MEN'S PELVIC PHYSIOTHERAPY
Typically we hear of pelvic floor physiotherapy related to women’s health issues. But men have pelvis too! This population is hugely underserved when it comes to pelvic floor dysfunction.
This is partly due to decreased awareness of rehabilitative options for men and also due to the stigma that surrounds pelvic floor dysfunction. Men will often keep their symptoms to themselves and not talk about it!
Men’s health is a specific area of physiotherapy focusing on the management and treatment of pelvic floor dysfunction. Men’s health issues can appear at various stages of life from a young athlete to an older man. Male specific concerns can arise in youth, present during sporting activity or show up in the later years of life. It is also quite common following surgery.
The two main reasons why men seek out pelvic health physiotherapy are for urinary incontinence following prostate surgery and secondly they seek treatment for pelvic pain conditions.
Men will often have issues with urinary incontinence after surgery for prostate cancer.
Urinary incontinence, or leakage is to be expected after prostate surgery as the muscles (sphincters) responsible for bladder control are removed with the prostate. It may be mild, needing pads to manage it for only a few weeks, or more severe and requiring protective pads for up to a year. For a few men, incontinence remains a long-term problem.
The pelvic floor muscles control the bladder and flow of urine. Exercising them effectively can help men regain bladder control earlier. Ideally, the exercises are started before surgery, but they can also help bladder control if started after surgery.
Check out our blogs on pelvic floor dysfunction after prostatectomy:
Pelvic floor physical therapy is a niche and growing sub-specialty of physiotherapy that can be of benefit to men with urinary control and other pelvic issues. They serve a vital role in the rehabilitative process. Patients are taught to coordinate the use of their pelvic floor muscles with functional activities including exercise, sitting, standing, home and daily activities, sexual intercourse, etc.
Seeking a pelvic floor physiotherapy assessment before a prostatectomy surgery has a number of benefits for recovery. The pelvic floor muscles are hard to identify inside the body, so expert help will ensure best possible technique and training. It can boost confidence knowing how to do these exercises correctly. It can also be a difficult time waiting for the surgery and being proactive with pelvic floor muscle exercises can help men cope.
Numerous clinical studies have shown the benefit of pelvic floor muscle training to facilitate an early return of urinary continence following radical prostatectomy. In addition to hastening recovery of urinary control, pelvic training has also been shown to improve the degree of incontinence and the severity of other lower urinary tract symptoms.
Increasing your general fitness before radical prostatectomy can ensure a quicker recovery. Pre-operative physiotherapy can encourage the body to be in the best shape for having surgery.
Physiotherapists can also educate men on specific behavioural techniques to help train the brain and body to control urination. The muscles can get stronger and more effective for avoiding leakage if the bladder is trained to retain urine for longer.
If you or your loved one is awaiting surgery or has recently had a prostatectomy, consider talking with a pelvic health physiotherapist. Call us at The Physio Space and Integrative Wellness Center and book your complimentary discovery session with Chantale or Amanda, our Pelvic Health Physiotherapists. Together, we can work towards achieving your continence goals!
It is important to understand that pelvic pain problems may not necessarily be linked to pelvic floor muscles and should be properly assessed by a health care provider.
Male pelvic pain is more common than you think. It can affect anywhere from 3 to 10 percent of men (if not more) during their lifetime.
Pelvic pain can be described as ongoing symptoms in the pelvic area, abdomen, anorectal area, scrotum or testicles. There may also be pain with sexual activity, when passing urine or with a bowel movement.
You may have already been assessed by your primary care provider or urologist and have received negative findings. You may have had a diagnosis of chronic prostatitis and given antibiotics, but you still have pain. This can be both good news and frustrating news as the pain and symptoms remain despite the negative tests.
The absence of any infectious or bacterial cause will often result in a Chronic Pelvic Pain diagnosis.
There are many aspects to pelvic floor rehabilitation.
On the first visit, your physiotherapist will take a full history. We ask about your pain symptoms, your bladder and bowel function and we ask what your sexual activity is like. We talk about your exercise and lifestyle habits. It is a conversation that is needed as those things can all be affected by pelvic floor dysfunction.
Men with questions about any part of pelvic floor rehab can call or email the physiotherapist before the first visit to talk through any concerns. We provide a free 15-minute consultation service for all men prior to their first in person visit.
A physical check. Your physiotherapist will check strength, flexibility and range of motion in the back, pelvis and hips.
An internal exam. Often, your physiotherapist will do a rectal exam with a gloved finger, to feel whether the muscles are weak or in spasm, or have some other dysfunction.
At The Physio Space and Integrative Wellness Center, we develop a care plan with you based on our findings while taking into account your symptoms, goals and your preferences for care (i.e. prefer independence with home exercises vs frequent appointments for accountability).
Your treatment could involve hands on manual therapy, exercise prescription, education, lifestyle modifications, coping strategies, or referrals to our colleagues in our community as needed.
We check in with you every session to ensure we’re meeting your expectations. We also aim to support you and help you stay accountable while keeping your goals in mind.
You can call our reception at 613-429-9000 to book your 15-minute free consultation session with Chantale or Amanda, our pelvic health physiotherapists. During this 15-minute phone call, you will be discussing your pelvic health story as well as your symptoms and goals of care. From there, we will book you in for your initial, 1-hour pelvic floor treatment.
Seeking a pelvic floor physiotherapy assessment before a prostatectomy surgery has a number of benefits for recovery. The pelvic floor muscles are hard to identify inside the body, so expert help will ensure best possible technique and training. It can boost confidence knowing how to do these exercises correctly. It can also be a difficult time waiting for the surgery and being proactive with pelvic floor muscle exercises can help men cope.
We do not require a medical referral to see patients for pelvic floor physiotherapy services. However, certain insurance providers require a medical certificate or referral for reimbursement purposes. Please follow up with your insurance provider as to their specific policy of reimbursement.
All Ontario pelvic health physiotherapists have completed post-graduate training, which includes in person exams to provide internal assessments and treatment physiotherapy services. The College of Physiotherapists of Ontario requires physiotherapists to be rostered in order to perform internal assessments and treatments.
Our pelvic floor physiotherapist, Chantale Pryor, has also completed more advanced courses including Pelvic Genital Rehabilitation post vasectomy, circumcision, hernia repair and penile assessment and treatment as well as the Male Pelvic Health course.
Yes, if you have physiotherapy as part of your extended health benefits, pelvic floor assessments and treatments are covered.
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