Men’s health encompasses a wide range of issues that are specific to men and occur across the lifespan.
These include but are not limited to:
- chronic pelvic, testicular and penile pain,
- sexual dysfunction (erectile dysfunction, ejaculatory pain or pain during intercourse),
- prostate cancer, pre/post prostatectomy,
- urinary or fecal incontinence,
- bladder overactivity,
- abdominal hernias,
- osteitis pubis, adductor strains/sprains, and groin pain.
50% of men with symptoms of pelvic pain or dysfunction do not seek medical attention because of fear of the symptoms getting worse, embarrassment, and/or interruption to daily activities (Dorey, 2006).
While physiotherapy has been shown to improve functional outcomes for men’s health (decreased pain and improved continence), it is a specialized area of physiotherapy and additional training is required. Be sure to enquire if the physiotherapist you are seeing has taken extra training in this field.
Listen to Calvin explain our philosophy for Men’s Health in the video below.
What to Expect at Your First Pelvic Floor Physiotherapy Session
Telling Your Story is Important
A pelvic floor physiotherapy assessment begins much like any other physiotherapy assessment, that is, hearing your story. This will include a review of:
- medical and surgical history,
- functional abilities (and limitations),
- stress, anxiety and other psychological, social and emotional issues.
Specific questions pertaining to your bladder function may be asked including:
- frequency of urination (how often do you void and how much urine is produced when you do),
- pain with urination,
- urinary urgency (do you feel like you need to void more often than ‘normal’),
- leakage and (is there a specific event that makes you leak? I.e. cough, sneeze etc.)
- If pain and/or sexual function are an issue, questions around the behaviour of the pain (what aggravates, what relieves) or erectile function will be addressed.
These are very personal and sensitive questions for most, rest assured that your comfort and consent are of the utmost importance. We would appreciate it if you could have the answers to these questions ready for your first visit.
The Physical Examination
The physical examination includes a whole body assessment using the Integrated Systems Model. The assessment will aim to find the drivers (underlying causes) for pelvic pain and dysfunction to determine where to focus treatment. Typically, a postural assessment is done and muscle function is assessed. Pelvic muscle function (or dysfunction) can be assessed in a variety of ways which can include:
- observation of the abdominal wall and/or perineum,
- real-time ultrasound of the abdominal wall and/or perineum, and
- digital rectal examination of the perineum.
One, or a combination of these assessment methods, may be used during your assessment. The methods used are always based on your comfort and consent. Your physiotherapist will discuss all options with you during your assessment.
Take Home Message
You should expect to come away from the assessment with some knowledge of your condition and a treatment plan. If time permits in this first session, you will be shown techniques to use at home for symptom reduction as well as ideas for improving your posture and muscle strategies.
Subsequent treatment will address all the deficits found in this initial assessment with the aim being to provide you with the knowledge and tools to improve your musculoskeletal, urological and/or sexual function. Should you need, physiotherapists often work closely with urologists, physiatrists, colorectal surgeons, family doctors, sexual health therapists and psychological counsellors in order to create a comprehensive treatment plan to restore health.