Editor’s Note: This story is Part 2 of a 2-part series on pelvic health. Part 1 covers pelvic health for women.
Pelvic health isn’t something most men think about – until they experience an issue.
“Male pelvic health services are generally very underutilized,” said Cory Sebert, a physical therapist with UCHealth SportsMed Clinic in Steamboat Springs. “The important thing is for men to know it’s okay to address these issues if they have them.”
Common issues: The pelvic floor is a collection of muscles at the base of the pelvis that stabilize the core and support posture and endurance, while playing a critical role in various bodily functions, such as holding and releasing urine and feces, and having sex.
Common issues that men experience include urinary or fecal dysfunction or incontinence, pelvic pain and sexual dysfunction.
“All of these issues can come back to the pelvic floor and whether the pelvic floor is weak or too tight,” Sebert said.
Oftentimes, the prostate is involved – for instance, treatments for prostate cancer may result in urinary dysfunction.
Hip or low back pain can also be connected to pelvic health.
“These problems do often exist together, as the whole system works together,” Sebert said. “Sometimes you can have weakness in the hips, which can contribute to significant pelvic floor weakness and then urinary and fecal problems.”
Getting help: Physical therapy can make a big difference, but men first have to seek help.
“There is stigma associated with these types of problems, so men may not want to talk about or address them,” Sebert said. “Getting people in through the door is the toughest part. After that, because these issues are so motivating, people are invested.”
Sebert encourages men to share any issues with their primary care provider or urologist, who can then provide a referral for physical therapy.
Older men are most at risk, as prostate issues develop over time and general weakness can result with age. Problems that crop up in younger men are typically neurological issues.
Lifestyle habits also play a role – chronic stress can cause tightness, lack of activity can result in overall weakness, and diet can drive or worsen issues.
“Not having a balanced diet that includes fiber can lead to or worsen fecal issues, while drinking bladder irritants can drive you to have issues with urinary urgency and frequency,” Sebert said.
The role of physical therapy: A physical therapy appointment starts with talking through issues, as well as bladder and bowel habits, diet and activity level, and then an exam to determine how the pelvic floor is firing. A biofeedback machine gives insight to muscle activity, highlighting when the pelvic floor muscles have too much or too little activity.
“Oftentimes, when someone comes in, pelvic health is a whole new concept – we review what the pelvic floor is, how it fires, and how to coordinate firing and relaxing without using other muscles,” Sebert said.
Patients follow a simple home exercise program, and return once a week or every other week to check in. It takes time to be able to find and fire these muscles consistently, so it’s important for patients to practice.
“Most patients are pretty motivated to do the program,” Sebert said. “The good thing about this type of treatment is it does work well for people. A lot of men don’t really know how to contract these muscles when they start treatment. When they learn that, they can see a big improvement in their symptoms.”
Sebert encourages all men to pay attention to their pelvic floor strength and health.
“Like your core, it’s an insurance policy that helps you prevent problems over time,” Sebert said.
Susan Cunningham writes for UCHealth Yampa Valley Medical Center. She can be reached at cunninghamsbc@gmail.com.
