Male Pelvic Health

The pelvic floor consists of a group of muscles acting like a "hammock" that runs between the hips (side to side) and from the pubic bone to the tailbone (front to the back). They are involved in bowel and bladder control and sexual function, though each patient typically presents with their own unique combination of symptoms. These muscles, like any other muscle in the body, can become tight or overworked, leading to any one or more of the following most common symptoms:

  • Difficulty starting urination or fully emptying the bladder
  • Urgency and/or burning with urination
  • Constipation/difficulty emptying the bowel
  • Passing thin stools
  • Pain during or after ejaculation
  • Pain in the anus, testicles, penis, or general groin area
  • The sensation as though you are sitting on a golf ball
  • Pain with sitting or exercise that is often relieved when lying down

Pelvic Pain

Pelvic pain can affect men at any age, but most commonly affects younger and middle-aged men between 20-50 years old. Men who suffer from pelvic pain and are seeking relief may have been referred to a wide variety of specialty physicians, such as primary care physicians, gastroenterologists, urologists, chiropractors and other pain management clinics. Common diagnoses for pelvic pain include urinary tract infection or prostatitis, which usually involves a course of anti-inflammatories and antibiotics, which may offer little to or no long-term relief.

Left with no definitive answers as to why they have pain or how it can be treated most effectively, many male patients are left feeling frustrated or depressed, as this pain can drastically affect their work life, personal life, and overall quality of life. It is typically at this point, that many patients seek out physical therapy for examination and treatment of their pelvic floor.

A physical therapy evaluation includes an assessment of the pelvic girdle and muscles of the pelvic floor. The most effective way to evaluate the pelvic muscles for men is rectally. Similar to a routine prostate exam by your physician, we are able to assess pelvic muscle tension and muscle imbalances, which are often one of the primary causes of pain and other above symptoms. Treatment can include breathing techniques, biofeedback to help relax tight muscles, inter-rectal manual work to lengthen the muscles, exercises to strengthen the muscles of the pelvic girdle, relaxation training and postural training.

It is also important for patients to understand that self-management and lifestyle modification are also key components to successful, long-term treatment of pelvic floor pain and dysfunction. We will provide you with all of the necessary tools and education to proactively and properly administer treatment at home to prevent and relieve potential future flare-ups.

Prostate Cancer Rehabilitation

Physical therapy BEFORE prostate surgery can be very effective in decreasing the time to improve the common problem of urinary incontinence after surgery. During a short course of physical therapy prior to surgery, we will ensure you understand how to perform "Kegels" or pelvic floor strengthening exercises correctly. Using biofeedback and other treatment techniques, we teach you how to strengthen your pelvic floor and core muscles to get you as strong as possible prior to surgery.

Physical therapy AFTER prostate surgery addresses any pain or discomfort you are having from the surgical procedure as well as education on strengthening and flexibility exercises for the hips, core and pelvic floor muscles to improve urinary incontinence

Other common pelvic conditions or symptoms treated with physical therapy include:

  • Increased urinary frequency
  • Constipation/difficulty emptying the bowel
  • Fecal incontinence (partial or complete loss of bowel control)
  • Pelvic pain following a hernia repair procedure
  • Pudendal neuropathy (pelvic pain caused by compression or irritation of the pudendal nerve)
  • Pelvic adhesions and scarring
  • Coccydynia (tailbone pain)