What Is Pelvic Floor Physical Therapy For Men?

Pelvic floor problems in men may show up as changes in bowel, bladder or sexual health, and they may even result in pelvic pain. Many of these difficulties are due to underlying muscle dysfunction and can be treated by a pelvic floor physical therapist.

“We know that pelvic floor muscles have to do three important things,” said Franciscan Health pelvic floor physical therapist Sarah Randolph-Kaminski, PT, DHSc. “The muscles should be able to contract, they should be able to relax, and they should be able to stretch, just like any other muscle. The ability to contract the muscles helps maintain bowel and bladder control (or continence), while the ability to relax and stretch the muscles is necessary to be able to empty our bowel or bladder. Sometimes with age, injury, or surgery, we lose the ability to have good muscle control. That’s where physical therapy can really help.”

In this article, Randolph-Kaminski explains what pelvic floor therapy is, signs of pelvic floor problems in men and how pelvic floor therapy differs for men.

What Is Pelvic Floor Therapy?

Pelvic floor therapy, also known as pelvic rehabilitation, is a type of treatment that can help people with various conditions that affect the muscles and tissues of the male pelvic floor.

“Sometimes we forget that men have pelvic floors too,” Randolph-Kaminski said. “Women get most of the attention because many of us choose to have babies and go through the trauma of pregnancy and delivery, but men have pelvic floor muscles and they can also have pelvic floor dysfunction.”

These conditions can include incontinence, constipation, erectile dysfunction and chronic pain. A pelvic floor physical therapist can help men improve their pelvic muscle strength and control, increase blood flow to the area, and reduce pain and discomfort. It may also help men improve their bladder control, bowel control and even erectile dysfunction.

What Are Signs Of Pelvic Floor Problems In Men?

Several signs and symptoms may indicate a pelvic floor problem in men, including:

• Frequent need to urinate. When you go, you may start and stop several times.
• Urinary or bowel accidents.
• Chronic constipation or straining to have a bowel movement.
• Painful urination.
• Pain in the lower back, genitals or rectum.
• Erectile dysfunction.

“Men may blame some of their early symptoms on normal changes with aging. One of these early changes that men will notice is urinary frequency and urgency. While some changes are expected, some of these men are going to the bathroom every 15 or 20 minutes, and that's a major impact on quality of life,” said Randolph-Kaminski. “Others are waking up 4 or 5 times a night to urinate, and they are just exhausted.”

“Male pelvic pain can also be quite disabling,” Randolph-Kaminski said. “This pain might manifest in some very uncomfortable ways. Patients may complain of pain or cramping in the lower pelvis, genitals, or even in the rectum. It may be worse when they sit for a long period of time or when they empty their bowel or bladder. As you might suspect, these can be very scary sensations.”

Consult with a healthcare provider if you are experiencing any of these symptoms as they can provide a proper diagnosis and treatment plan. A men's pelvic floor therapist is a healthcare professional who is part of the team that specializes in treating many of these conditions.

What Causes Pelvic Floor Dysfunction In Men?

Several factors can lead to pelvic floor muscle dysfunction in men, including:

• Age: As men get older, their pelvic floor muscles naturally weaken, leading to issues such as incontinence.
• Obesity: Excess weight can put additional pressure on the male pelvic floor, leading to weakness and other problems.
• Chronic coughing: Persistent coughing can lead to weakened pelvic floor muscles in males due to the repeated strain on the area.
• Prostate surgery: Some men who have undergone prostate surgery may experience weakened pelvic floor muscles as a result of the procedure.
• Chronic constipation: Straining to have bowel movements can lead to weakened pelvic floor muscles in males over time.
• Pain: Chronic back or hip pain may result in tense or tight male pelvic floor.

What Is Pelvic Floor Physical Therapy Like For Men?

A men's pelvic floor physical therapist can provide education and exercises to help men learn to strengthen, relax, and stretch the pelvic floor muscles to improve their function.

“Treatment for each patient is individualized,” Randolph-Kaminski said. “Sometimes we need to work to strengthen the pelvic floor muscles, especially if patients have undergone surgery or radiation. But more often, we are teaching patients how to relax and stretch the pelvic muscles. Many of the men may have an underlying orthopedic condition, such as chronic back or hip pain, which may have been the catalyst to causing symptoms. Unknowingly, the patients tense their pelvic muscles to ‘protect’ the painful area, resulting in genital pain and difficulty emptying their bowel and/or bladder.”

What Exercises Can Help The Pelvic Floor?

“One of the things that we find so very helpful and so very important is to learn to do what we call diaphragmatic breathing,” Randolph-Kaminski said. “That's a belly breathing technique that quiets our nervous system. It helps our abdominal wall expand, and most importantly, it helps our pelvic floor muscles to relax. When those muscles are relaxed, that helps with pain as well as those annoying sensations of constantly needing to empty our bladder.”

Should Men Do Kegel Exercises?

The answer is…sometimes.

Kegel exercises are pelvic floor muscle exercises that can improve bladder control, prevent incontinence, and may improve sexual performance and pleasure. These exercises can be performed by tightening and releasing the muscles that control urine flow in the male pelvic floor.

“I will often have my male patients stand in front of a mirror so that they can visualize the muscles working. It is important not only do contract the muscles, but also to give themselves time to fully relax between contractions.”

However, for many patients with bladder urgency/frequency or pelvic pain, kegel exercises can actually make their symptoms worse. “If your problem is due to tense muscles instead of just weak muscles, repeatedly contracting the pelvic muscles can be irritating to the muscles and result in more tension,” Randolph-Kaminski said. “In this case, you should seek out the advice of your physician or qualified pelvic floor physical therapist for more specific ways to learn pelvic muscle control.”

How Do I Begin Pelvic Floor Physical Therapy?

Franciscan Health offers physical therapy specializing in the pelvic floor. A physician referral is not needed. If you feel that you could benefit from a pelvic health evaluation by a Franciscan pelvic health physical therapist, visit our website at franciscanhealth.org/rehab.