So my symptoms associated with pelvic floor dysfunction when I started my physical therapy were constant tightness of the perineum/ pelvic floor muscles throughout the day, pain in the perineum area, soreness of these muscles, the tissue being hard and ropey in my pelvic floor area and also the sexual symptoms of erectile dysfunction and loss of sensation in my penis.
My physical therapist took these symptoms and came with the idea/goal that the pudendal nerve could be impinged or blocked somewhere or multiple places in the hard, ropey tissue and tense muscles and her treatment plan reflects this. So in my PT sessions she is physically stimulating/ massaging these tissues to try to loosen the hard tissue, relax the muscles, and stimulate the pudendal nerve in the areas it should be moving through.
Essentially I’m being fingered in the butthole most of the time…haha! That’s how most of these muscles and tissues are reached. She will also externally work on the tissue as well though.
Exercises I am assigned to do on my own mostly involve things that will stretch these pelvic floor muscles and just massaging areas that get tight or sore to try to relax the muscles and stimulate blood flow to the nerve. Some of these included sitting on a tennis ball and putting my weight on it to a level that wasn’t too painful and moving back and forth to massage/ loosen these muscles. While standing, put one foot up on a chair and massage the tissue that goes over the sitting bones on the leg up side- then switch. This is an area the pudendal nerve goes through. Another: lay on back in yoga “happy baby” pose and breath deeply. On the inhale focus on pushing your diaphragm down toward the pelvic floor, this is a stretching method. Another: hold the edge of a chair or something and have feet squat width apart. do a squat, when at the bottom of the squat hold the position and move your head up and down in a “yes” motion, then go back up and repeat. Another: go into a squat pose and massage any of the pelvic floor muscles that are sore and tight. I think there are more I’ve done but those are the ones I remember or think are the best.
Once my symptoms improved from no longer experiencing pelvic floor muscle tightness and pain throughout the day, we moved on to more strengthening exercises. I do these now along with all the massaging and stretching things as well. These strengthening ones are essentially kegels. I was assigned to do a set of ten twice a day, but I usually do quite a bit more. I found an old research study online that had the guys do a set of ten kegels in which you hold the kegel for 5-10 seconds or as long as they can, and then they would do a set of 10-20 quick release kegels. The study had the guys do that on their backs with legs bent, feet on the floor, while feeling their pelvic floor muscles with their hands to ensure they were only flexing these during the exercises. I think they did this three times a day. I try to do this now but not always on my back, I’ll do it standing or sitting as well.
I don’t really know the difference between a reverse kegel and regular kegel I guess. I just looked it up and they seemed really similar.
Hopefully some of this was helpful. I have never done any biofeedback or electrostimulation in my sessions. I have asked about the electrostimulation and they don’t have it where I go.