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Men’s Health

posted on: Mar 16th, 2018 category:news, rehabilitation

by Amanda Swearingen, PT, DPT, PRPC

An often misunderstood part of the human body which can lead to multiple dysfunctions are the muscles of the pelvic floor.

The pelvic floor muscles are a group of muscles that attach to the bottom of the pelvis. They provide several functions including postural and organ support, bowel and bladder control, and sexual function. These muscles can create a broad spectrum of dysfunction that includes abdominal and pelvic pain, urinary and bowel dysfunction, sexual dysfunction, and post-operative issues.

Urinary problems can include incontinence (unwanted leakage), excessive urinary urgency, increased frequency, hesitancy, intermittent stream, or dribbling after voiding. Often times these issues are related to muscle weakness and/or excessive tension in the pelvic floor muscles.

If weakness or poor coordination is the culprit, the muscles can be trained to help decrease the chance of leaking or dribbling. In addition to strengthening the pelvic floor, increasing awareness of proper pelvic floor muscle isolation and contraction of the abdominal muscles can help eliminate symptoms.

Often times men experience bladder dysfunction after prostatectomy (surgery to remove the prostate) due to the loss of structural support that the prostate creates. Without this support, the bladder neck can become less stable and urine is more likely to escape. Studies show that strengthening the pelvic floor muscles decreases the amount of leakage men experience.

Conversely, muscles can also be weak due to excessive tightness. When pelvic floor muscles are tight, they can cause pain, compress nerves, or decrease sexual function. Common diagnoses that may stem from muscle tightness are urinary urgency or frequency, urinary tract infections, or erectile dysfunction.

Pelvic floor therapists help to guide men to release and relax the muscles in and around the pelvis, as well as increase awareness of muscle holding patterns. Therapists also manually stretch and release tight muscles and other soft tissue structures, improve neuromuscular control, and improve coordination.

In addition to bladder and/or sexual dysfunction, bowel (fecal) issues can arise from pelvic floor weakness or tightness. Constipation, fecal urgency, and fecal leakage are common diagnoses that can arise from pelvic floor muscle tightness or weakness.

When the pelvic muscles are excessively tight it impairs the ability to completely empty the bowels. By improving the control of these muscles during bowel movements, the sensation of constipation decreases.

Pelvic floor physical therapists may also use biofeedback– a computerized tool that analyzes pelvic floor muscle use– to assist in the re-education of the pelvic floor muscles. This is helpful for patients who struggle with awareness of the pelvic floor muscles, and assists in learning how to relax or contract the muscles appropriately.

As with any dysfunction, it is best to address any of these symptoms as early as possible. It may be hard or embarrassing to discuss symptoms with a healthcare provider, but, these issues are more common than one may think.

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