MEN’S PELVIC HEALTH
Certain men’s health issues, like Chronic Pelvic Pain Syndrome (CPPS, and also known as Chronic Non-bacterial Prostatitis), Pudendal Neuralgia, Levator Ani Syndrome, and Post-prostatectomy urinary incontinence, can benefit from physical therapy of the pelvic floor.
Men’s Health Issues
Men’s Health Issues which can cause pelvic pain include prostatitis, pudendal nerve entrapment, constipation, Levator Ani Syndrome (also known as coccygodynia) and post-prostatectomy urinary incontinence. Symptoms may include burning, pressure or aching in the rectal, groin, low back, buttock, abdominal or thigh regions. Symptoms may also include increased urinary frequency and urgency, painful urination and bowel movements, voiding dysfunction or pain with normal activities (i.e. walking, climbing stairs, lifting objects).
Treatments for men’s health issues include patient education to address bowel and bladder habits as well as diet and exercise. Physical therapy treatment may include manual therapy to target painful internal and external muscles. Trigger Point Dry Needling can eliminate taut bands in muscles causing pain., Modalities, including biofeedback for relaxation or muscle re-education, strengthening exercises and postural education may also be utilized.
Urinary Incontinence is the inability to hold urine. This represents another common men’s health issue that Orthopedic Physical Therapy specializes in treating. Normally, the bladder stores the urine that is continually produced by the kidneys, until it is convenient to urinate. Sometimes, as a result of accidents, certain infections, diseases or types of surgery, this complex and delicate process is upset.
Physical therapy treatment for urinary incontinence includes exercises for the pelvic floor muscles (Kegel exercises), biofeedback, behavioral training, and patient education. In mild to moderate cases, proper instruction in pelvic floor exercises should cure 70% or more cases in 3-6 months.
WOMEN’S PELVIC HEALTH
Pregnancy and Postpartum
Stress placed on the pelvic floor muscles during pregnancy and childbirth may result in pelvic pain, constipation, urinary and/or bowel incontinence, and painful sex during and after pregnancy. Hormonal changes in both pregnancy and postpartum may result in excessive joint motion and changes in posture, and muscles may become tight and fatigued, each resulting in pain and difficulty with certain movements. Working with a pelvic floor physical therapist will help to prepare the body for safe and effective childbirth, and address any dysfunctions that may occur during pregnancy or postpartum.
Pelvic pain may be caused by a variety of factors, such as pelvic inflammatory disease, direct trauma (i.e. low back injury, surgery, childbirth), habitual poor posture, sexual abuse or chronic pelvic inflammation (i.e. endometriosis, ovarian cysts). Often individuals note pressure, burning or aching at one or multiple structures, including the genitals, tailbone, hips, buttocks, and abdomen. Pelvic pain may also be accompanied by additional dysfunctions, such as painful intercourse, painful gynecological examinations, bowel and/or bladder dysfunction, decreased range of motion, and difficulty performing daily tasks and activities.
Urinary and Fecal Incontinence
The pelvic floor consists of muscles that attach to the pelvic bones in order to support the internal organs, control the release of urine, stool, and gas, and assist with sexual function. These muscles also work closely with the abdominal, back, and diaphragm muscles to stabilize the body during motion, as well as function to maintain continence in the presence of increased stress or pressure. Weakness, tightness and/or incoordination of these muscles can contribute to unwanted release of urine, fecal matter or gas. Additionally, the bladder may become ineffective at properly filling, resulting in increased urinary urgency.
Constipation, whether persistent or acutely onset, can be exceptionally disruptive to daily life and limit activity participation. Muscles of the abdomen, diaphragm, and pelvic floor work together with the autonomic nervous system to mobilize and expel fecal matter. Weakness, decreased tissue mobility, and/or incoordination of these muscles groups, along with diet and medications, may result in the onset of constipation due to decreased or ineffective fecal motility.
HOW CAN PELVIC PT HELP?
Following a thorough conversation and examination, your Pelvic Physical Therapist will work with you to establish a plan of care that addresses your individual needs as there is no such thing as a “one size fits all” treatment. Pelvic PT is a specialized branch of Orthopedic PT, and will assess the body as a whole. Evidence based manual techniques, exercise, education, and functional tools are utilized to address and treat the source of the dysfunction, and work to prevent the return of symptoms in the future.