Hi All,
I will relate my experience which is somewhere else about pelvic pain. It is completely anecdotal and I have no idea if it is an accurate description of what might have been the issue, just something my PT and I thought as a real possibility.
I initially really injured my groin, playing tennis. Didn't really allow it to heal and continued to try and play on and off for about a year. I stopped playing completely. several years went by, and I tried again and ended up in the same position.
I had pain at my groin by my genitals sometimes going into the genital area, burning at the front, top part of the pelvis and the upper inner thigh. simple movements increased the pain.
Especially after sitting.
The pain appeared to be so deep I could not really touch it. Simply frustrating and irritating when I allowed it to be. Nothing on x-ray, MRI, or examination.
A Tennis court opened up near my place here in NYC which was to good to be true. I decided to go to the doctor and see if I could get some PT. He diagnosed me with groin strain and I asked for a referral to the hospital for special surgery for sports injuries here in town. I knew I no longer had a groin strain because of the time that had passed but accepted the 14 visits of PT.
When I was first evaluated by the PT her first comment was she did not see how it could be a groin strain, she said my muscle strength was fairly good in the area and I seemed pretty mobile considering that I did have some tightness in the area. I explained the sitting thing and also one other thing that I have not mentioned.
Sometimes in the mornings, when I would stretch my legs out straight in front of me in bed (a leg yawn I guess). I would feel and hear a loud popping under my genitals. I thought it might be a tendon riding over something and wondered if what was happening constantly and causing irritation. She said highly unlikely, that most likely it was my pubis symphysis joint which at some point during the treatment I was able to reproduce and she confirmed that. I was not even aware that this was a moving part! She said there had to be a lot of tension and pressure put on the joint to move it in that way. and suggested stretches especially in the opposite direction of how ones body would be in the sitting position. Ouch, those muscles and tendons were super tight.
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The other thing I requested from the start was, that I was going to start to play again at the outset, of course not too vigorously. She said that they usually recommend no activity during the therapy and I asked her to please humor me and I would not tell if she didn't and if it turned out to be detrimental I would stop.
My first time out, I had no pain or sensation until bout 30 min in. Then I felt a slight tearing in the muscle in my inner thigh from the inside of the knee to where it attaches at the top of the groin, I played another 45 min which was probably too long to begin with but I had taken it pretty easy. the pulling sensation eased over the next couple of days.
Within a few weeks, I was not able to reproduce the popping no matter how I tried, the groin pain eased in proportion to how much I played, by the end of 8 weeks, I could play a couple of hours hard with no groin pain, no pain upon standing up ( other then sore muscles), by out week 9 I had a strange occurrence of a pelvic pain I had not had before which was in the hip joint as I stepped down, it only lasted a couple of days. By the end of the fourteen weeks, my balance which had been off in the beginning, was now spot on, the last 6 weeks I had asked her to really work my core and it was rock solid and I can now play 3 times a week when I have the chance sometimes for 3 hours. I am a happy camper!
What do we believe occurred?
Because of the multiple times I had re-injured myself, scar tissue had formed and shortened the muscles, tendons and ligaments. In the sitting position these do not feel shortened as the position shortens them naturally, upon standing, they pull because of the tightness and alter the natural structure of the pelvis moving that little joint back and forth creating irritation which would be felt from almost any ordinary movement of the legs including simply initiating lifting ones leg up.
In addition, because of the amount of nerves that pass through the area (and they do not run all the same way in everyone) the tightness can effect them, would never appear in any diagnostic test because one would have to duplicate all the movements one goes though during the day and those nerves referred pain to other places in the area.
Hence, the tearing of the muscles from the initial playing may have freed up some of the tension, the continued playing and stretching allowed them to fall back into and heal at a more normal length putting less tension on the pelvic structure and eliminating the cause of my pain.
Sounds reasonable, yet as I said strictly anecdotal.
