Consultation and Treatment
Consultation and Treatment
Women’s - Men’s - and Pelvic Health Physiotherapists are a group of specially trained physios who have a special interest in the management of an array of conditions, for example:

  • Bladder/bowel health and continence.
  • Sexual pain/dysfunction.
  • Pelvic pain.
  • Pelvic Dysfunction especially complex lumbar spine, pelvis, and hip pain.
  • Faecal Incontinence.
  • Urinary Incontinence.
  • Prostatectomy: Urinary Incontinence, Erectile dysfunction.
WHY PELVIC HEALTH FOR A MAN?
As a man, you also have a pelvic floor. The pelvic floor muscle has both sprinter fibres (Fast twitch fibres) and endurance fibres (Slow twitch fibres).

  • It needs to be trained with other muscles like your abdominals and hip muscles, coordinated with breathing.
  • Your pelvic floor needs to be strong (exercise helps), but your pelvic floor also needs to relax. There must be a balance between work and rest.
WHAT IS PELVIC FLOOR DYSFUNCTION
Pelvic floor muscle dysfunctions include incoordination, spasms, muscle hypertonicity, muscle shortness, trigger points, scar adhesions, pelvic floor muscle weakness and issues with bowel and bladder functions.

During your physiotherapy sessions, you can experience emotional release, muscle soreness or short-term exacerbation of your pain. You must dedicate at least one hour per day to yourself to do your home treatment.
WHAT TO EXPECT DURING A CONSULTATION:
  • Firstly, we will take a thorough history asking personal questions about your sex life and toilet habits to get the full picture (do not worry, we have heard it all before and just want to help!) before moving onto a physical examination.
  • Education about bladder/bowel function in relation to the pelvic floor. How the pelvic floor relates to continence and how poorly functioning pelvic floor muscles may be contributing to bladder/bowel issues and driving some of your pain.
  • Normal bladder/bowel function and how to optimise this.
  • Optimise breathing, “core” function and muscle condition around the pelvic region.
  • The complex interplay between pain, sleep, stress, exercise, and diet. (Do not underestimate the simple stuff!!!).
TREATMENT PLAN:
Your management plan will be guided by what is found on assessment, considering each individual man’s treatment preference and goals. You know your body best, so we will collaborate and solve the problem together.
Treatment is focusing on the whole person with hands on physiotherapy treatment and exercises for both mind and body. Exercise alone will not set you on the road to a pain free life. You need to address your mind set and perform mental hygiene daily.

You are what you think!!!
Avoid negative self-talk!! Never give up on yourself!

By adopting a positive outlook, having the will to change the things you can and learning the options in the physiotherapy toolbox, you will be on the road to recovery.
Depression, stress and anxiety lead to catastrophic thinking and result in negative behaviours. Stress does not cause pelvic pain, leaking or inflammation but can make those symptoms worse.
Men who possess or develop a positive fighting attitude and learn to take control of their pain and pelvic floor issues have a good success rate of healing.
PHYSIOTHERAPY TOOLBOX TO TREAT THE MALE PELVIC FLOOR:
  1. Evaluate posture, lower back mobility and pelvic girdle alignment.
  2. Deep and superficial massage.
  3. Trigger point release:
  4. Myofascial release: Manual or with a foam roller, tennis ball, fascia gun/cupping or shockwave
  5. External and internal rectal examination with your informed consent checking for sensitivity and pelvic floor activation. For the deeper pelvic floor muscle spasm, the Physio wand can be used. https://www.physiowand.com
Exercises focusing on:
- Relaxation exercises
- Foam rolling
- Pelvic floor muscle relaxation exercises
- Diaphragmatic breathing
- Scar mobilising
- Stretching when appropriate
- Strengthening if weak
- Pelvic Wand uses to release pelvic floor tightness.


Transcutaneous electrical stimulation (TENS):
Transcutaneous electrical nerve stimulation has been used effectively for the purposes of decreasing pain.

Biofeedback:
Can visualize the pelvis floor muscle action on a computer screen.
Work out an individualized strengthening and / or stretching program and an appropriate exercise type/dosage.

  • Biofeedback tells you when your bladder and urethral muscles contract, to help you gain awareness and control of your urinary tract muscles.
  • This means that weak muscles can be better activated on demand, muscles that are too tense can be relaxed, and overall muscle activity can be coordinated.
  • Biofeedback can take different forms.
  • The physiotherapist's hand: can you squeeze your muscles round a finger.
  • Electromyography (EMG): electrical sensors are placed on the skin inside the anus to measure the electrical activity of your muscles at rest and when they contact. The reading is shown either on a graph or screen.


Stretching:

Your pain is NOT “all in your head,” and it is certainly not as simple as “just relax”! Persistent pain is very real and complex.

Living with pain can cause ripple effects to all areas of your body, your mind and your life and relationships; managing it often requires an integrated approach with an understanding multidisciplinary team and support network which hopefully involves a good Pelvic Health Physio.