Did you know that I work with males?
That’s right! Pelvic floor physiotherapy is not exclusively for women, and in fact, can benefit men in many ways. Just like with females, the unique male anatomy can lead to specific symptoms and conditions that the female counterpart does not experience. However, both sexes also share many similarities, and the pelvic floor challenges that both males and females experience may surprise you. As you continue learning more about male pelvic health in this blog, consider how these services may help your father, uncle, or husband.
In this blog, I will highlight the five most common conditions that I treat with my male clients as a pelvic health physiotherapist. We will also go over some examples of treatment options that can help address each condition. From techniques like manual therapy to specific pelvic floor muscle strengthening protocols, you will gain a general idea of what a treatment plan may look like.
Let’s get to some learning!
Prostatectomy Prehab & Rehab
Prostate - The prostate is a structure located beneath the bladder and above the pelvic floor muscles. The size is that of a chestnut and it only exists in the male anatomy. The function of the prostate gland is to produce a specific ingredient that is part of semen. It also plays a role in managing specific hormones including testosterone.
Prostate Cancer - Prostate cancer is the leading cancer in Canadian men. In 2024, the Canadian Cancer Society estimates that there will be 27,900 new prostate cancer diagnoses averaging 76 males diagnosed every single day. This means that 1 in 8 men will develop prostate cancer during their lifetime.
Prostatectomy - This is the name of the surgery performed to remove the prostate in order to treat prostate cancer. There are different types of prostatectomy procedures with varying levels and kinds of post-operative implications. Common symptoms that men can experience after receiving the surgery include:
Urinary incontinence (involuntary leakage of urine)
Fecal incontinence (involuntary leakage of stool)
Erectile dysfunction
Pelvic pain
Prostatectomy Prehabilitation - “Prehab” is a common term used to describe a process of improving function and measures in preparation for an upcoming surgical procedure. At Bespoke Therapy, an individualized prehab program for a future prostatectomy would include a thorough initial assessment to gain knowledge of baseline functioning, a customized exercise program, and comprehensive client education. The benefits of participating in pelvic health physiotherapy prior to a prostatectomy are significant. Physically, one would experience better post-surgical outcomes and recovery. Psychologically, you can expect to feel much more equipped and confident heading into and out of the surgery.
Prostatectomy Rehabilitation - After completion of a prostatectomy, pelvic floor therapy is pertinent. Studies demonstrate that early physiotherapy treatment can significantly improve urinary incontinence within the first three months. A pelvic health exercise program will focus on regaining pelvic floor muscle awareness, strength, and coordination. Investing time and effort into early post-operative rehabilitation can greatly decrease your risk of developing long-term complications including lifelong urinary incontinence.
Overactive Bladder
Overactive bladder syndrome is defined by the International Continence Society as experiencing urinary urgency, often alongside increased daytime urinary frequency and nocturia. Basically, the sensation of needing to pee is sudden and urgent, you pee a lot throughout the day, and you also need to pee a lot when sleeping. On top of this annoying strong desire to pee, you may also experience urge urinary incontinence (leakage of pee associated with the onset of urgency).
Scenario #1: Imagine…you walk into your local grocery store and BAM…you need to pee…like RIGHT NOW. You finally lay eyes on a washroom, pick up the pace, and the panic sets in.
Scenario #2: You are hanging out at home when suddenly you realize the time…30 minutes before you have to leave for an appointment. You think, “I better go for a pee right now.” You continue to get dressed…and now it is 15 minutes before you have to leave. “I feel like I could pee again.” Finally, time to head out, but wait…maybe you should pee once more before leaving...because you have a 20 minute drive ahead and you don’t know if there is a washroom at your destination. So…you go pee...again.
Scenario #3: In bed by 10:30 PM. Wake up at 6:30 AM. Eight hours of sleep. Sounds pretty good, except that you got up four times to pee. Just another typical night.
Do any of these scenarios sound familiar to you? Overactive bladder is widely experienced by both men and women, greatly affecting quality of life for many individuals on a daily basis. Although the presenting symptoms are all physical, this syndrome has a big connection to our psychological status. Many with overactive bladder report symptoms of anxiety. Some studies also suggest that the severity of anxiety is correlated with the severity of bladder symptoms. Pelvic floor physiotherapy programming would include bladder training, bladder desensitization, building pelvic floor muscle awareness, and case-specific lifestyle/behavioural adjustments.
Bowel Health
Although research suggests that constipation is more prevalent and reported in women, men surely do also experience these symptoms. Constipation can include low frequency of bowel movements, frequent need to strain, and hard/firm stool consistency. Experiencing prolonged constipation can have huge negative effects on other aspects of your pelvic health. It can lead to urinary issues, development of pelvic pain, or tissue injury (fissures and hemorrhoids).
Working with a pelvic health physiotherapist for constipation management can be a game changer. Your physiotherapist may go over the following key points with you:
Pelvic floor muscle strength and coordination assessment/treatment
Exercises to improve mobility of pelvic floor muscles during bowel movements
Proper evacuation techniques during your bowel movements
Dietary considerations for optimizing stool consistency
Hands-on techniques to encourage gut motility
When investigating structures and symptoms relating to bowel health, a rectal examination can be a very effective assessment tool. This type of assessment is completed for both men and women in order to gain an in-depth evaluation of the pelvic floor muscles and structures contributing to your constipation. Although this is a valuable step in the assessment process, if you are uncomfortable or wish not to have this completed, your physiotherapist will present to you an array of alternative options.
Pelvic Pain
As a pelvic health physiotherapist, I work with many male clients to address their symptoms of pelvic pain. Pelvic pain can be experienced when the pelvic floor muscles and surrounding structures are irritated. Do you experience pelvic/genital pain with any of the following?
During or after sexual intercourse/masturbation
During or after exercising
During or after a bowel movement
During or after urinating
Prolonged sitting or walking
When coughing or sneezing
In times of higher stress
Although pelvic pain can be caused by many different factors, a common finding at the clinic is that those with pelvic pain often have increased pelvic floor muscle tone (high state of muscle tension). Manual therapy to release muscle tension around the pelvis can greatly reduce discomfort. A tailored home exercise program will give you the tools to manage any flare ups and further reduce this extra muscular tension.
Sexual Health Concerns
Men and women share some similarities in their sexual health concerns, but there are several that are unique to males. It is often more difficult to seek professional help when it comes to sexual issues, but let's normalize the importance of addressing them! If you ever feel awkward bringing this up to your doctor or health care provider, try to remember that we deal with this all the time, and that we are human too! Don’t let this stop you from addressing issues that can have huge negative impacts on overall quality of life and relationships.
Did you know that pelvic floor physiotherapy can help with concerns relating to sexual function in males? Erectile dysfunction is the recurrent inability to achieve or maintain an erection. Premature ejaculation is the lack of ejaculatory control associated with distress. Both of these conditions are commonly treated at Bespoke Therapy.
Male sexual dysfunction increases with age. Some reports indicate that 50% of men aged 40-70 years have some degree of erectile dysfunction. And remember, some conditions and procedures can greatly increase your risk of developing sexual dysfunction like having prostate cancer and undergoing a prostatectomy!
As your pelvic floor physio, a thorough investigation into your health history is an important starting point. Followed by an exploration into current lifestyle factors that could be contributing to your erectile dysfunction, premature ejaculation, or pelvic pain. From previous injuries and sexual experiences to your current exercise regimen and diet, we will be touching base on topics that you would not expect to play a role in your sexual dysfunction (but do indeed)! Once a foundation is established, we will then move into our physical assessment portion of the appointment, evaluating measures like range of motion, muscle strength, points of tenderness, and sensation. All of these pertinent pieces of information will guide us towards developing the best treatment program tailored to your needs and goals.
If you are ever wondering, “when is it the right time to address my concerns relating to my sexual health,” let me tell you that the time is now. Addressing dysfunctions sooner than later will set you up for a better prognosis and decrease the risk of developing long-term issues down the road. Let's take action now, together!
So, after learning more about how a pelvic health physio can help with a variety of conditions affecting men, who crosses your mind? Your uncle? Your partner? Or perhaps it is yourself. And if you are wondering, “Is there even pelvic floor physiotherapy near me,” then you are in luck. We offer pelvic floor physiotherapy in Markham, serving clients right in the community and neighbouring cities like Pickering, Stouffville, Thornhill, North York, and Scarborough. And if you cannot make it in person to our clinic, virtual appointments are also offered!
Remember, you don't have to face these concerns alone. Your healthcare provider is your ally throughout this journey, offering guidance, support, and expertise tailored to your unique needs.
Your Next Step: Book an Appointment for Pelvic Floor Therapy
Book a complimentary 15-minute discovery call to ask questions or book an initial pelvic health appointment today. BOOK NOW.
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