Why men’s pelvic health mat­ters

Strong mus­cles around the hip and groin op­ti­mise body’s ba­sic life func­tions

Business Daily (Kenya) - - FRONT PAGE - Jemimah Ka­mau phys­i­cal ther­a­pist at C&P Health Centre, Karen

Men’s phys­io­ther­apy deals with male pelvic pain and or­gan dys­func­tion. The phys­io­ther­apy com­bines a unique skill set to as­sess and di­ag­nose prob­lems af­fect­ing the pelvis.

Who gets pelvic floor prob­lems?

Prob­lems af­fect­ing the pelvis or pelvic floor mus­cles could po­ten­tially hap­pen at any age. As we age the like­li­hood of the pelvic prob­lems in­creases.

How­ever, erec­tile dys­func­tion oc­curs in around 50 per cent of men with re­ported prob­lems in the sec­ond decade with an in­ci­dence of around 13 per cent. Over the age of 40 there is a re­ported in­ci­dence of a third of men suf­fer­ing uri­nary dys­func­tion.

Pelvic pain or dys­func­tion is not only as­so­ci­ated with older and less ac­tive men but it is also some­thing that may strike even the most ath­letic of per­sons. Ath­letes may de­velop symp­toms re­lated to their pelvic floor as a re­sult of their ac­tiv­ity. Hip and groin prob­lems are pro­lific in the am­a­teur and elite foot­ball do­main and poorly man­aged can lead to dys­func­tion in the pelvic re­gion.

The pelvis anatomy

Do men have a pelvic floor? They have a very stable and strong pelvic floor. The pelvic floor is formed by layer of mus­cle and con­nec­tive tis­sue formed and stretched like a cord from the tail­bone at the back, to the pu­bic bone in front.

We need to move pelvic floor, stay up­right, for ef­fec­tive and bal­anced agility, to main­tain an erec­tion, uri­nate and for bowel func­tion. There­fore, a strong pelvic floor op­ti­mises some of the most ba­sic of life func­tions.

The pelvic floor can weaken, be­come un­co­or­di­nated and even de­velop pain syndromes. Sim­ple and nor­mal daily tasks may be­come im­pos­si­ble.

Our pelvic as­sess­ment uses a sub­jec­tive com­pre­hen­sive ex­am­i­na­tion where we will en­cour­age di­a­logue from the pa­tient to dis­cuss their prob­lem in as much de­tail as pos­si­ble. The his­tory of any con­di­tion as told by the pa­tient re­veals much more than any test or ex­am­i­na­tion.

There­fore, this phase may take a lit­tle time to en­sure we get all the im­por­tant in­for­ma­tion down. Some ques­tions may be of a sen­si­tive na­ture. Ex­am­i­na­tion in­cludes the lum­bar spine, pelvis, hips and pelvic mus­cles. Most of the ex­am­i­na­tion will be ex­ter­nal but may in­clude di­rect pal­pa­tion of the per­ineum or in­struc­tion to the pa­tient to pal­pate their own per­ineum — sad­dle re­gion be­tween the anus and scro­tum. We may also pal­pate on the in­side of the pelvis.

This is by no means an ab­so­lute ne­ces­sity but re­mains the gold stan­dard for as­sess­ment of the pelvic floor. Dy­namic ul­tra­sound may also be used to achieve this.

In­ter­nal ex­am­i­na­tion, while use­ful, is not tol­er­ated by all pa­tients and is never forced upon one.

Once we have com­pleted both phases of the ex­am­i­na­tion we will then for­mu­late an ac­tion plan with the pa­tient and be­gin treat­ment.


What does men’s health phys­io­ther­apy treat­ment in­volve?

The fol­low­ing are ex­am­ples of treat­ments and in­ter­ven­tions used by our men’s health phys­io­ther­a­pist to man­age symp­toms of pelvic floor dys­func­tion:

• Pelvic floor mus­cle train­ing (strength­en­ing): This en­sures cor­rect pelvic floor ex­er­cise tech­nique which in­volves ad­dress­ing pos­ture and breath­ing tech­nique.

• Pelvic floor mus­cle re­lease: This en­sures full re­lax­ation of tight pelvic floor mus­cles which can con­trib­ute to pelvic pain and pelvic floor dys­func­tion. This also ad­dresses pos­ture and breath­ing tech­nique.

• Blad­der re­train­ing: This in­volves sched­uled void­ing tech­niques for the man­age­ment of blad­der con­trol is­sues.

• Man­ual ther­apy/trig­ger point re­lease: This helps to re­duce tight­ness and op­ti­mise func­tion of pelvic floor/ hip/groin and back mus­cles.

• Pos­tu­ral cor­rec­tion: Pos­ture is ex­tremely im­por­tant in ad­dress­ing pelvic floor dys­func­tion.

• Core sta­bil­ity train­ing: This in­volves spe­cific train­ing and reed­u­ca­tion of pelvic floor and core co-or­di­na­tion to pro­vide op­ti­mal pelvic sta­bil­ity.


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