Male Pelvic Floor Dysfunction: The Low Down on Down There

Maureen Mason DPT

Conservative Care with Physical Therapy:

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!

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.

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.

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