including active trigger points in the abdominal wall, and scaroiliac joint dysfunction.

We recommended that the patient undergo a PNTLT. At the time, we relied on this test to determine if the patient's symptoms were caused by a pudendal nerve entrapment. We also recommended that the patient begin weekly physical therapy.

We referred the patient to our physiatrist, Irene Minkowsky, for further scaroiliac joint and low back work-up and evaluation.

We also recommended that he begin a stress reduction program.

Treatment- the first two sessions

During the first visit with doctor, the patient underwent trigger point injections to the abdominal wall and subsequent spray and stretch therapy

During the first physical therapy visit, the patient underwent CTM to the left LQ, MFR at the RA, psoas, and iliacus, muscle energy techniques for the scaroiliac joint and internal pelvic floor stretching and neural mobilization.

We discussed lifestyle modification. It was important for this patient to minimize any activity that caused an increase in abdominal, LB, buttock, or pelvic pain while we were treating his problems. This involved sitting on a cushion and standing when the symptoms increased as a result of sitting. We requested that he stop all direct abdominal exercises until we resolved the trigger points and the muscle hypertonicity. We discussed stopped exercise that exacerbated his symptoms: biking (caused further compression of the comprised tissues and irritated the PN0, running (unilateral impact through a dysfunctional SI joint led to further dysfunction). It is important for the patient to remain active; he could do this through swimming, walking, pull-ups and push-ups. We discussed diet modification to normalize the bowel habits and avoid starining to have a bowel movement, which can cause further neural inflammation and muscular dysfunction.

Very importantly, we discussed his habit of 'puckering up'...essentially clenching his pelvic floor muscles together all day. He was informed this would help him prevent hemrrhoids and had been using these faulty holding patterns most of his life, which could have contributed to the short pelvic floor and the inability to relax the muscles to have a normal bowel movement.

During the second visit the patient reported a complete resolution of abdominal symptoms following the trigger point injections and physical therapy to the abdominal wall. Between his first and second appointment he had undergone the recommended electrophysiological testing. The results of the PNLT were 1.48ms on the R and 2.96 ms on the L. His left pudendal latency was slightly prolonged.

The patient's main complaint was now the burning inside the sit bones and at the tip of the penis. Doctor performed a finger-guided pudendal nerve block at the ischial spine and Alcock's Canal.

The patient reported his pain was eliminated during the period the anesthetic was in effect from the nerve block. His symptoms were reduced but he pelvic burning was still present. Upon examination, the pudendal nerve was no longer tender to palpation. His symptoms were present, at this point with minimal pudendal inflammation we began to address the other findings that were likely the sources of the remaining problems: the sacroiliac joint, hypertonic abdominal and pelvic floor muscles, trunk and LE connective tissue dysfunction, and peripheral nerve adverse neural tension.

The patient continued with weekly physical therapy and also under a series of 6 proliferative therapy injections with Irene Minkowsky to treat his SIJ hypermobility.

We continued to make weekly gains in physical therapy; however the patient remained concerned that his symptoms were caused by a nerve entrapment that would require a surgical decompression. He contacted 2 US surgeons who recommended a surgical consult and did not support conservative management both informed our patient if he did not get surgery as soon as possible his outcome would be worse,

The patient continued weekly appointments with SAP and monthly appointments with doctor.

About four months after the patient began consistent treatment, his symptoms were almost completely eradicated- no abdominal burning, LBP, or groin pain, the penile pain was 90% resolved and he could sit for several hours on a cushion. On a weekly basis, he would experience a transient symptom of burning or pain that would last for a few seconds.

The patient continued weekly therapy and monthly dry needling into the abdomen or medial to the ischial tuberosity. He did not require any further injections.

Approximately one year and a half later, as his sitting tolerance increased and the transient remaining symptoms completely minimized, the patient decreased his frequency of PT visits to two times per month.

Four months later, the patient had returned to all previously limited activities and could sit limitlessly on a cushion and for 2 hours without a cushion. He had been on several plane trips, rode trips, and was hunting without a problem. He was able to surf, ski, and exercise. We decreased his visits to one time per month.

The patient had persistent connective tissue restrictions at the bony pelvis and inside his sit bones. The tissue was improving slowly and the patient had not had pudendal nerve sensitivity upon examination since January of 2004. The connective tissue dysfunction was the reason the patient could not yet sit without a cushion limitlessly. Because of this, his monthly sessions consisted of emphasis on this tissue: for the entire hour we performed CTM at the bony pelvis, internally and externally, to the restricted tissues.

Two years after beginning treatment, the patient was sitting without a cushion, doing all previously limited activities, and was entirely symptom free. We continue to see him one time per month for follow-up.

Three years after beginning treatment, he is about to have his third child, he no longer uses a cushion ever and had resumed all activity.

July 2012–still great. What pelvic pain?

[Φαέθων]

Πολύ ενδιαφέρον. Κρίμα που είναι στα Αγγλικά.

[Hyper Ban]

Διαβασμένο πριν καιρό και πράγματι με μεγάλο ενδιαφέρον και προσοχή .

[aman]

Σχετικα με την φυσιοθεραπεια στο παρακατω λινκ υπαρχουν τα βιντεο ενος σεμιναριου. Εχεις επισης και τεχνικες φυσιοθεραπειας - διατασεις.


http://www.imop.gr/ourologika-ekpaideytika-video/fysiotherapeia-pyelikoy-edafous

[Hyper Ban]

Σχετικα με την φυσιοθεραπεια στο παρακατω λινκ υπαρχουν τα βιντεο ενος σεμιναριου. Εχεις επισης και τεχνικες φυσιοθεραπειας - διατασεις.


http://www.imop.gr/ourologika-ekpaideytika-video/fysiotherapeia-pyelikoy-edafous

Πολύ καλό .

[john dim]

Υπαρχει στο ιατρικο κεντρο Αθηνων υπερσυχρονο κεντρο πυελικου εδαφους.