Exercises for Pudendal Nerve Entrapment

Pudendal nerve entrapment or PNE, is a rare and debilitating condition caused by entrapment, impingement or compression of the pudendal nerve which are located within the bony pelvis, at the tips of the ischial spines. This painful condition often develops with childbirth or prolonged cycling.

However, this condition can affect both men and women, resulting in a variety of disabling symptoms including genital or groin pain and numbness; urinary difficulties and sexual dysfunction. Pudendal neuralgia exercises can help.

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The chief symptom of pudendal nerve entrapment is severe pain when sitting, which worsens then longer you stay in this position. This pain might be burning, tingling or even numbing. According to a December 2017 article published by International Journal of Sports Physical Therapy, this condition is particularly aggravated by prolonged periods of cycling.

PNE is frequently mistaken for other conditions that affect the hip and pelvic region. Diagnosis can prove difficult, and requires evaluation by specialists who are familiar with this specific condition, and who are skilled in diagnostic modalities such as nerve conduction testing and magnetic resonance imaging.

If you have this condition, you will likely need to alter your daily tasks to avoid activities that worsen your symptoms. Treatment also includes pudendal nerve flossing, stretching and strengthening exercises — often under the direction of a physical therapist.

Pudendal nerve entrapment can be caused by shortening and contraction of the muscles that line and support the saddle regions of the body, also known as the pelvic floor. These areas include the buttocks, thighs, hips and perineum.

The goal is to lengthen and loosen the muscles that are potentially causing compression of the nerve — but without making symptoms worse. You might feel tightness or slight discomfort, but stretches that are painful could be causing more damage.

According to an article published in September/October 2016 by ACSM's Health & Fitness Journal, stretches should be held for 10 to 30 seconds, or even up to 60 seconds if tolerated. Repeat each stretch two to four times.

Any pudendal nerve exercises that increases the range of motion of the affected muscles is beneficial. Wide leg bridges, standing hip extension, as demonstrated by ExRx.net, leg lifts while lying on your side, and Cobra pose.

Consider performing pudendal nerve exercises in a pool to relieve pressure on weight-bearing joints, helping to reduce pain.

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In addition to stretching and range of motion exercises, treatment for pudendal nerve compression also includes learning to relax muscles in the pelvic floor. Sitting on a donut cushion can also help decrease pressure directly on the affected nerve.

Manual therapies, such as soft-tissue mobilization can be performed by a physical therapist to further increase range of motion and flexibility in the affected muscles.

Medical interventions can include prescription muscle relaxants and pain medications, as well as injections of cortisone, Botox, platelet-rich plasma or hyaluronic acid, according to Physiopedia. In severe cases, the nerve might need to be surgically released.