Sunday, October 19, 2014

Hockey and Hernias, Part IV: Men's Pelvic Health

“Have you ever had a pelvic exam?” my PT specialist asked.

Sure, I surmised. Doctors’ hands thumping on the region between my fifty-year-old hips, physical therapy, and surgery—all that must count for something, right?

No, this would be a different kind of probing, an internal exploration of the pelvic floor region.

Yikes. Okay.

After the test, eight sessions of myofascial release, prescribed light pelvic movements and a ton of Internet research, here’s what I’ve discovered.

Pelvic health problems apply to women and men. Just because we males don’t bear children doesn’t mean we’re exempt from chronic pelvic pain syndromepudendal neuralgia, pudendal nerve entrapment or a combination of these (pelvic myoneuropathy).

“Pelvic” pertains to more than what meets the hip.

The perineum supports the diaphragm, bladder and bowel and is bordered by the pelvic floor.

We have two superficial transverse perineal (STP) muscles. They stabilize the perineum. They remind me of shock absorbers. In my case, the left STP is more clenched—as if bracing itself against additional injury—than the right.

Many people, myself included, have forgotten how to breathe like a baby; stress and fatigue cause us to inhale through the chest rather than through the rib cage, thus putting unhealthy pressure on the perineum.

Everything’s connected: Abdominal bloating, pelvic floor and radiating pain come and go and vary in type intensity and duration, but guided meditationdiaphragmatic breathing, playing the guitar, walking and light exercise can deflate the symptoms and, more importantly, the negative “here-it-comes-again/what-am-I-doing-wrong/I’m-never-going-to-be-free-of-this thinking that enters my mind.

Progress will be slow and is best measured by what pain I can tolerate or how often I reach for Advil. For example, if I play golf and am not debilitated the next day or two (did that twice in the last month), then I’m on the right track.
My STP is more relaxed than it was before the eight sessions.
Dealing with healthcare insurance and the pending appeal for additional sessions is a pain in the perineum.

I have options as I await that decision and for UMASS Worcester to develop a better MRI: Restorative yoga, cold laser therapy or trigger point massage for hockey players.

I can’t say when or even if I’ll ever return to the AMHL but am grateful for the opportunity to help others with this same injury and similar conditions. I’m grateful for the proactive professionals who care about and for me and who have responded to email. I thank goodness for financial and spiritual stability, the guitar my mom and dad gave me, my wife, my hockey friends and….the list goes on as long as I want it to.

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