Men’s Health Physiotherapy

Mans Health with Sam Hughes Physiotherapy

Men have a pelvis too, and although not as common as women, they may present with pelvic pain, sexual and bladder symptoms that can be addressed and treated by seeing a pelvic floor physiotherapist

 Pelvic floor physiotherapy for men or men's health physiotherapy to treat pelvic pain, sexual and bladder symptoms. 

 

I have over 10 years of experience in the area of men's health physiotherapy. I treat men of all different ages with pelvic related problems or conditions, such as:

  • Pre and Post Prostate Cancer Surgery
  • Bladder Leakages (Urinary Incontinence)
  • Pelvic/ hip/ low back pain
  • Chronic Prostatitis or Chronic Prostate Painful Syndromes
  • Scrotum or Penile Pain
  • Erectile Dysfunction (difficulties maintaining erections)
  • Urgency and Frequency (Bowel or Bladder)
Men Urinary Incontinence and Prostate Cancer 

Urinary Incontinence and Erectile Dysfunction can be successfully treated after prostate cancer surgery! Although urinary incontinence usually improves after the surgery, a small percentage of men will continue to suffer from  it. This can be devastating to men and affect immensely their lives. 

Prostate Cancer Surgery is one of the main cause of urinary incontinence in men. During surgery the internal sphincter (the sphincter that involuntarily controls urine leakage) is usually removed. Loss of urine control will occur after surgery and might continue thereafter. The recovery process can be different for each men, most cases urinary incontinence is resolved anywhere between 6 weeks to 1 year after surgery.  

I have been treating men with urinary incontinence after prostate cancer surgery for over 10 years, and found that most of the time, men seem to overdo their "kegels". Part of my treatment is to educate and make sure that they are doing their best to help their bladder recover well, while encouraging positive behaviour that can help them gain continence as soon as they can.

Pelvic Floor Muscle Training (Kegels) can help treat incontinence but so many other factors can be contributing to a slower recovery. Finding out the root of the problem, is the most important thing. For example, if the cause of incontinence have and emotional or psychological component, and it is not addressed, incontinence may not improve just with exercise.

"The most important part of the treatment is connecting with my clients and understanding their struggles while offering my support and expertise."

To learn more about the surgery and what to do after to help bladder recovery click below to order my book "The Guide to Optimizing Recovery after Prostate Cancer Surgery". 

 

Pelvic Floor Muscles in Men

Pelvic floor muscles are located at the base of the pelvis and act as a sling supporting the bladder and rectum in males. The pelvic floor muscles plays a key role in controlling the bladder and bowel function, sexual appreciation, core stability, and helping to pump out the lymphatic flow of the pelvis. These muscles can sense whenever there is change in pressure (for example when you cough or sneeze) and contract to support the organs, at the same time clamping the urethra tube to prevent urinary leakages.

Pelvic floor muscle tension that can be generated by sports, stress, anxiety or depression can overtime cause bladder, bowel or sexual issues in men. 

 

Male Pelvic floor muscles anatomy

 

Why is  important to address the pelvic floor muscles, its ligament or fascia system? The pelvic floor muscles can be palpated internally, and not all physiotherapists have the training and expertise to be able to assess them. Some cases of low back pain, hip pain, pelvic pain, bladder symptoms such as leakages or urgency and frequency can be a result of a tight, tensed or over stretched pelvic floor muscles. 

 

HOLISTIC PELVIC HEALTH FOR MEN

 

Holistic pelvic health goes beyond assessing the pelvic floor musculature, its ligments or fascia: it also addresses the entire body or other contributing factors for the disease or condition. It treats each individual and body uniquely, with the goal of identifying key factors, which are affecting the pelvic condition.

Holistic health approach is addressing all the independent parts that can affect health (emotional, physical or psychological), and by addressing the part that is not working properly, harmony and wellbeing is established. Treating urinary incontinence, or pelvic pain holistically is addressing poor sleeping habits, strong emotional response to every leakage episode, GI inflammation, depression, etc... all components needs to be addressed to improve incontinence and/or pain.

Principals of Holistic Health.

  • Healing comes from unconditional support and understanding
  • A person is ultimately responsible for his or her own health and wellbeing
  • All people have healing powers
  • Healing takes a team approach, including the health practitioners and especially the patient
 
THE BODY AS AN EMOTIONAL ORGAN

I usually explain to my male clients how our body can carry or store emotions. It is common that our body can be affected by emotions, such as fear, fright, feeling of overwhelm, sadness or grief. Emotions usually is transient, but if your state of being is altered, and negative emotions are prevelant, it can affect the body in many different ways. There is a strong relationship between depression and anxiety with pain and incontinence

There are studies that show how we usually tense up our pelvic floor muscles during a stressful situation. Studies observered how the pelvic floor muscles were the first muscles to store tension during a fright episode while watching horror movies. "The pelvis stores emotions, history or trauma!" I find this correlates to what I usually see in my practice, especially in individuals who has long-term stress or anxiety. I noted how stress and anxiety is linked to a dysfunctional pelvic floor in men (mostly tensed and sensitive). Having a body reaction to a stressful situation is healthy and normal. But if stress is long-term and if you are unaware and continues to store tension in your body, eventually it will give you symptoms. Pelvic floor muscle tension symptoms can be as mild as an increase of urinary frequency to severe pelvic pain, urine retention and sexual pain. 

 

WHAT TO EXPECT DURING YOUR FIRST PHYSIOTHERAPY VISIT

You first visit with me can in-person or online via telehealth. We will have time to connect, talk about your history and symptoms and to discuss the contributing factors to your symptoms. My goal is for you to leave with information and strategies that you can start to work right away once you leave. Pelvic Health usually can be a sensitive matter, and it is important for me to take the time to have you feel comfortable and safe. I usually will not perform pelvic exam during your first appointment.

Follow-up appointments can be 1h and 45 min long. I will usually recommend all second visits to be 1h long and then 45 min after. Your second visit will mostly include a thorough physical examination that can include pelvic exam. Pelvic exams can include rectal examination, but it is not required for every visit. I will NEVER perform pelvic exams if you are nervous or uncomfortable with it. 

Please wear comfortable clothing and bring a pair of shorts. I highly recommend to book 3-4 subsequent appointments after your first appointment.