Hard Flaccid Forum

toster

Inguinal canal & external oblique muscles are mostly there, and rectus abdominis near it, internal obliques deeper. At the deepest level it is transversus abdominis muscle. Much much deeper under it there are iliopsoas tendons. Ext. obliques are most probably what is troubling you. Rectus femoris points would be just above penis and bone.

http://www.exrx.net/Muscles/Obliques.html

obitoo

@toster: You are the man. Are you studying to become a Physical Therapist? You'd be great at it.

arthurgebel

I purchased both the spiky balls and roller, cant wait to exercise with them. I've noticed that most of my trigger points are on my left side and located in the gluteal muscles. Most of the videos I watch, they use a roller to release this area and some with the spiky ball too. I think I have to work to release to tension and correct the alignment of my pelvis cause I can feel my posture isn't the same as before.

toster

@obitoo No, I am not. I am at IT profession but looking to move to something more healthier, both mentally and physically. Tough times make man learn to help himself, especially when there is nobody else to do it instead of him.

burnout

I have found something that is a combination of the spike ball mentioned earlier and the foam roll. It gives you the best of both worlds and was actually designed to release trigger points. It is called RumbleRoller.
For more information check out this site and also view the videos as they are quite informative: http://rumbleroller.com

For reviews check out the amazon site: http://www.amazon.com/RumbleRoller-Extra-Firm-31x6-Black/dp/B004INQSPG/

I have already ordered the blue one in large and the black (extra firm) in small. I'll report back as soon as I've got some results in releasing my trigger points with it. :)

Alternatively there is also the Trigger Point Grid, but I don't think it is as good as it is IMO too flat to attack the trigger points.

more information: http://tptherapy.com/shop/smrt-core-products/the-grid.html

reviews: http://www.amazon.com/The-Grid-Revolutionary-Foam-Roller/dp/B0040EKZDY/

toster

I was surprised not to find a single mention of pubococcygeus ( PC ) muscle on this forum. It is The one all kegel obsessed people know of and are trying to strengthen it. It is major part of pelvic floor muscles, but not so much at the same depth as ischio and bulbo muscles which are superficial ones. PC muscle is much deeper and stronger and have effect on pelvic balance and posture.

http://en.wikipedia.org/wiki/File:Gray407.png
(It is not named on picture, but PC muscle would be in level of constrictor urethe and levator ani)

Reason to believe it is implicated in HF condition as, or even more than ischio/bulbo are (as wiki describes):
http://en.wikipedia.org/wiki/Pubococcygeus_muscle

"The Pubococcygeus muscle controls urine flow and contracts during orgasm. It also aids in urinary control ... as well as core stability."

1. There is large number of HF sufferers that experience temporary reduction of firmness symptom during urination, myself included. It is the action that relaxes PC muscle, same as bulbospongiosus. Bladder sphincter muscles are in the level and part of PC muscles. Internal anal sphincter also.
2. I can confirm that since I got HF, my orgasm feeling and contractions are reduced to almost nothing, feeling like all the pelvic floor is cemented and sleeping. I am talking about that pleasurable deep tremor in muscles and general joy of orgasm, before contractions of ejaculation. bulbo muscles contribute to this, too.
3. Core stability problems are also something I have (core would be abdomen, back, hip flexors, glutes).
4. Last but not least, PC muscle can be easily overworked by PE, kegel exercises etc. as some people here found out on the hard way.

This doesn't changes current understanding of our condition. Problem is still in the PF muscles. But naming PC muscle as part of equation expands possible effect to whole body.

obitoo

I'd like you all to read this and tell me what you think:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1513892/pdf/annsurg01362-0322.pdf

It's quite old, but pretty thorough. There are a number of very interesting similarities to HF in there. Difference between standing and lying down, left/right imbalance, mass in the perineum, etc.

Just found it interesting.

obitoo

Another link... Urologist familiar with HF chimes in on a Q&A site:

It's in Norweigan, so you might want to view it in Google Chrome so it will translate for you. http://www.klara-klok.no/wips/453389532/caseId/1309934356/

Doesn't reveal any new information, but shows that it is a known condition, and that it is nothing more than smooth muscle contraction.

searchforthecure

Interesting read regarding the hernia article, but not so sure that's what we are looking at. Could make sense for the guys who developed HF doing squats, but doesn't seem likely for the guys who were jelquing. Also, I know many of us complain that our perineal area is "congested" (i.e., the BC muscle is spasmed), but I don't recall any reports of a mass that sounds like a hernia. Of course there are all kinds and sizes of hernias. Also doesn't seem to be consistent with the ability to make HF go away temporarily during urination or certain stretches. I am having a pelvic MRI in a few weeks... I wonder if a hernia of that sort is the kind of thing that would show on an MRI. Definitley and interesting article - not sure what to make of it.

obitoo

searchforthecure said:
Interesting read regarding the hernia article, but not so sure that's what we are looking at. Could make sense for the guys who developed HF doing squats, but doesn't seem likely for the guys who were jelquing. Also, I know many of us complain that our perineal area is "congested" (i.e., the BC muscle is spasmed), but I don't recall any reports of a mass that sounds like a hernia. Of course there are all kinds and sizes of hernias. Also doesn't seem to be consistent with the ability to make HF go away temporarily during urination or certain stretches. I am having a pelvic MRI in a few weeks... I wonder if a hernia of that sort is the kind of thing that would show on an MRI. Definitley and interesting article - not sure what to make of it.

Oh I don't think it's what we are dealing with either, just noted so many similarities that I thought it was worth a read. Stumbled it upon it while reading up on hernias, as I'm getting ready to have one surgically repaired.

MRI with contrast *should* potentially be able to show a hernia, though the entire area sort of bunches together quite a bit when lying down. Imaging the perineum is pretty tough in general because of that.

searchforthecure

Regarding the norwegian article... the translation was interesting but (at least for me) incomplete. Looks like the doctor is relating it to stress and the sympathetic nervous system. Couldn't quite make out what the doctor was recommending, as a few words wouldn't translate:

"If you do not have morgenereksjon, which regulates the muscle mass in your penis, I would suggest that you get from your medical plan a lavdose of a ereksjonsfremmende drug that will normalize natteereksjonen and possibly violating this condition."

Looks like all we need to do is pick up a bottle of morgenereksjon, and some ereksjonsfremmende to normalize our natteereksjonen, and we will be fine! :)
I keep trying to translate those things but all I get is more Norwegian...

obitoo

Haha! Looks like there are some spaces missing when the page is rendered.

morgen ereksjon = morning erection

natt ereksjon = night erection

ereksjons fremmende = erectile-enhancing

And yes, it is just saying that the smooth muscle of the penis (and elsewhere) is controlled by the balance of the sympathetic and parasympathetic nervous systems, and that a tight penis can be the result of overreaction of the sympathetic, which can be caused by drugs, stress, etc.

It can also be caused by trigger points, tension and inflammation, which are not mentioned in this particular post.

arthurgebel

toster said:
I was surprised not to find a single mention of pubococcygeus ( PC ) muscle on this forum. It is The one all kegel obsessed people know of and are trying to strengthen it. It is major part of pelvic floor muscles, but not so much at the same depth as ischio and bulbo muscles which are superficial ones. PC muscle is much deeper and stronger and have effect on pelvic balance and posture.

http://en.wikipedia.org/wiki/File:Gray407.png
(It is not named on picture, but PC muscle would be in level of constrictor urethe and levator ani)

Reason to believe it is implicated in HF condition as, or even more than ischio/bulbo are (as wiki describes):
http://en.wikipedia.org/wiki/Pubococcygeus_muscle

"The Pubococcygeus muscle controls urine flow and contracts during orgasm. It also aids in urinary control ... as well as core stability."

1. There is large number of HF sufferers that experience temporary reduction of firmness symptom during urination, myself included. It is the action that relaxes PC muscle, same as bulbospongiosus. Bladder sphincter muscles are in the level and part of PC muscles. Internal anal sphincter also.
2. I can confirm that since I got HF, my orgasm feeling and contractions are reduced to almost nothing, feeling like all the pelvic floor is cemented and sleeping. I am talking about that pleasurable deep tremor in muscles and general joy of orgasm, before contractions of ejaculation. bulbo muscles contribute to this, too.
3. Core stability problems are also something I have (core would be abdomen, back, hip flexors, glutes).
4. Last but not least, PC muscle can be easily overworked by PE, kegel exercises etc. as some people here found out on the hard way.

This doesn't changes current understanding of our condition. Problem is still in the PF muscles. But naming PC muscle as part of equation expands possible effect to whole body.

I believe this too, I got hard flaccid after doing kegel exercices and I feel pain in the PC muscles. The exercice so far that helps me the most with HF is reverse kegels and they relax these muscles. Also this stretch helps the zone where the rest of my pain is :

But I stopped doing any stretch, going to the PT tomorrow to get more infos.

searchforthecure

That stretch is part of my routine - it is a good one. There are a couple that stretch the piriformis. I also have a lot of relief after doing that kind of stretching. Of course, the HF retrurns shortly after.

toster

@arthurgebel that link or flash thingie is all garbled to my browsers. Can you just copy paste URL ?

Also, PC muscle is said to contribute to core strength. So, any tightness or overworking of muscle is common case when one of agonist muscles are weak (muscles of same function group). In this case, it means that some core muscles might be weak, in turn making PC muscle work overtime and tight up too much.

toster

Related to anterior pelvic tilt (on both or just one side): tight calf muscles can cause it by shifting body weight more anterior, thus forcing low back to go in hyperlordosis.

http://rpm-therapy.com/2011/tight-calf-muscles-low-back-pain/

Also, rounded (protracted) shoulders on both or single side also seems to commonly go hand in hand with hyperlordosis, so upper back is affected by that pelvis imbalance.

searchforthecure

Not to change gears too quickly... but... here's a little experiment I've done over the last few days that might suggest the HF condition is more related to adrenaline and/or the sympathetic nervous system than it is to CPPS, although admitteldy they may go hand in hand. And of course this is a very unscientific experiment. But here it is. I've been having some improvement lately (not sure if it is due to the calcium channel blocker cream, the alpha blockers, the additional stretching, etc.). But whatever the case, I have had some pretty good evenings lately with some decent (but not great) hang. Now, we happen to have an exercise room in our house. In that room is a pull up bar. If I am having some pretty good hang (i.e., lessening of HF) and I stand under the pull up bar and *gently* do a few pull ups (that is, try as much as possible to use only the arms and not clench anything in the pelvic area), the HF comes on STRONG. Back to very tough HF and a nugget. After a while, it relaxes. I've done this quite a few times, quite a few nights. Now of course one possibility is that despite my best efforts to use ONLY my arms, I am also using other muscles in the abdomen, perhaps unconsciously contracting the pelvic floor, etc., which is making the HF really bad. But on the other hand, perhaps the increase in adrenaline which clearly happens during a pull up is causing the overreaction in the smooth muscle tissues. This "experiment" has similar results with doing bench presses - i.e., the HF worsenes during the lifting, but not as bad as when doing a pull up. I would imagine the bench pressing is much less likely to cause pelvic floor tightening, and perhaps produces less adrenaline rush, which explains why a pull up causes me more HF than does a bench press. Look - I am not saying anyting one way or the other here... but I have had more than one doctor state that HF is somehow related to an adrenaline response, or an overreaction to endothelin. Just something to think about - and to me it is a reminder to keep all options open as far as the cause and treatment of HF.

obitoo

@searchforthecure: This sounds to me like a typical "adrenaline penis" situation. Adrenaline definitely has these effects on the penis, our bodies are engineered this way as a defense mechanism. But any average joe will experience temporary hf-like symptoms after an adrenaline boost. Anyone who does CrossFit or any kind of endurance program will attest to that.

The fact that it lessens shortly after indicates that your adrenaline level has returned to normal. If your adrenaline level was permanently at that level you'd see a lot more symptoms than just HF all the time. Also, it's implausible that someone's adrenaline secretion become permanently heightened instantly by a single physical injury, unless it were some kind of bizarre brain trauma, and even that would be super unlikely. The HF onset is instant, 99.9% of the time.

It sounds to me like it is just taking a bad thing (HF) and making it temporarily worse (from the temporary adrenaline boost). That said, trigger points, tension and inflammation result in a "neural windup" situation, where the effected areas do become more sensitive to normal amounts of stuff like adrenaline, norepinephrine etc.

toster

I would just want to add that, even it seems you are not activating PF muscles, any heavy weight manipulation by hands require body torso to tighten up.

Pull ups stretch waist muscles (low back) pretty much. As mine are tight due to hyperlordosis etc. I feel them greatly as they pull back of my pelvis even more in anterior tilt. Only way to counter that is to keep abs tight. So only hanging out with hands holding to a bar will make a lot of your muscles and bones work and moving.

Those are tiny things that go unnoticed. If you have tight low back muscles, then pull ups even more exaggerate pelvic angle.

Bench press hits abs and low back too. Not the surface muscles, but the deep ones, including PF.

Even heavy breathing, like when doing exercises, activates more of abdominal cavity muscles (abs, low back, diaphragm, PF).

toster

To @kiwiguy and anybody interested in taking pics of himself to evaluate posture, here are few tips to make it easier.

Stand barefoot, without socks on flat surface only in underwear. Best position would be in middle of doorway, so you will have 2 vertical lines as references how to rotate picture later to be absolutely vertical. Have somebody take pictures of you from position exactly perpendicular to middle of doorway, holding camera at about your waist or chest height. Then you rotate yourself 90 degrees to get front, rear and sides, 4 pics total.

With attention to this detail, you can latter easily get exact measurement in photo editor. First you rotate pics to be exactly vertical, keeping doorway sides as vertical marker.

Then you evaluate symmetry.Check height of: shoulders, fingertips of arms, pelvis, knees, ankles. There are 2 types of problems: left to right asymmetries when you look from front and back & lower cross/upper cross like symptoms looking from the sides.

arthurgebel

sry this is the link if you still want : www.youtube.com/watch?v=Nm1a7SBXRMo

also what do you guys think about alternating ice/heat on muscles. I hear different opinions about it

toster

It increases blood flow through the muscle. If there is condition like sprain/strain etc. then it may not be good option. They are separately used to help heal (ice in first 24hrs of injury, heat afterwards or something like that). Doing the other way around makes thing worse. Not 100% certain, check it more thoroughly.

Only heat might help with muscle tightness.

Thanks for the link. I have seen it. I would just like to say again, that this is classic video and doc that jumped the piriformis online bandwagon. They all assume pirirformis is in need of stretching and they do not talk anything about testing it or evaluating posture first to see is it really the case. PIriformis is often painful because is already in stretched position like in anterior pelvic tilt (or irritated by SI joint dysfunction), so any stretching it will make things worse.

arthurgebel

ok thank you

rarara

I've been taking diazepam for sleep issues, its definetly reduced the discomfort i experience, although not noticed any direct relation to actual HF.

HFproblem

@obitoo, When you cured yourself, did erectile function directly correlate with hard flaccid level?

I ask because I have been adamantly doing trigger point therapy at home, and have worked my way to where I have spent the last week or so with about 100 percent normal flaccid sitting and lying down, and about 70-80 percent normal flaccid standing up. However, issues with soft glans, erections dying without stimulation, inability to maintain standing up, all seem to still be a problem.

obitoo

HFproblem said:
@obitoo, When you cured yourself, did erectile function directly correlate with hard flaccid level?

I ask because I have been adamantly doing trigger point therapy at home, and have worked my way to where I have spent the last week or so with about 100 percent normal flaccid sitting and lying down, and about 70-80 percent normal flaccid standing up. However, issues with soft glans, erections dying without stimulation, inability to maintain standing up, all seem to still be a problem.

You can't be "cured" of muscular dysfunction, because it is not an illness. You can be healed or rehabilitated though. ;)

Anyway, glad to hear about your progress. Sounds to me like you have a ways to go. Being normal when doing nothing is great, but your muscles are obviously not behaving themselves during any kind of sexual activity, which is typical. Once you regain control over the spasming and clenching during sex, you will see all that stuff return to normal.

There's no way you've got all those erection issues happening without some serious tension getting in the way.

rarara

I think you've pretty much summed up exactly whats happening to me obitoo. I can get rid of the hard flaccid no problem but second I ejaculate all hell breaks loose haha.

HFproblem

Sorry, I keep using the word "cured" out of old habit from posting way back in our wonderful days of trying to figure this out over at the PEGYM :-D .

Is there any specific way to target muscle tension during sexual activity, or is the best route to just continue with the typical "trigger point, lengthen, strengthen" method that has gotten me this far?

burnout

@obitoo I could not find anything about this on google and my PT could not help me with this either. Do you mean with clenching while masturbation/sex that during stimulation your pelvic floor muscles must be fully relaxed without any kegeling at all?

Is this the way "normal" people experience stimulation? I find it very hard not to do some slight kegels when stimulating my penis. This is just an automatic reflex. I am not saying that I am clenching but I automatically do some uncontrolled slight kegels while stimulation happens.

kiwiguy

I'm quite keen as well to find out what is a normal usage of pelvic muscles during an erection, and what should be considered 'clenching' or unnecessary tension.

Thanks to trigger point therapy and the short-term pain it has produced in my inner thigh, I've determined that I recruit my adductor magnus' pretty much all the time when I have an erection. Not sure about the pelvic floor though.

What would be ideal is a medical study recording the activity of all the different muscles during an erection. I've seen such a study for the ischiocavernosus and bulbospongiosus, but not for any other muscles.

burnout

Maybe I can help here: Before having real hard flaccid (I sometimes had very slight hard flaccid before and considered it normal) I always lost my morning wood when lying in the bed and spreading my legs. I always had to squeeze my legs together in order to have a hard morning wood. Same thing happened while standing up.

I've already thought the worst that I have a venous leak and have to do surgery. And knowing about how bad the results are from this kind of surgery I suffered a real bad panik attack thinking I will never have a normal sex life again. (this mindset built up over a few weeks)

Thankfully on the first day when I had really bad hard flaccid I've found this forum and read through most topics. I immediately started to relax, knowing that relaxing is key to getting better. I also did trigger point massage and my hard flaccid is already much better then at the beginning. What is even better, however, I don't lose my erection anymore when I spread my legs. I actually tried it every morning when having a morning wood because I just could not believe that my dick is working again and I don't have a venous leak. Anybody else noticing losing his erection (or getting weaker) while lying in the bed with spread legs?

I can also highly recommend the RumbeRoller http://rumbleroller.com/ (http://www.amazon.com/Rumble-Roller-RR316-RumbleRoller-Full-Size/dp/B0042JFAUK) . It makes releasing trigger points on my legs much easier, especially on the adductors. But go really slow with it at the beginning because I had some real muscle soreness the day after using it as if I were at the gym doing leg press.
(I am using the big blue one for the whole body and the small black one for the glutes and hamstrings because it is a bit stiffer but I think the big blue one is totally sufficient)

john1960

Little off topic, but I forgot to bookmark the sight that had those spiky balls that one poster was talking about that really helped him??? Anyone remember??

kiwiguy

@john1960:
They're called 'spikey balls' and they're on Amazon. They come in 2 sizes, I've ordered the smaller 7cm ones, but they haven't arrived yet. I'm making do with a tennis ball for now.

@burnout:
I seem to always be one gadget behind :-( How do you use the rumble roller exactly? (lying down, seated?)
Hey, I tried spreading my legs today, my erection weakened immediately. Thanks for that, further confirmation that the thigh muscles are playing up.
How long did it take you to sort out your thighs, and did that improve your erections?

toster

@burnout @kiwiguy Does spreading legs changes HF firmness in any way, during or without erection?

kiwiguy

When not erect, spreading legs may well increase HF (cannot tell for sure) but major effect is penis shortens considerably.

toster

Most urologist would tell you something along lines "Don't spread legs and you are cured". Joke a side, that is great observation. Single most important muscle group I identified on myself are adductors too, not so obviously linked with HF symptoms like yourself. That makes us 3 guys so far having adductors / spreading legs connected with PF muscle disfunction and HF.

kiwiguy

I read somewhere that the adductor magnus is the 3rd largest muscle in the body. It makes sense that if it's tight, it would potentially affect the proper functioning of smaller muscles that have adjacent insertion points, and the ischiocavernosus is first in line.

Toster, where are you at with your adductors right now? Do you have muscle soreness or tightness?

toster

They are tight, no TRPs or something massage can help. Only stretching them (same as hamstrings) is completely useless, even contra productive. So I am on gentle strengthening and stretch program to see is it related to weakness. Also, I am trying to balance them to hip abductors which are also quirky (tight, weak, painful). Not both sides are equal, which complicates more.

I don't think muscle size has to do anything with strength and effect on body. Calves are not that big yet they do arguably most work in life, after the heart etc. They all have their role.

burnout

@kiwiguy
I don't think the RumbleRoller is a must-have as I did my TPs before without it, it just seems easier with it. I am using it this way while lying: http://rumbleroller.com/foam-roller-exercises.html
On the second picture you can see how to do a great adductor TP workout.
The time my erections got better (no more weaker/losing erections while spreading my legs) was when I kept hammering the TP on my legs, hips and glutes (for the glutes I prefer a 7cm superball to go really deep and I either sit on it or lean against the wall on it).
At this point I did not even do any internal TP release, just external on my legs, glutes, hips and pelvic bone.
But I also have to add that I'm nowhere done with my legs, hips, glutes and I have to continue working on them. I hope I soon get my erections to obitoos level where I have to bend my morning wood down in order to piss. :)

@toster I can't answer this as most of the time I don't have HF while lying down or sitting

burnout

I would really love to hear what condition of the pelvic musles is normal while having sex or masturbation. I find it very hard not to do some slight kegels when stimulating my penis. This just seems to be an automatic reflex. I am not saying that I am clenching but I automatically do some uncontrolled slight kegels while stimulation happens. It's just very hard to "work" against this as it seems to be natural and part of the stimulation process.

On this site: http://icadvice.com/node/26 it says that it is normal to clench or tighten the pelvic while having sex: "...Problems largely arise because you clench and tighten your pelvic muscles (we all do) while making love. This is normal, but for someone with pelvic floor muscle problems it can exasperate their symptoms and lead to further pain and a sharp increase in symptoms."

Obitoo said several times that clenching/tighting/kegeling is not normal during stimulation, but is there any literature on this? Because all I've found are some people claiming that this is natural (maybe they don't know better and soon end up with PF dysfunction as well).

obitoo

burnout said:

Obitoo said several times that clenching/tighting/kegeling is not normal during stimulation, but is there any literature on this? Because all I've found are some people claiming that this is natural (maybe they don't know better and soon end up with PF dysfunction as well).

You've misunderstood me a bit. What I mean is...

It's normal when normal people do it in normal amounts, with normal amounts of force.

We are not normal people, the way we do it is not normal, and the reaction our bodies have to it is not normal either. :)

mhowardmh1

I have pelvic tension and have had difficulty urinating long before hard flaccid was noticeable to me. I have shy bladder at times and I assume I tense up even more than usual during these moments. My doctor usually recommends that I see a psychologist for this but it doesn't help. I am wondering if the physical therapy might help more. Do any of you have shy bladder and has physical therapy helped? Or if you have difficulty initiating urination at any times have you seen major improvements? Sorry if this has been posted, I couldn't find it in the search

obitoo

mhowardmh1 said:
I have pelvic tension and have had difficulty urinating long before hard flaccid was noticeable to me. I have shy bladder at times and I assume I tense up even more than usual during these moments. My doctor usually recommends that I see a psychologist for this but it doesn't help. I am wondering if the physical therapy might help more. Do any of you have shy bladder and has physical therapy helped? Or if you have difficulty initiating urination at any times have you seen major improvements? Sorry if this has been posted, I couldn't find it in the search

I think physical therapy AND psychological therapy should be mandatory for everyone with HF, or any CPPS in general.

rarara

I'm definetly biting the bullet and going to go to a physchologist aswell. Would literally rather (and have) had a guy put his fingers up my butt before I would want to see a shrink but I think it really is vital to sort out the emotional side aswell as physical. I don't even think of myself as a particuarly depressed person or anything but think alot of problems stemming from fathers death and then having to live with a step dad with mutual hate has put my subconcious in an awful place.

searchforthecure

I haven't posted since my visit with a proctologist (colorectal surgeon) a month or so ago, but I had an optimistic visit today so here is an update. I think I described that the proctologist noted spasmed muscles (including anal sphincter muscles) and gave me a multi-pronged approach to treatment. Here's the status of each one:

Had a pelvic MRI yesterday but don't know the results. Not expecting much there.

I also started a calcium channel blocker cream on the anus and rectum 3x per day. This has not been an instantaneous and magical cure of HF, but I do believe it is helping relax those muscles and I am going to stick with it. Most importantly, it has once again confirmed for me a connection between HF and sphincter spasm, which I first experienced when HF completely let go (momentarily) as a GP was checking my prostate. (As an aside, I think there is also a medical research article on the connection between urethral spasm and sphincter spasm which I need to dig up again). Sometimes as I am applying the cream, HF will let go. Anyway, I am not yet to the point where I am suggesting everyone run out and try this treatment, but I am going to stick with it.

The best part of all of this is that the proctologist also sent me to a local pain management clinic to start some biofeedback. I just had my evaluation appointment today and was very impressed and am optimistic about the treatment. They are putting together a plan I will start in 1 -2 weeks, that covers 3 different disciplines in a weekly 3 hour program. One hour is with a PT who has been dealing with CPPS in men for 10 years and has considerable experience with internal TP release. I was impressed with her background and experience and the volume of men she has treated with CPPS, but was a little disappointed to hear that none of her patients had complained of HF symptoms. Many have complained of referred pain to the shaft of the penis, but not HF. The second hour is with people who specialize in biofeedback. They do full-body muscle tension biofeedback, as well as more specific areas (abdominal, cardiovascular, neck). They described some biofeedback approaches (I think the cardiovascular and abdominal) that are specifically designed to "reset the nervous system" (their words - which were like music to my ears). Directly related to the autonomic nervous system and the sympathetic nervous system, which in my non-medical opinion are involved in HF and CPPS. The third hour is a "group" relaxation and stretching program that is based on MBSR techniques (although clearly not as intense as the daily MBSR that Obitoo was doing). Today was just the eval, so I haven't seen/done any of these things first hand, but I was very impressed with their experience with these issues and with their approach.

I will, of course, continue to keep you all updated and will let you know if I make any breakthroughs. On that note, for those of you "keeping score" with alpha blockers, I gave Minipress a good solid try, but finally decided it wasn't doing anything for me and certainly was not helping me sleep. So I am back on terazosin, and am sleeping better and feeling better (although again no magic HF cure). For anyone who is considering alpha blockers, I would try terazosin before the others. Also, the ability of terazosin to stop me from waking up every 90 minutes tells me it is calming down the sympathetic nervous system.

Ok, this is a very long post that doesn't really say a whole lot. I'll be back when I have some "real" news to report.

obitoo

@searchforthecure: Great news man! Sounds like you are off on the right path. I would love to hear more about that clinic, sounds like a very progressive place.

I think you'll get a lot out of all this stuff. Keep us posted.

toster

Worth reading. Anyone has idea or know what stretch is described here? Description is ambiguous. I feel aversion to any article about exercises without a pictures, but this one is only one that mentions PF being overactive and describes direct stretch for releasing it.

http://neurokinetictherapy.wordpress.com/2011/09/24/the-pelvic-floor-overactive-or-underactive/

burnout

@searchforthecure
Massaging and stretching my sphincter for about 15 minutes gives me instant results. My penis gets soft with a really nice low hang and my glans fully inflate.

I don't know, however, if stretching without any TP work on the sphincter will bring permanent results as I don't want to be incontinent one day because of this.

obitoo

@burnout: When I had HF I was able to get the same results by fondling my testicles. It would trigger some automatic nerve response that loosened up the right muscles and HF would instantly vanish until I stopped.

Regarding the sphincter stretching: My uncle-in-law had HF really bad a few years ago. He got it while doing dead lifts at the gym. Anyway, he was prescribed an anal stretcher (a "butt plug") to wear for a few weeks, along with some PT. His HF went away fairly quickly. The sphincter definitely plays a role, how far up the rectum it extends is anyone's guess. I think it's different for everyone.

burnout

@obitoo Just stretching and relaxing my rectum solves EVERYTHING for me (HF and Soft Glans). Do you think that just doing the stretching of the sphincter would be enough for me or do I still need TP work?
My doctor and PT don't have a clue regarding this.

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