Let’s Hear it for the Guys! Yes, They Have Pelvic Floors!

Men Have a Pelvic Floor?? And PTs Work with Men, TOO??

Yes, Men have a Pelvic Floor. The musculature and function is the same (basically!) as in women. A primary difference is that in the male pelvic floor, there are only 2 passages through, the rectum and in the urethra. The pelvic floor in men, as in women helps to maintain continence for bladder and for bowel, and helps to provide a stable base for the trunk or core, the hips, and the shoulder girdle. It is the base of the core and must work in combination with the entire system.  And yes, men can have pelvic floor dysfunction, pain, and leakage.

If you think that eyebrows are raised when discussing pelvic floor problems in women, it is even more so with men! When you come to Embody PT, expect some education about your pelvic floor and core anatomy. We want you to have knowledge about what some consider an “often mysterious part of anatomy.” Yes, we know that you are aware of the external genitals, but how does it all work? More importantly, why is it not working as it should and why pain?  It can be embarrassing and frightening.

“Men don’t tend to think about their pelvic floor, whereas women know a lot about their pelvic floor.” By the time a woman sees a  urologist because of incontinence she’s probably had several children and her obstetrician has recommended pelvic floor exercise. Men simply don’t have that experience.” From Roger R. Dmochowski, M.D.  Vanderbilt University Medical Center).  In one cohort study, the average time from onset of pelvic pain to diagnosis was 87 months!  In our practice, the average time from onset of symptoms to PT is 6-8 months. That’s quite a long time to deal with pain, uncertainty, leakage, and more!! Have the discussion with your doctor! And ask us! there are answers.

What are some of the reasons that you should work with a Pelvic Health Specialist? Here are a few of the diagnosis and concerns that we see at Embody Physiotherapy.

*Pelvic Pain. Feeling like you are sitting on a golf ball is not normal. Neither is pain in the scrotum, in the penis, or in the perineum. And definitely pain with intercourse is not normal. Having discussions about intercourse and pain can be uncomfortable, but it is important to address in order to help to resolve your pain. Pelvic Pain in men is often diagnosed as “prostatitis” or inflammation of the prostate, and is treated with 1 course of antibiotics or more.  Prostatitis is the most common pelvic floor problem for men younger than age 50, and the third most common problem for men over age 50. It affects 10-15% of the male population in the US. It is challenging to understand, and can create changes in your life because of the pain. It IS treatable with PT.

*Incontinence or urinary leakage. Often a side effect of prostatectomy (removal), “It has become evident from a lot of very well-done studies that the earlier we get men into therapy, the quicker their continence or urinary control returns.” Better surgical techniques, including robotic surgery, and earlier use of physical therapy mean that today, about 90 percent of men” become continent after prostate surgery. (Roger R. Dmochowski, M.D.  Vanderbilt University Medical Center)

*Urinary frequency, urgency, and leakage not related to prostatectomy. This can include post-void dribbling. Addressing the musculoskeletal system, coordination, breath and the pressure system, as well as behavioral and bladder training can make a huge change!

*Fecal incontinence and constipation. Yes, PT can help with both of these issues (and these concerns can also be related to any pain or incontinence you are experiencing.). Gi dysfunction occurs in men, and impacts on the pelvic floor and your body. We all need regularity!

*Back and hip pain. The pelvic floor musculature works with the abdominal, hip, spine muscles, and the diaphragm to form a “stable table” for movement and for function. It’s important to regain the teamwork of all of these muscle groups.  Often a PT not working with the pelvic floor is not aware of how all of the systems work together. Or they simply tell you to “do kegels” (hint: it takes a bit more than that!).  Often, men come to Embodycfor one concern, such as back or hip pain, and during the history they report their pelvic health issues….because we ask!  Often, we are not the first PT who has worked with them for the spine/SI/hip issues, but the first to pull it together

*Hernia management:   PT can help you manage the strain and pressure through the trunk and abdomen onto the hernia, preventing worsening.  After Hernia Repair surgery, specialized PT in the form of visceral mobilization  helps you retrain the system, regaining motion and strength, and improving mobility in the scar to decrease pain and restrictions. Please note, hernia scars and mobility are repairs should not be painful. If you are experiencing pain after 4-8 weeks, please ask!

*DRA/Diastasis Rectus Abdominus. Yes, men can have a diastasis. Often it is not symptomatic, but they might not like the appearance of the abdomen. Because the diastasis affects the pressure system (and in men, may be a result of how they have been using the muscles and training the core), if you are experiencing pelvic floor problems, back and/or pelvic pain or abdominal pain, the diastasis should be considered. As with women, PT will help you retrain the core and pressure system to decrease the strain through the tissues and to change how you recruit the muscles.

Our body is a really amazing machine. When all of the parts are working together in coordination and in unison, we can experience high levels of function, confidence in our body, and be painfree. But as with a piece of machinery or equipment, when one part is not working, it can affect the entire unit. Our job, working with you at Embody Physiotherapy is to assess the parts and to help to bring them back online in a coordinated fashion. If you’re looking for better function, less pain, and more confidence in your body, ask us. Our 20 minute consultation is free.


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