men’s health physiotherapy
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Male Pelvic Health is an important issue which is not discussed nearly enough.
Whether you are having pelvic pain, erectile dysfunction or incontinence, you are not alone!! And we can help!
Men’s pelvic health is an important issue which is not discussed nearly enough.
It is estimated that pelvic pain can impact up to 16% of men, and that 1 in 10 men will experience erectile dysfunction or incontinence in their lifetime.
Pelvic health related issues can significantly impact your sexual function and quality of life. Up to 50% of men who are struggling with pelvic dysfunction do not seek help. You do not need to live silently with pelvic dysfunction as there is treatment available.
At Resolution Physiotherapy & IMS Clinic in Barrie, our Pelvic Health Physiotherapists have specialized, post-graduate training in the assessment and treatment of male pelvic health disorders and can help restore your pelvic function.
If you are struggling with pelvic dysfunction, know that you are not alone and that we can help!
“Amazing experience @ Resolution. I was hesitant to start a physiotherapy program because I wasn’t sure what to expect for pelvic floor therapy; however, the process from the get-go was so smooth. Staff is friendly & extremely helpful. I was assigned with Beata and I don’t even know where to start - she is honestly the best. She works with you and encourages you throughout each visit. Her positive attitude is refreshing & I actually enjoy going to physio! If I could give Beata & the Resolution team a 10 out of 5 I would! I would 1000% recommend Resolution & if you are seeking reviews for pelvic floor - ask for Beata (if possible), you won’t regret it. Thanks Resolution - see you all soon!”
What issues can lead to Pelvic Dysfunction in men?
There are a wide variety of issues that can lead to pelvic floor dysfunction in men. Pelvic floor isssues in men may begin after trauma, surgery, or infection.
They can also be related to prolonged postures, exercise programs, or stressful events. The ability for the male pelvic floor to function properly requires effective functioning of the pelvic nerve supply, vascular supply and muscular system.
Pelvic Health Physiotherapy can help improve function in all of these systems, and help restore normal pelvic function.
Our team of Pelvic Health trained Physiotherapists have post-graduate training in male pelvic health and success helping men recover from pelvic dysfunction. Our Physiotherapists utilize a variety of validated techniques to help restore pelvic health function for our clients.
What male pelvic health issues can be improved with Pelvic Health Physiotherapy?
Prostatectomy related issues …
Prostate cancer is the second most common cancer in men, impacting an estimated 1 in 7 men. While surgical interventions are very successful, with up to 95% survival, there are serious post-surgical issues which may significantly impact sexual function and quality of life.
Post-prostatectomy incontinence
Post surgical incontinence is very common following prostatectomy, with up to 80% of men experiencing some level of incontinence which can last longer than 12 months. (Hodges 2020)
Continence requires coordinated functioning of the multiple layers of the pelvic floor muscles and communication from the complex pelvic neurological matrix. Radical prostatectomy results in injury to the pelvic floor muscles, injury to the local pelvic nerves, and a shortening of the urethral length, all of which often results in incontinence.
Our Pelvic Health trained Physiotherapists use research validated techniques to help strengthen the pelvic floor muscles and improve the health of the nerves thereby helping to restore bladder control and continence.
Post-prostatectomy Erectile Dysfunction
Erectile Dysfunction (ED) following radical prostatectomy is significant issue impacting up to 46% of men (Lima 2020). Erectile function is complex and is dependent on many mechanisms including spinal tracts, nerve plexuses, vascular function, and muscle function. ED which occurs following radical prostatectomy is related to the injury of the cavernous nerves, either through the need to remove these nerves or by nerve damage where the nerve plexus is stretched and compressed during surgery.
The ability to initiate and maintain an erection requires sufficient blood flow into the penis and an effective contraction of the bulbospongiousus & ischiocavernosus muscles which are pelvic floor muscles located near the base of the penis. The function of this whole system is mediated by the cavernous nerves.
Our Pelvic Health trained Physiotherapists use research validated techniques to help improve the health of the cavernous nerves, maximize penile blood flow and improve pelvic health muscle strength with the goal of restoring erectile function.
Non-prostatectomy related erectile dysfunction is increasingly prevalent with age, affecting approximately 40% of men at age 40 and nearly 70% of men age 70 (Cleveland Clinic 2018). Risk factors for ED include cardiovascular disease (CVD), diabetes, depression, alcohol use, smoking, pelvic/perineal surgery or trauma, neurologic disease, obesity, pelvic radiation, and Peyronie’s disease.
The development of an erection is a complex event involving integration of psychologic, neurologic, endocrine, vascular, and local anatomic systems. The ability to initiate and maintain an erection requires sufficient blood flow into the penis, an effective contraction of the pelvic floor muscles located near the base of the penis, and adequate functioning of the pelvic floor nerves which supply all these structures. As we age and in relation to various age related disorders, men’s blood flow, muscle strength and neurological function may reduce, resulting in a less functional erection.
Our Pelvic Health trained Physiotherapists use research validated techniques to help improve vascular function, muscle strength, and neurological function, thereby helping to improve erectile function.
Pelvic Pain
Pelvic pain is the most common urological condition impacting men under the age of 50 (Clemens 2008), with it impacting an estimated 8% of men (Krieger 2008). Chronic Pelvic Pain Syndrome (CPPS) is a disorder that significantly impacts the quality of life for men and for which too few men seek treatment. It is estimated that 66% of men are still experiencing pelvic pain 1 year post diagnosis (Greene 2020).
Pelvic pain can be located in the penis, scrotum, anus/rectum, perineum, lower abdomen, groin, sacrum, or tailbone. It may also produce a sensation of urinary urgency, frequency, difficulty urinating, constipation, difficulty or pain with emptying bowels, or pain during/after ejaculation.
The diagnosis and treatment of pelvic pain is complex and requires an understanding of multiple systems which could be contributing to this issue. Anatomically, the pelvic floor is made up of multiple layers of muscles and is supplied by a complex network of nerves, all of which could contribute to pain in this region. Pain could also refer from the lumbosacral spine or other visceral structures including testicles, prostate, bladder, urethra or gastrointestinal structures.
Our Pelvic Health trained Physiotherapists will determine the source of your pain and whether a referral to your doctor is required to rule out more serious disorders. Once any serious disorders are ruled out, our Physiotherapists will develop an individualized treatment program designed to reduce myofascial tone and improve neurological function and reduce super-sensitivity, thereby reducing pelvic pain.
Athletic Pelvic Pain
Athletic Pelvic Pain is a chronic injury to the pelvic/inguinal region. The reported incidence rate is between 3 and 23% in the physically active population, and can significantly impact an athlete’s performance and career.
Determining the source of athletic pelvic pain is complicated due to the complex anatomy in this region and the possible interaction of the hip joint, lumbar spine and pelvic region.
Our Pelvic Health trained Physiotherapists will assess the lumbar spine, hip and pelvic girdle/pelvic floor in order to develop an individualized treatment program that will address all issues contributing to pelvic pain, with the goal of resolving your pain.
Hard Flaccid Syndrome
Hard Flaccid Syndrome (HFS) is considered a type or pelvic pain and is characterized by a constantly semi-rigid penis at the flaccid state and a loss in erectile rigidity. It tends to occur in men in their 20’s or 30’s but may also occur in younger or older men as well.
HFS usually commences after some sort of trauma to the penis. It is theorized that this injury leads to damage to neurovascular structures, which then leads to sensory, muscular and vascular changes. HFS also leads to significant psychological distress which can further worsen symptoms.
Symptoms of Hard Flaccid Syndrome include:
consistent semi-rigid penis when in the flaccid state
penis feels rubbery
loss of full rigidity during erections
loss of morning and spontaneous erections
intermittent retraction of penis and/or testicles
penile skin changes
pelvic pain or supersensitivity
Treatment for HFS must be multifaceted and include down-training/relaxation of pelvic floor muscles, neuromodulation to improve the health of the nervous system, as well as stress reduction and relaxation techniques. Our Physiotherapists will develop an individualized treatment program designed to reduce myofascial tone, improve neurological function, reduce super-sensitivity/pain, improve penile relaxation and erectile function, and promote relaxation and stress reduction, thereby normalizing penile function.
How can our Pelvic Health trained Physiotherapists help you recover?
Our Pelvic Health Physiotherapists have specialized, post-graduate training in the assessment and treatment of male pelvic disorders.
Pelvic Floor treatment from our Physiotherapists may include:
pelvic floor muscle strengthening including manual, biofeedback and muscle stimulation techniques
pelvic floor muscle release/relaxation techniques
self-myofascial release techniques
radial shockwave therapy to improve vascular function, as well as reduce myofascial tone and adhesion
Gunn IMS with neuromodulation to help reduce myofascial tone, reduce pain and improve neurological function
education regarding the use of negative pressure devices to improve erectile function
education regarding stress reduction techniques
postural re-education with the goal of maximizing pelvic floor function
strengthening of all core musculature
treatment of any identified low back, hip or sacroiliac dysfunction
education regarding dietary, lifestyle and toileting habits which will minimize risk and maximize function of your pelvic floor
collaboration with extended healthcare team including urologists, gynecologists and family physicians
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