All posts by 1wcspt

About 1wcspt

Pelvic Rehab, ortho and Pain specialist, Medical Yoga Therapist, Credential Clinical Instructor APTA, Integrative Therapy, member Academy of Integrative Health and Medicine (AIHM), Institute of Professional Yoga Therapy, National Institute of Complementary and Behavioral Medicine (NICABM), presenter on specialty topics in Physical Therapy

Male Pelvic Floor Dysfunction and PT

Male Pelvic Floor Dysfunction,

                       The low down on down there,

                                     Conservative Care with Physical Therapy

 

Maureen Mason DPT

Men come to Function Smart  PT for all sorts of pain problems, of the “usual sort”, such as low back and hip pain. But certain pain areas require a unique analysis in the realm of  PT:Pelvic Specialty.Male Pelvic Floor Dysfunction (PFD) may include pelvic pain, including the genital structures and or the rectal area, bladder and bowel problems, sexual problems, and difficulties with participation in activities as well as problems with rest due to discomfort.Here’s a little background on pelvic PT:

What is Pelvic Physical Therapy?

We have posted info on anatomy and Pelvic PT in this prior post, and this post will give you more insight on male concerns: First, the overview/medical screening and examination can find things that may cause pain into the pelvic area that may be referred from other areas! We have direct access for PT which allows individuals that have not seen a MD come to PT for screening and examination and treatment if indicated. Therefore we look for “red flags” requiring MD attention,or musculo-skeletal signs and symptoms that indicate appropriateness for conservative care with PT.

The abdominal muscles may refer pain into the genital area, and investigation of trigger points may reveal distant sites that spread pain into the pelvic area.Sports hernias, as well as post hernia surgery the muscles and scar tissue may radiate into the pelvis. Nerves can be under compression and cause all sorts of uncomfortable sensations. Bowel, bladder and prostate issues may cause pelvic pain. The prostate surrounds the urethra at the bladder neck, and is involved in urinary control and comfort, as well as sexual function. Often, multiple systems are involved with symptoms that lead to seeing multiple medical specialists.Investigating what is causing the problem is critical to finding the driver of the pain, and not just treat the symptom area!

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Lumbar and sacral nerve irritations can spread pain from the spine into the pelvic area.And the most hidden and misunderstood nerve associated with pelvic pain is the pudendal nerve, which has a loopy course from deep in the pelvis over and under stiff ligaments and into the perineum, supplying sensation and motor function and automatic (autonomic) control . Anything from rectal spasm to testicular discomfort to penile shaft and tip pain may be linked to pudendal sensitization.

Anatomy-01-Old_1.jpg

 

Myofascial systems such as the hamstrings, gluteals, deep hip muscles and pelvic floor muscles attach into the ligaments pictured here, and into the bony pelvis and may cause weird pains in the “privates”. Falls on the tailbone can leave someone unable to sit, and have pain with activities as well.

The bladder may be a source of pain and this may be from a genetic predisposition, from a disrupted bladder biome, from urinary tract infections, and or prostatitis, benign prosthetic hypertrophy, or post prostatectomy. Also poor bladder habits may be contributory.PT focuses on conservative care with protocols including Bladder training, biofeedback, myofascial and organ specific fascial mobilization, therapeutic exercise, yoga and meditation training, and pain management.

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Male pelvic cases we have helped over the past few years, with very grateful clients (these are private and complex matters) include:

Post vasectomy pain, post spine surgery bowel and bladder leakage, post prostatectomy urinary incontinence, urinary distress related to BPH, Interstitial cystitis/painful bladder syndrome, male fitness related groin, abdominal and pelvic pain, coccyx pain, post op colorectal surgery pain, constipation and abdominal pain, sexual dysfunction with penile/abdominal strains, ED,early ejaculation, pain with sexual function, and deep hip, hamstring and pudendal pain.

Feel free to contact us via our e mail on our “staff” Function Smart site, or call for a complimentary 5-10 minute phone Q and A as needed! 858 452 0282

 

 

 

 

 

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Pregnancy Pain and Physical Therapy

Pregnancy can be blissful and care free, or some women start to develop musculoskletal problems such as pelvic pain, back pain, hip pain, and bladder pain. Our national organization has links explaining pregnancy related physical therapy, and specifically pelvic pain, check it out: http://www.womenshealthapta.org/patients/

pregnant-belly-2-1431447-639x961Be an advocate for yourself and speak to your health care provider to obtain a prescription for specialty Pelvic PT, with goals to increase your comfort, confidence, safety, and fitness power during the pregnancy and in preparation for baby care. Direct access also allows women to come in independently for musculoskeletal screening, such as diastasis rectus abdominus testing, load transfer and body mechanics, sacro -iliac and pubic symphysis alignment, pain and spasm, and biomechanic analysis. (Also I screen for red flags such as high blood pressure which may sneak up on you). Pelvic muscles and the abdomen and spine can benefit from mini workouts and longer exercise routines as needed. Women who exercise at their own comfort level and capacity have better pregnancy outcomes in general re shorter labors and interventions.Also, binders, belts and belly bands may help and we can offer expert advice and equipment sampling.

Here is a direct quote from a recent systematic review of Physical exercise during pregnancy, Nascimento, S, Surita, F, and Cecatti J, Current Opinion, http://www.co-obgyn.com, Lippincot Williams and Wilkens; “Exercises during pregnancy are associated with higher cardiorespiratory fitness, prevention of urinary incontinence and low back pain, reduced symptoms of depression, gestational weight gain control, and for cases of gestational diabetes, reduced number of women who required insulin.”

The trouble with musculoskletal pain is, it may limit your ability to participate in activities of daily living as well as fitness programs. Feel free to call for a complimentary question and answer as you may need,

I often provide yoga and pilates exercises adapted for therapeutic purposes, to make programs fun and mind body spirit engaged. All the best to you,

stay fit and functional,

Maureen.mom of 2 girls!

Mind Body Skills: The Pelvic Floor

rock stack beach image Your pelvic health, is it “balanced”?

I am speaking this week at the Academy of integrative Health and Medicine AIHM17# , on The Secret World of Pelvic Physical Therapy. Some “secrets” I will divulge include:

1.Kegel Power (Pelvic Muscle Strength) does not always =bladder control, or continence.

2.A “Short Pelvic Floor” is a common condition, and it is too tight to function well! It may be associated with pelvic pain, bladder leakage or pain, constipation or bowel leaks,  pelvic pain with rest and play activities, and/or sexual problems.

3. Sexual  function may be improved with pelvic physical therapy!

4. Mind-Body Skills such as Medical Therapeutic Yoga, Meditation and Mindfulness Training can help improve quality of life, reduce pain, and provide a drug free “re-set”, all helping your Pelvic Floor with improved function. Respiratory exercises and daily health care routines established in therapy can enhance your well being.

Many people are shy about pelvic problems, and so are many medical professionals, so if you have a pelvic health concern, talk with your health care provider regarding conservative care with Physical Therapy.

Meditation, mindfulness training requires “practice”, I suggest my clients start with a comfortable position for 10 min per day, 3 x a week. Results are “dose related”.

https://health.ucsd.edu/specialties/mindfulness/programs/mbsr/Page

Pelvic PT for men and women; details:

http://www.womenshealthapta.org/patients/