case study extremely big problem. HELP SOMEBODY PLEASE....

somehow ive ended here after battling this injury for al most 6 months. im in my 40's . i had jelqed off and on and pumped for a month or 2. nothing serious. felt better, and hung better it seemed. no real serious gains expected. just wanted better bloodflow and quality.

one day, i jelqed a bit harder than i had been, but no pain, and jsut for a minute. next day i pumped and accidentally went more than i wanted. no pain. immediately released and red along the base of the shaft. within the day it was gone. several days later i woke up with a shrunken unit and slight numbess on the shaft. had all hard flaccid symptoms.

was scared, so continued making my self have sex,. after a month or so, it seemed it was subsiding. i still woke up in the morning with a chub. but everything shrank to nothing during the day.then it started seeming like if we had sex more than once a week, it would traumatize everything and destroy my libido and size again.

very sensitive glans with burning /cooling feeling. shrunk all day. no erections. no night erections. then it would come back a week later with her, and we'd have sex again. eventually i figured out we had to quit for awhile. 6 months later, here i am. we just went a month of nothing. i still walk around all day shrunk to nothing. we had sex 2 days ago and it was great, but now it seems to be overly sensitive again. only time i hang normally , is if i lay down in bed awhile. but soon after i get up, its all gone again.

sensitivity/nerve damage, seems likely, but not sure. nothing feels like me down there unless im hard. it doesnt seem like i did anything too hard/painful to cause this, but i obviously did. not sure if this will heal ever, but i cant take any more panic attacks and anxiety. its hard to make it to bedtime every day. its the only relief i get.

it feels like i have half what i did on a normal day now, with no arousal. ive also noticed a constant pressure moreso while shrunken, in my rectum /perenium area,that tightens when i flex my penis. i get decent morning/night erections sometimes, and sometimes not as much. but im sure my anxiety day to day is effecting that . i cannot masturbate to get hard since the 2nd month of this, due to it irritating the nerves it seems on the head. actual sex doesnt irritate it as much, but it still does.

i always have the numbness/sensitivity issue to some degree, but its super bad when its shriveled up and burns. im just not sure the nerves will heal, and i dont know what to do now. im mentally exhausted and depressed. i can barely force myself to work or do anything that involves moving. it lets me know every step of every day what ive lost.
 
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Does it make sense that when your leg falls asleep due to lack of flow, it’s super sensitive and uncomfortable if your leg gets bumped? And does it also have numbness associated with uncomfortable tingling? Sounds like the same concept to me.
oh i totally get it. im just not convinced either way just yet. if its not nerve related, im not sure how to explain the glans tenderness/flushing. but this is all too stupid to deal with anyway, so my mind is shot as it is. honestly , it almost feels like both scenarios at the same time
 
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oh i totally get it. im just not convinced either way just yet. if its not nerve related, im not sure how to explain the glans tenderness/flushing. but this is all too stupid to deal with anyway, so my mind is shot as it is. honestly , it almost feels like both scenarios at the same time
It is nerve related by virtue of your nerves being affected by your floor. However, if out-of-nowhere your glans feel perfectly fine for awhile, then it is not nerve damage.

Be of good cheer. This is good news. You’ve had a taste of relief that you’ve not seen since the onset of this monster. Praise God. You’re getting somewhere now.

I’d take a warm (not hot) bath 15 to 30 minutes daily between 98.6F to 104F. This will help relax your floor and increase blood flow. If your floor is hypertonic (which it sounds like it is based on previous testimony), muscle relaxers could be helpful, as well.
 
yes. it is good news. im nowhere to the end yet, but its progress. i felt some mild relief last night stretchig again. couple hours later she came to bed. within seconds of being with her, it was over. i was immediately hard and had sex for longer thann i could ever imagine i could anymore. 30 min or so. and i wasnt wanting to get off the whole time like normal. might have been a bad idea, but i couldnt stand it. felt amazig in every way. but i never got off. didt want to chance it.

overall, my glans feelig seems to have improved a bit. but it still feels a bit weird. the whole thing does at times really. it never really feels "fine" ,but its improving. the feeling in it seems to have improved a lot over last few months. i remember 6-7 ,months ago i couldnnt really feel it . crossing my fingers and see how today goes. last night sleeping, i felt great all the way to gettingn up this morning. but that can change in seconds
 
It is nerve related by virtue of your nerves being affected by your floor. However, if out-of-nowhere your glans feel perfectly fine for awhile, then it is not nerve damage.

Be of good cheer. This is good news. You’ve had a taste of relief that you’ve not seen since the onset of this monster. Praise God. You’re getting somewhere now.

I’d take a warm (not hot) bath 15 to 30 minutes daily between 9.8.6F to 104F. This will help relax your floor and increase blood flow. If your floor is hypertonic (which it sounds like it is based on previous testimony), muscle relaxers could be helpful, as well.
i metioned muscle relaxers 7 months ago. doctor said oh absolutely not. he also chuckled at me even beig able to hurt myself. theres just not much hope i can progress further. i had a good week last week. had sex 4 times. pretty strong at night too. then a burn came back with bad feelig again.no libido. shrunk all day /cold. night erections past 3 nights are crap. half way. i can fold them in half.
last week they were rock hard at night and very active. zero burnig. felt that blood flow in my pelvis a bunch. hung like a mule all day. reverse kegels happened strongly and with ease.

this week i struggle to find any postion i feel blood flow at all. very very depressig
 
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i metioned muscle relaxers 7 months ago. doctor said oh absolutely not. he also chuckled at me even beig able to hurt myself. theres just not much hope i can progress further. i had a good week last week. had sex 4 times. pretty strong at night too. then a burn came back with bad feelig again.no libido. shrunk all day /cold. night erections past 3 nights are crap. half way. i can fold them in half.
last week they were rock hard at night and very active. zero burnig. felt that blood flow in my pelvis a bunch. hung like a mule all day. reverse kegels happened strongly and with ease.

this week i struggle to find any postion i feel blood flow at all. very very depressig
Get a different doctor. You heavily edited my post (words) by mistake.

Do whatever you can to get unlocked, and don’t sit directly on your floor if you can help it.
 
i did. theyre all clueless though. nothig seems to help though. whatever it is just decides to change whenever it wants to. which is cruel and stupid confusing. ive made my mind up on this 15 times or more, and it keeps making me eat my words every time
 
It’s your floor. You were getting better, then you testified that sitting aggravated your floor again. Coincidentally, one of the suggestions when battling HFS is to avoid sitting for long periods. We now can see why.

Take a warm bath daily. Do your stretches. Try to stay calm at all times. Stay hydrated. Do whatever you can to unlock your pelvic floor. And sit in such a way so that you’re not sitting directly on your floor until this goes away completely.
 
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theres more here tha that. standig is much worse .somethig is clogged up in there, . been slowly degrading for 8 or 9 months now. up,down,up,down,repeat. the downs just keep hitting harder
 
i know how to do it. it was merely an accidental key stroke or somethig. try being me for a day if you want to see what a real problem is like
 
Don’t worry about it. It was just an accident.

I think the only “clogging” you’re experiencing is your locked pelvic floor. You’re almost always locked while standing, that’s why it feels at it’s worse while standing. It does unlock briefly during urination.

Sleep as much as you can. Do all the things you’re supposed to do, or should be doing, and try your best not to re-aggravate your floor.
 
PT today. she's confused as i figured shed be. no trigger points she could find. i was shrunk as always. its pretty apparent, ill stay this way until whatever day it decides to let me out again for a couple days of semi relax state. i guess this is the new life pattern. whatever flows inside me is the only time i get any sort of normal feeling . and i really dont even know if thats the way im supposed to feel cause its been almost a year since i know what it feels like. guess that means ill evetuallly get used to it. which is good ,cause it looks like im stuck in no dick land from now on. ill keep doing therapy, cause what else do i have to do other than work. i cant go do anything else cause this makes every activity literally unenjoyable. got zero interest in hanging out with much of anybody either. i ran a mile yesterday and every time i do this , it shrinks to even farther realms of small than you can imagine possible. very dark, and if i touch my leg with it, its cold as ice. awesome. well done idiot.
 
im just out of ideas and pretty tired. nothig i try seems to kick this. 2 weeks ago i really thought somethig was happenig. now im stuck right where i was again. 24 hr shrinkage is here again. i cant do anything to shake it. which seems to engage the stinging spot again. which wipes out most of my feelig in the glans. and sometimes, its not so much the shrinkage, but the absolute zero life/blood in it,or response to any mental stimulation whatsoever all day.. night erections have went south along with it. no size, no blood, glans doest even seem to fill up much like it did 2 weeks ago.

no amount of stretchig seems to open anythig up ever like it did previously. somethig died in me 11 months ago that day i woke up.. it trashed my drive or somethig somewhere. and ive fought tooth and nail tryig to get it back. and quite often i did. but it seems like the erection stregth and size have fallen off progressively with time. along with drive which started day one. the only thing that seems to hang around is the small tense soreness in my rectum.and needing to poop feels more prominet than it ever has. my penis is just never connected to me any more. maybe ill take a cialis today and see if i get Any response at all. ive exhausted myself totally to death. i have nothing left to give.
 
Okay, have you use the approach everyone has been contributing yet?
  • Warmth compress and hot shower. This mobilize the blood flow. Japanese like to soak in hot baths to move their blood for similar reason. If you don't like long hot shower or bath, then warm compress for your butt, specifically, your pelvic floor.
  • Do not spend too much time sitting, be driving, couch potato, or even hanging out. If you must sit, you must not cut your blood off around your hamstrings and glutes. May need to invest in special sitting pillows to decrease the amount of pressure off your hamstrings and floor. I sit on one of them right now.
  • Reverse kegels while doing warm compress. Everything points back to warmth, blood flow, and relaxation of the pelvic floor. We're going in circle on the subjects as we all see it.
  • Massaging device for the pelvic floor. If you don't like to carry the pillow everywhere you go, and you may like to sit to do things, how about investing in a nominal pelvic floor massage device? Go back and read the prior post for the devices.
  • Since we can't get and MRI or ultrasound to see what's being blocked, we're stuck. Push for it.
 
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nothing i do seems to help enough to matter. even when it does help. walking around generally makes me feel worse and shrunk except for 2 weeks ago when i seemed to have great flow and libido durig the day. still cant figure that out. once that went away, my size diminished again and my glans sesitivity issues /burning came again, and i just generally feel cut off feeling /flow wise. i know i have a slight nerve issue in the glans, but it has never bothered me too bad when my penis wasnt retracted in this state. sitting used to actually help. at the moment,i thik it only helps cause nothing is beig moved around


last night was weird really. i woke up with my same erection ive had every day for over a week now. it was garbage, small, and most important,the glans wasnt filled. and no matter how much kegeling i did, the glans never swelled at all. fell asleep. then woke up later with a decent chub. even though it wasnt a full erection, it had more mass than before, and mainly , the glans was fat again. and it responded to kegeling as it always has. i dont get it. had a mornig erection this morning(and full size) just layig with the wife as well. and it kegeled well also. now that im up, i dont have much going on other that this dull pressure deep in my rectum when i kegel.

i think my glans on top is missig a little feeling, but i can only notice it when its in this smallest state. walking around with a chub still makes me feel pretty great. but i dont know how to get that life back. and yea, i know this is going in circles. but it really is like that. and has been devastating to my body and mind trying to figure out why
 
and today really is not all that bad. i have a little over sesitivity issues,etc. but overall that doesnt really effect me that much if my junk is fat and plump as it normally was. but its not. its retracted and very thin and short. and i have almost zero connection with it when its like this. and cant get a single arousal out of it while like this either. i just now pooped cause it was starting to hurt, and i dont even really have to go all that bad. i had cialis yesterday, but ive yet to see any effect from it. i occasioally get the good weird flow feels, when i go from standing to sitting for a few minutes, but i rarely get any farther relief than that from it. a year ago, if id taken cialis, id have felt like a adult entertainment star all day. it was un real.

my junk is still all in there somewhere. i just cant figure out how to get it out. it was out 2 weeks ago. but something took it right away again. this is what really freaked me out early on. really alot. ive learned somewhere in there it comes back. at least mostly. i try to stay calm about it, but its stayig gone longer and cutting me off more than it used to it feels like. and trashed my sexual interest in anything sexual other than my wife(which is fine by me totally)

EDIT:i take back what i said about today not being bad. i had my normal sensitivity issues today, although a tad worse. after walking for a couple hours, its got me feeling worse than ever. this nerve spot is worse than ive thought apparently. itsalso causing me to tighten up rectal/deep internal penis. when my burning came back last week at the same spot, it was differet. it was actually a spot on the surface i could actually touch and feel the irritation. its always been ghostly, or internal until then. that lasted a day or 2 ,then i cant actually feel it with my finger any more. im not sure if thats a good sign or not, but ive been having a rough time since. this kills me thinking the nerves are stuck like this forever, since next month will be a year from my injury. it seemed it took so long for feeling issues to appear. and even longer to notice any repair happening....

SO... i just ordered a sleeve to wear for the time being. maye im underestimating how much the irritation is affecting me. maybe the nerves cant ever relax to repair while being constantly agitated whether i feel it or not. perhaps thats why i feel things the most in the morning after being at rest all night. and i swear ive had times i had really decent feeling. and it wasnt during times i had irritation going on that day. worth a shot i guess. i have nothing to lose at this point.
 
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Again, I am no doctor and I still would recommend a 3rd, 4th, and 5th doctor to review your case. I would say that if I were in your shoes, I would be doing 30 min a day with RED + NIR either with MOS RED or a pad. I have seen wonders with this for healing and I would recommend you try that for 60- 90 days and report back.
 
its in progress. it takes so long to even get in,and they see you for 5 min ,then down the road you go. this takes hours, and months to digest. they aint that interested, i use the red light currently.i cant say i see a difference whatsoever really.
 
im kinda starting to come around some days, but the feeling really does fluctuate very weirdly. its so hard to to go, i just gotta preted its not there some days. ive been pretty worthless the last week. but then my nightly erections got strong again after the last two mornins of light edging for a couple minutes. but its weird. last night, first iwoke up good and hard, glans wasnt very strong and didnt respond to kegel and had a faint numness to it. . then not long after, woke up with a nother one just as strong, glans seemed fat and had good response to kegel,felt good. . super dumb. then by morning, wake up with nothing going on at all really. which has never been the norm for me
 
I have never had morning erections but in a way your morning erections are proof you are getting better
 
i dont know about all that. i pray theres more healing to the feeling and flaccid bloodflow/libido. thats what really gets to me all day. so i can put this nonsense behind me
 
i dont know about all that. i pray theres more healing to the feeling and flaccid bloodflow/libido. thats what really gets to me all day. so i can put this nonsense behind me
Have you started doing kegels?
 
i do. have for 2-3 months. no idea if it helps. only 15 min-20 usually
. im doing decent at the moment. only thing that keeps me halfway normal is edging a few min every day, or sex. that has made my night erections fuller, and just general everyday feeling seem ok. my glans is just trying to heal it seems and my feeling is still lacking at light touch. if i ever get more sensitivity things feel like they will improve . its slow going though. im still not ejaculatig. i feel good enough im scared to chance it
 
Ke
i do. have for 2-3 months. no idea if it helps. only 15 min-20 usually
. im doing decent at the moment. only thing that keeps me halfway normal is edging a few min every day, or sex. that has made my night erections fuller, and just general everyday feeling seem ok. my glans is just trying to heal it seems and my feeling is still lacking at light touch. if i ever get more sensitivity things feel like they will improve . its slow going though. im still not ejaculatig. i feel good enough im scared to chance it
It is a long healing process but you'll get there
 
no kiddig its slow. very slow. during the day it the worst. i just cant keep a normal feeling long enough to not have anxiety. the weird, tip irritation trumps all other feeling most of the time,which makes it annoying as crap. and takes/distorts all my feeling away . ive tried normalizing this feeling but its so dang hard to do. sometimes i do. its a serious mental game
 
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no kiddig its slow. very slow. during the day it the worst. i just cant keep a normal feeling long enough to not have anxiety. the weird, tip irritation trumps all other feeling most of the time,which makes it annoying as crap. and takes/distorts all my feeling away . ive tried normalizing this feeling but its so dang hard to do. sometimes i do. its a serious mental game
Im sure it is a major head fuck but try to be patient and know this will clear things up just don't give up.
 
you have no idea. its impossible to under stand this feeling until its you. im making it. but im not happy about it.

one thing i find highly odd.. i had sex yesterday morning. for a good 30 min. then again last night. wasnt planning on the second time, jsut kinda happened. but through all of this, now when i get hard. im hard . used to , id get hard, then have to hurry up and get going or id start to lose it. sometimes id even have to go fast till i almost came, then back off. i dont understand it. but i dont understand any of this either.
 
It's not about trying to decript an unfathomable enigma. We already know what's going on and how it came about. The issues simply lingered for many years and final came bursting through from a PE incident. A comparative example is you have a bad knee, known about it for years, and you went a bit too hard on an activitity and broke your leg because your knee gave out on you.

What you've describing is a pelvic floor manifestation. Think about it slowly and clearly. Every time you try to initiate a series of active kegels to get your blood into your penis, your pelvic floor becomes stressed. As you plainly put it, when your pelvic floor is stressed, you have a limited time before your pelvic floor gives in and completely drains the blood out of the penis. Rather than initiate kegel exercises, the pelvic floor reverse kegels should be used to relax the floor as much as possible. If you haven't notice, you constantly initiate kegels naturally. When you pee, you instinctively perform quick twitch kegels to vacate the remaining volume in your bladder and cease the flow. When you sneeze or cough, you initiate kegels to prevent pee from coming out. When you walk, jog, or do sudden stop, you initiate kegels to prevent sudden release of pee. You'll be surprised how much kegels you perform daily by instinct.

It's no longer about just popping pills and wish the pelvic floor to heal by miracles. Miracles based on your forward efforts to get it to heal properly. You've gone to a pelvic floor therapist. Are you doing the same relax floor exercises consistently?

You indicated you use the red light therapy. Are you using it to shine at the bottom of the floor and not straight in from the public region? Light can't just magically bend 90 degrees. The devices have limited penetration level, and each device is made with different specs. If you have the MOS Red unit, make sure to lay down, spread your legs like wide eagles, allow the unit to come as close as possible to to your butt, shining direclty into the pelvic floor area. There's a limitation on how far the NIR+ spectrum can penetrate below the skin.

What about extra devices to assist with blood flow, such as cushions designed to take the load off the pelvic floor? Massage seat that literally massage your pelvic floor for 20 to 40 minutes? Stay off your butt from sitting too long to take the pressure off the pelvic floor.

You have to realize that you see this coming a mile away. Signs of immenent dangers were chiming throughout the years but you selected the ignore button. Now, we're helping you to put out the fires. Just be patient, do all that you can using every tools available, including supplements, and we'll do our best to cast nets out find more info to help you. No matter where search for info or ask questions, the same info and suggestions will come up, be from professional medical, physical, or therapeutical fields.
 
yes. i uderstand. still doesnt explain my distressed feeling glans and irritation and odd feeling all day. i never saw this comig at all really either
 
yes. i uderstand. still doesnt explain my distressed feeling glans and irritation and odd feeling all day. i never saw this comig at all really either
It's simple to explain a few things actually.

The cold hard feeling of the penile shaft and glans is due to the lack of fresh blood flow. During a hypertonic pelvic floor lock up episode, the blood is reduced to a level where the blood can't be released and enter the penis fast enough. You may have flaccid penis, but without that nice flow of blood to keep the penis warm and loose, you end up with cold and slightly hard penis.

When you had a shriveled up penis that looks like a little mushroom crowding up from the skin, that an episode of pelvic floor muscle dysfunction, where blood could not cycle and retain in the penis long enough. Sometimes, a combination of dysfunctions cause blood not to enter the penis and the floor locks up and prevent any blood from moving in at all. The penis attempts to preserve itself and skrinks to practically nothing.

The sporadic nerve misfiring is not a nerve damage but a pinched nerve at the pelvic floor. Think of it as phantom pains. Imagine your arm went numb from someone or something pressing on the nerve near your bicep and triceps. Not only your arm is numb, but your terminal nerve branches at the finger tips are numb and tingling like needles are poking you. This is what you are feeling. Pressure and kinking of the nerves by the tightness of the pelvic floor muscles.

My colleagues also recommend trigger point injections, where Botox is used to relaxed the tightness of the pelvic floor. They also recommend testing and scanning of the pelvic floor for other possible hidden issues. More a small population with the issue, they noticed that cycling while doing reverse kegels during the rides helped tremendously. Something to test for a few times at the gym.

You can get this just by being old, or an old injury decides to make your life a living hell. This happens to both men and women. You are not alone. PE may accelerated the manifestation but you are part of the Russian Roulette chance of life.
 
i dont know. lack of feels in the glans sure feels like damage to me. and it comes and goes with intensity, but the glans feels "puffy"/tender for lack of better description while masturating. sex the other morning was really good. later that night, the glans seemed over used, and i could hardly contain orgasming, due to high sensitivity.

only thing that seems to help me along in all areas seems to be using it and getting it hard every day, with occasional sex. otherwise, it just goes into a coma, and never comes out or responds all day to anythig
 
i dont know. lack of feels in the glans sure feels like damage to me. and it comes and goes with intensity, but the glans feels "puffy"/tender for lack of better description while masturating. sex the other morning was really good. later that night, the glans seemed over used, and i could hardly contain orgasming, due to high sensitivity.

only thing that seems to help me along in all areas seems to be using it and getting it hard every day, with occasional sex. otherwise, it just goes into a coma, and never comes out or responds all day to anythig
Nerve damage takes time to solve. Continue on what you are doing and be patient knowing it will heal
 
im wearing down. i try and try, and everythig jsut keeps backfiring on me. last week i had sex 4 times. got off twice. really thought i was at a mile marker it seemed. stretching seemed to open things a little. i felt fairly decent considering. i never feel "right", but i wasnt terri ble. i wake up fairly plump most days now. and my feeling is really ok before i get out of bed or at night. even got a little arousal during day at times. but its just so screwed up it wont stay that way for long.

i thought i had patterned sitting or driving causing the weird feelings of no penis. but at times, that doesnt even seem right. i dont get how a week ago i had amazing sex that felt ungodly good, but today at work, i dont even feel like a human again. this morning i masturbated, and while doing that, i feel so so much, and good. but yet i sit here now with a feeling of nothing, a disinct burn in the glans,and pressured pain wheni kegel.
totally freaks me out still to this day . waiting on these stupid doctors to get an MRI is a joke as well. sept, they say. i keep having hope a nerve will heal, and sometimes it really feels that way, until one day it doesnt again. my night erections are mainly still good. daytime is nothing at all unless i provoke it to . and my feeling in bed is as good as i get. but i feel like an alien during the day. i dont even know what right is supposed to feel like anymore, except this aint it. and ive had days that were substantially better that this.

so after a year now, im not sure there is any healing left to have???. i can only hope God will give me a little more than this someday. This is pure living HELL to try and cope with.
 
God is with you! Continue to pray for you recovery an I pray for you.
 
i did experiment with cialis last week again. this time i used 5mg . it didnt seem to improve flow at all last time. opposite actually. this time last friday, i felt a little improvemet by saturday. things felt like they were moving inside again /stretches opened up things a little. by sun, i felt sitting on pew at church was locking me up again. started stinging again. monday, i took another pill. i waited till thurs, didnt seem to have much positive flow effect. took another on thursday. hasnt been very good at all . worse actually. stretches seem pointless when i dont have positive flow feelings. it almost feels like after cialis wears off 2-3 days, it makes my penis even more distant, and lifeless. and then i get the burning again. im exhausted and so disappointed in this life.
 
Look into healing peptides like TB500 and BPC157.

I had a penis injury and an actual hole in my pelvic region. I had to pack it with gauze. Was an inch deep and an inch wide. Took over a year to heal. It was terrible. But there’s always light at the end of the tunnel. Long story short but I wish I would have known about these healing peptides sooner.
You took these injections in penis head where injury occurred..

Or you took it other part of body
 
Currently, my colleagues and I are stumped. There are way too much nuances and sub triggers. What you're describing for the past few months are like a golden goose of bizarre phenomena. They all voted on possible lingering nerve damages manifested from the recent injury, with possible plague hindering the circumflex blood vessels around the glans and mid penile shaft. They also brought up pelvic degeneration and tightness that also need to be assessed and addresses, but overall, ultrasound for the entire penile body by urology specialist is advised to discover the hidden monster or monsters.

One colleague indicated a possibility of a blockage for one of the veins, causing unique manifestation of phantom pains. The other indicated a possible rare intertwined of recovered blood vessel and nerve branch, causing a sporatic pressuring of the nerve, creating misfires. Think of sciatica.

All voted on ultrasound and shockwave therapy to initiate remedies since cocktails of pills are not working. The lingering symptoms have been going on too long to be just a normal injury.
Discuss my case with your colleagues tooo... And tell me some procedures to accelerate my healing process... Find more details about PShot and Shockwave therapy
 
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