Frequently Asked Questions

Below is a list of frequently asked questions about the DCT course. If you have any specific questions about the course please contact me at david@freedomfrompelvicpain.com. If you have started the course you contact me by email with questions and you can also join the DCT Facebook group.

I have been diagnosed with Chronic pelvic pain syndrome/C.P.P.S ? How can I recover?

Chronic Pelvic Pain Syndrome is characterized by chronic pelvic pain symptoms lasting at least 3 months during the past 6 months, in the absence of a urinary tract bacterial infection or identifiable bacteria in the prostate but in the presence of urinary symptoms and sexual dysfunction.  Symptoms include pain in the perineum, suprapubic region, testicles, or tip of the penis and are sometimes exacerbated by urination or ejaculation.  Men can also experience pain in the lower abdomen, hips, and pelvis.

If you suffer from chronic pelvic pain syndrome it is important to remember you are not alone. CP/CPPS has a worldwide prevalence estimated between 11% and 16% (1,2,3) and is the most common urologic diagnosis in men below 50 (1). There are more than 2 million visits for prostatitis every year in the United States alone.(4)

C.P.P.S / Type III prostatitis is the most common form of prostatitis, accounting for 8% to 15% of urology outpatient office visits (5). Currently, available therapies have limited effectiveness, resulting in frustration for patients and caregivers. Due to its high prevalence and lack of effective therapies, direct and indirect costs associated with type III prostatitis/CPPS are substantial. (5)

The Freedom for pelvic pain course is designed for men suffering from CPPS.

What causes C.P.P.S?

There are different proposed theories for what causes CPPS. However, it is widely accepted that muscle tension is a causative factor in CPPS and pelvic pain in general. You will find this theory proposed in pelvic pain books and many physical therapy websites.  This is a theory that we agree with. In order to recover from CPPS excessive muscle tension must be treated.

How is excessive muscle tension treated?

This is a question David McCoid was obsessed with for two years.  His research eventually led him to find the work of physical therapist Nic Bartolotta. Nic Bartolotta had developed a system for treating both muscle and fascial tension called Dynamic Contraction Technique™. While Nic was using this approach for pain conditions he had also established a reputation in professional sport and was using his technique with many elite sports teams particularly in the NBA.

As someone already working with pelvic pain patients and a former sufferer himself David approached Nic to enquire about DCT.  David made the decision to train in DCT in San Diego. After completing his training David and Nic went on to create an online program instructing CPPS sufferers on how to apply DCT to their own body.  The program has been created specifically for CPPS. It is the first online course to be created for treating the muscle tension associated with Chronic pelvic pain syndrome.

I have been diagnosed with trigger points in the pelvic floor? Can DCT help?

Myofascial trigger points are a controversial concept. Myofascial trigger points as described by Travell and Simons have now been refuted. (6) No one doubts that people have sore spots that can create or refer pain but the theory of taut bands or myofascial trigger points has never been proven.

Many people have recovered from pelvic pain without internal trigger point treatment. Internal treatment is not necessary to recover from pelvic pain.

How is Resistance Stretching different to PNF

Proprioceptive Neuromuscular Facilitation (PNF) is a form of assisted resistance stretching that has been around since the 1940’s.  It was originally used in the rehabilitation of individuals suffering from paralysis and or muscle disorders because of its neurological effects on the body.  Proprioception is knowing where a joint is located in space.  For example, if you closed your eyes and someone lifted your arm out to the side and bent your elbow to ninety degrees you would be able to tell them that your elbow was bent without looking.  Neuromuscular facilitation is referring to the fact that ultimately it is signals from your brain that stimulate muscle contractions.  Here is how PNF is performed and the theory behind why and how it works.  The practitioner picks a muscle they would like to stretch on their patient/client like the hamstring muscle.  They then lengthen that muscle and ask the patient to resists against them using that muscle.  In the case of the hamstring, the patient would be lying on their back with one leg lifted by the therapist and they would be kicking their heel into the therapist’s hand for resistance.  The therapist does not let the leg move forcing the patient to hold an isometric contraction for 5-6 seconds.  The therapist then places their hands on the front of the foot/leg and asks the client to pull their leg towards their chest against resistance.  Again an isometric contraction is held for 5-6 seconds.  Finally, the therapist returns their hands to the heel and asks the client to relax while they move their leg into a deeper stretch.  The process can be repeated indefinitely continually providing more and more range of motion (ROM).  With PNF the range of motion that is gained is due mostly to a neurological effect where activating two groups of muscles that are in an agonist and antagonist relationship(means one muscle does the exact opposite action that the other one does) causes relaxation of tone in the target muscles.  As soon as the muscle undergoes stress the tone will return and the range of motion that was gained will be lost.  This does not mean that the method lacks value, actually, it is an extremely effective way to accomplish exactly what the name describes, “Proprioceptive Nuromuscular Facilitation.”  PNF essentially helps reestablish a connection between the mind and body relative to joint function at different ranges of motion.  This is very different than removing muscle tension, and very different in practice than DCT™.  DCT™ utilizes three different muscle contractions to remove tension from muscles.  Let’s compare the PNF hamstring stretch described above to that of a DCT™ exercise.  A DCT™ Practitioner would allow the client to perform hamstring extensions by resisting them at the heel but allowing them to slowly kick their leg down to the floor.  This is a concentric contraction that builds strength in the hamstrings of the client.  The concentric contractions will be repeated until the client begins to feel fatigue or a burn in the target muscles.  Once fatigued, the Practitioner will have the client hold an isometric contraction at the smallest range of motion (with the heel close to the floor).  The isometric contraction is used to further isolate the hamstrings and to make sure that the muscle tissue remains engaged as the Practitioner begins to push the client’s leg towards their chest against the client’s resistance.  This is an eccentric contraction and is actually the phase of a DCT™ exercise where tension is removed from a muscle. (See Lesson 3 in the How my Body Works section of our website)  A DCT™ exercise recruits muscle tissue that is around areas of tension (knots), maintains the activation, and then forces the muscle to pull against itself removing the muscle tension from the inside out.  This is a physiological phenomenon and has immediate and lasting physiological effects on the body

References

1. Chronic Prostatitis current concepts. Ram Vaidyanathan and Vibash C.Mishra 2010

2. Prevalence of a physician-assigned diagnosis of prostatitis: the Olmsted County Study of Urinary Symptoms and Health Status Among Men. Roberts Roberts, Lieber MM, Rhode T, Girman CJ, Bostwick DG, Jacobsen SJ.

3. Prevalence and correlates of prostatitis in the health professionals follow-up study cohort. Collins MM, Meigs JB, Barry MJ, Walker Corkery E, Giovannucci E, Kawachi

4. How common is prostatitis? A national survey of physician visits Collns MM, Stafford RS, O’Leary MP, Barry MJ.

5. Male Chronic Pelvic Pain Syndrome: Prevalence, Risk Factors, Treatment Patterns, and Socioeconomic Impact

6. A critical evaluation of the trigger point phenomenon Quintner and Bove 2015

7. Randomized multicenter feasibility trial of myofascial physical therapy for the treatment of urological chronic pelvic pain syndromes. Randomized multicenter feasibility trial of myofascial physical therapy for the treatment of urological chronic pelvic pain syndromes. Fitzgerald MP Anderson RU, Potts J, Payne CK, Peters KM, Clemens JQ, Kotarinos R, Fraser L, Cosby A, Fortman C, Nevlille C, Badillo S, Odabachian L, Sanfield A, O’Dougherty B, Hallke-Podell R, Cen L, Chuai S, Landis JR, Mickelberg K, Barrel T, Kusek JW, Nyberg JW, Nyberg LM.

8. Increased range of motion after static stretching is not due to changes in muscle and tendon structures. 2014 Jun Kondrad A, Tilip M.

9. Increasing muscle extensibility: a matter of increasing length or modifying sensation? Weppler CH, Magnusson SP. 2010

10. Equal Improvement in Men and Women in the Treatment of Urologic Chronic Pelvic Pain Syndrome Using a Multi-modal Protocol with an Internal Myofascial Trigger Point Wand Wise Anderson Sawyer Nathanson Smith 2016