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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 strong connection between the pelvic floor and male pelvic health. It plays a role in various conditions and symptoms, including sexual dysfunction¹, urinary incontinence following prostatectomy (prostate removal), pelvic pain², non-bacterial prostatitis³, and chronic pelvic pain syndrome³, among others.

The Pelvic Floor?

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The pelvic floor muscles are located within the pelvis, connecting to the pubic bone at the front, the tailbone (coccyx) at the back, and the sitting bones (ischial tuberosities) on either side. They form a supportive sling or hammock that helps hold the internal organs in place. In addition to providing organ support, these muscles contribute to bladder and bowel control, sexual function, circulation, and overall core stability.

Pelvic Floor Dysfunction

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Pelvic floor symptoms occur when the pelvic floor muscles are either underactive or overactive. Underactivity means the muscles do not contract efficiently; they tend to be hypotonic (too relaxed) and weak. Overactivity happens when the muscles contract too much and too often, resulting in hypertonic (too tight) muscles that can, over time, become weak because their excessive tightness limits their ability to contract further.

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In both cases, the muscles lose their ability to properly contract and relax, which disrupts their normal function. This dysfunction can lead to symptoms such as pelvic pain, urinary or bowel problems, and sexual difficulties. Overactive pelvic floor muscles often cause chronic tightness, spasms, and pain, making it hard to relax the muscles and control bladder or bowel movements, while underactive muscles struggle to provide adequate support and control.

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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 evaluating and treating pelvic floor dysfunction and related conditions. Your first appointment will include a detailed health questionnaire to help the therapist understand your symptoms and concerns. The physical examination will assess the muscles, ligaments, tendons, and connective tissues around the pelvis, hips, sacroiliac joints, lower back, abdomen, and thorax. With your permission, an internal examination of the pelvis and pelvic floor muscles may be conducted, allowing the therapist to evaluate anatomical changes, muscle tone, contraction symmetry, and any areas of pain⁴. If an internal exam is not appropriate or preferred, a variety of external assessment techniques can be used to identify the underlying causes 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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