By Cora Tomowich, MSc PT Hons BKin
When I talk about my work, most people automatically assume that my practice focus lies exclusively in the realm of women’s health. Although I do treat primarily female clients, I also treat men for pelvic floor issues. Yes, you read that correctly – men too! Everyone has a pelvic floor, and everyone has the right to ensure it is functioning properly.
Now you may be wondering what sort of issues a man could experience in the pelvic floor since women are the ones who have a lot more to deal with ‘down there’. True, there are notable differences in how men and women present with pelvic floor issues. Pregnancy, for instance, along with labour, menstrual cycles, and menopause are just a few of the challenges faced exclusively by a female pelvic floor. So, what about men?
Well, the following is a list of my top four reasons why men may also benefit from regular pelvic floor physiotherapy.
Reason 1: Pelvic floor physiotherapy is the gold standard for treating incontinence
One of the most common pelvic floor issues that I see in practice is urinary and fecal incontinence. These issues can happen to anyone of any age, regardless of gender. Incidentally, urinary incontinence, which is more common for women, still effects 1 in 9 men – which is far too many!
Pelvic floor physiotherapy uses hands-on techniques, breathing exercises, and the proper training of deep core muscles to reduce and eliminate the problem of incontinence. In fact, because pelvic floor physiotherapy has proven to be so successful in treating incontinence, many European countries have embraced it as the gold standard for helping patients avoid unnecessary surgery, regain bowel and bladder control, and re-establish a higher quality of life. If you wish to learn more about incontinence or how pelvic floor physiotherapy can help, please read my previously published article, 5 Things You Should Know About Urinary Incontinence.
Reason 2: Pelvic floor physiotherapy can help ensure everything else functions properly
A few male-specific pelvic floor issues that I have seen in practice include premature ejaculation and erectile dysfunction (ED) during sexual activity. Although these issues are fraught with social stigmas and misunderstandings, they tend to require a multilevel approach to treatment, not just oodles of medication.
Depending on the individual, one of the root causes to either premature ejaculation or ED could be poor blood flow to and through the pelvis and pelvic floor muscles. Since pelvic floor muscles surround and envelop the sexual organs and genitalia, blood flow congestion would absolutely interfere with the ability to obtain and maintain an erection during sexual activity.
Pelvic floor physiotherapy could be a very helpful strategy in managing these issues. For example, the simple release of tight pelvic floor muscles in the male pelvis could help reduce congestion and improve the flow of blood and other fluids to sexual organs. Also, the addition of simple breathing exercises that better pair the muscles of the deep core can ensure the normalization of intra-abdominal and intra-pelvic pressures during all activities of daily living.
Reason 3: Pelvic floor physiotherapy can properly address the underlying causes of low back pain, SI joint dysfunction, and core weakness
Although this is not gender-specific, a lot of pelvic floor dysfunction can manifest as low back or SI joint pain, sciatica, leg cramping, and core weakness. If you have exhausted all options related to managing these conditions, perhaps it is time to have your pelvic floor assessed and treated to better ensure that an underlying dysfunction in this area is not the true culprit.
In my practice, many men have found pelvic floor physiotherapy to be a huge help in eliminating longstanding low back or SI joint pain. A few clients have also reported that pelvic floor physiotherapy significantly helped increase their deep core strength and improve their weight-training or cardio performance.
If you are someone who likes to participate in whole-body workouts, endurance activities, and/or weight-training, perhaps a session with a pelvic floor physiotherapist can help prevent or eliminate low back pain, SI joint dysfunction, and ensure proper deep core activation. We can also suggest alternatives to some of the less-effective or more risky exercises seen in gyms today.
Reason 4: Male-specific pelvic pain can be properly addressed
There are many different ways that pain can present in the male pelvis. For example, chronic non-inflammatory bacterial prostatitis (CPPS) is just one condition that affects approximately 10-15% of the male population, and accounts for 11% of all annual visits to primary care physicians. These numbers may be less than the actual values when we consider that men are often more likely to under-report symptoms of pain and dysfunction. CPPS (formerly known as Prostatodynia) makes up 95% of all men diagnosed with prostatitis; and symptoms include painful ejaculation, increased urinary urgency and frequency, moderate to severe pelvic and low back pain, and the sensation that one is sitting on a golf ball.
Other male-specific pelvic pain conditions include prolonged painful erections lasting more than 4 hours and painful ejaculation in the absence of CPPS. Orchalgia is another condition whereby pain is localized in the scrotum and/or testes, while Peyronies disease is a painful penile deformity caused by fibrous tissue plaques that develop in the surrounding pelvic floor muscles.
In cases of male-specific pelvic conditions with underlying muscle or fascial restriction, pelvic floor physiotherapy has been paramount in reducing pain, correcting deformity, and repairing deep core functioning. Many male patients have also reported to me how helpful it was to learn more about how the pelvic floor works and how its treatment seemed to correct other seemingly unrelated issues, like postural instability and gluteal atrophy.
So, are you convinced yet?
Hopefully now you can see that men, from time to time, may also need a little pelvic floor TLC. No one should have to live with pelvic pain – ever! So ladies, if you are reading this, please share your newfound knowledge with your male counterparts. And guys, if you are reading this, please know that if you suffer from pelvic pain or dysfunction, you are not alone – there are solutions available to you! Feel free to contact me anytime if you have questions or would like to book an appointment… Until next time then… Cheers!
Learn more about Cora and how she can support your pelvic health.
- Faghani N. and Vandyken C. (2016) Pelvic Health Solutions [Level 2 Course]
- Potts J, MD. (2014) IPPS [Conference]
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