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Physiotherapy

Men's Pelvic Health

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‘Aren’t pelvic floor exercises just for women?’ Think again. 

In fact, there is a close relationship between the pelvic floor and male pelvic health, including sexual dysfunction¹, prostatectomy (removal of prostate) related urinary incontinence and pelvic pain², Non-Bacterial Prostatitis3, and Chronic Pelvic Pain Syndrome³, amongst other symptoms and conditions. 

The Pelvic Floor?

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The pelvic floor muscles sit within the pelvis, attaching to the pubic bone, tailbone, and sitting bones, and acting as a sling to support our internal organs. Their functions include bladder and bowel control, organ support, sexual health, circulation, and core strength.

Pelvic Floor Dysfunction

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When pelvic health symptoms are present, the pelvic floor muscles are either underactive or overactive. Underactivity refers to when the muscles are not contracting as efficiently as they need to be, and tend to be hypotonic (too relaxed) and weak. Overactivity occurs when muscles activate too much, and too frequently, which results in hypertonic (tight) muscles that over time, may become weak as well, as their state of hypertonicity leads to an inability to further contract.

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Pelvic Health Symptoms

 

  • Urinary incontinence, urgency, or frequency

  • Urinary retention or incomplete emptying

  • Pain with urination 

  • Fecal incontinence, urgency, or frequency

  • Constipation

  • Diastasis recti abdominis 

  • Sexual pain and dysfunction

  • Pain in and around the prostate 

  • Low back, hip, pelvic, sacroiliac joint, or groin pain 

  • Prostatectomy related pelvic health symptoms 

  • Chronic Nonbacterial Prostatitis/ Chronic Pelvic Pain Syndrome (CPPS)

How can Pelvic Health Physiotherapy help?

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A Pelvic Health Physiotherapist specializes in the assessment, management, and treatment of pelvic floor dysfunction and associated conditions. The initial assessment will include completing a detailed health questionnaire, which will enable your Physiotherapist to better understand your symptoms and health concerns. The physical exam will involve the assessment of the muscles, ligaments, tendons and connective tissue of the pelvis, hips, sacroiliac joints, low back, abdomen, and thorax. With your consent, an internal examination of your pelvis and pelvic floor muscles may be performed. An internal examination enables your Pelvic Health Physiotherapist to examine anatomical changes, symmetry to a contraction, muscle tone, and painful areas⁴. However, if an alternative is required, many external techniques can be performed to determine the root cause of your symptoms.

What does Treatment involve?

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Treatment is always tailored and specific to each individual. Your Physiotherapist will evaluate your health history, the physical exam findings, and your functional goals to determine the best course of treatment. Options may include:

 

  • Education regarding your symptoms, condition, assessment findings, and treatment plan

  • Bladder retraining

  • Constipation management and bowel retraining

  • Targeted manual therapy of the myofascial system

  • Visceral mobilizations

  • Pelvic floor muscle downregulation and relaxation

  • Pelvic floor muscle strengthening and training 

  • Motor control training and strengthening of the deep core musculature

  • Motor control training and strengthening of the abdominal wall, hips ,and thorax

  • Postural education and retraining

  • Diastasis Recti Abdominis retraining

  • Functional retraining of the neuro-muscular system to achieve movement and activity goals

  • Neuromuscular Stimulation of the Pelvic Floor

  • Liaising with your other healthcare professionals to achieve holistic and comprehensive treatment outcomes 

If you are unsure of whether Pelvic Floor Physiotherapy will help with your symptoms and condition, we highly encourage you to contact us for a 15 minute Free Phone Consultation. One of our specialised Pelvic Floor Physiotherapists will discuss your concerns with you, and help you determine whether this is the best course of treatment for you.

1. Cohen, B., Gonzalez, J., Goldstein, I. The role of Pelvic Floor Muscles in Male Sexual Dysfunction and Pelvic Pain. Sex Med Rev 2016 Jan;4(1):53-62. 
doi: 10.1016/j.sxmr.2015.10.001.
 
2. Scott, K.M., Gosai, E., Bradley, M.H. et al. Individualized pelvic physical therapy for the treatment of post-prostatectomy stress urinary incontinence and pelvic pain. Int Urol Nephrol 52, 655–659 (2020). https://doi.org/10.1007/s11255-019-02343-7
 
3. Van Alstyne, L.S., Harrington, K.L., Hashvitz, E.M. (2010) Physical Therapist Management of Chronic Prostatitis/Chronic Pelvic Pain Syndrome. Physical Therapy 2010 Dec;90(12)1795–1806, https://doi.org/10.2522/ptj.20090418
 
4. Navarro Brazález B, Torres Lacomba M, de la Villa P, Sanchez Sanchez B, Prieto Gómez V, Asúnsolo del Barco Á, McLean L. The evaluation of pelvic floor muscle strength in women with pelvic floor dysfunction: A reliability and correlation study. Neurourology and urodynamics. 2018 Jan;37(1):269-77. available from : https://www.ncbi.nlm.nih.gov/pubmed/28455942
 
5. Sherburn M, Murphy CA, Carroll S, Allen TJ, Galea MP. Investigation of transabdominal real-time ultrasound to visualise the muscles of the pelvic floor. Australian Journal of Physiotherapy. 2005 Jan 1;51(3):167-70.

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