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Training with CPPS / Chronic prostatitis

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  • Training with CPPS / Chronic prostatitis

    I have chronic pelvic pain syndrome and my pelvic physiotherapist has evaluated the muscles in the pelvic floor and has said that they are extremely tense. I will not go to the symptoms more than this, but I have almost all of the typical symptoms.

    This is actually the case for most men with chronic prostatitis and 90 percent of prostatitis cases do not have a clear origin (although there might be PSA inflammation due to unknown reasons).
    I've been trying to ask around and google the topic but so far I haven't found any studies on the correlation between lifting and pelvic floor dysfunction / cpps. My physical therapist has mainly given me stretches and bodyweight excersises and otherwise has just said that I can do different things if they don't caude excessive pain.

    Now this is the biggest problem: what is excessive pain? In a hyperstimulated state (such as chronic pain, chronic prostatitis) the "pain amplifier" is often way too loud to begin with. Avoiding pain altogether would often mean avoiding beneficial activities. Sometimes symptoms might get worse but it doesn't always mean that the excersise can't be good in the long term.

    I've seen guys on prostatitis forums and discussion groups giving advice against leg days and lifting, and even some doctors recommend avoiding these until the pain or other symptoms are "under control". However, I have never seen anything more than anecdotal or weak evidence for such claims.

    As BBM are experts on this topic, I would like to know if there's any studies done on this and if there are actually any movements I should avoid with pelvic pain syndrome. So far, I haven't receiver a clear answer. Things like kegels are commonly mentioned online as both harmful and beneficial.

  • #2
    Sorry to hear about this issue.

    This description of "tense" muscles from pelvic floor physiotherapists is extremely common; however, it is often framed to patients as the pathological cause of pain symptoms. I remain skeptical of this, as it seems at least as plausible (if not moreso) that any perception of "tense" muscles may be the result of pain, rather than the cause.

    Regardless of all the things you've read and been told by others, what do you actually experience when you lift weights? As with any other persistent pain state, there are typically NO specific movements we recommend people avoid - rather, we pay far more attention to the DOSAGE of activity and adjust based on tolerance. I do not see any clear mechanism by which a particular exercise (including kegels) would be harmful, especially compared to the known benefits of exercise.

    Finally, have you come across this resource? I have no connection or affiliation with it, but have introduced it to many of my patients and clients with persistent pain issues as an adjunctive tool together with exercise and recommend it.
    IG / YT


    • #3

      I am aware of Curable and was using it for awhile. Right now I'm on another similar program that relies on the same kind of reasearch (because I got this one for free). It's an effective tool.

      I have noticed that quite a strict stretching regimen (twice a day 2x20-30 minutes) does help with the pain and in general lifting has made the pain better. However, there are still other areas in my life that need to be worked on: sleep and stress control being the biggest ones..

      Thank you for the reply! I guess I wanted to hear what I thought from someone with some level of expertise from the field, so I don't develop an unnecessary fear of lifting.

      In general, only 2 movements seem to make the pain worse (for whatever reason) and these are deadlifts and kegels. Yesterday I did DLs and the technique was pretty poor towards the end resulting in general back and chest pain and later pelvic floor issues. I think the reason for the poor technique is in the tight hamstrings, so next time I plan on wearing a belt (although I'm not doing very heavy weights atm).


      • #4
        I am confident that you can find an approach (and load) to deadlift that will be tolerable.

        It sounds like you are on the right track, in general, and I would not have concerns about harm/damage with respect to this condition from lifting weights.
        IG / YT