A Physical therapist specializing in Men’s Health has had extensive training in the urologic, reproductive and colorectal systems. A physical therapist can evaluate the musculoskeletal anatomy of the pelvis and spine to determine the cause for low back and pelvic pain which plague men in sports especially biking and running. Some diagnoses treated by physical therapists for men include fecal/urinary incontinence, “saddle numbness”, and rehabilitation following prostatectomy. Incorporating manual therapy techniques with EMG biofeedback to assess and treat pelvic floor muscle dysfunction enables the physical therapist to restore normal function of the muscle.
EMG/Biofeedback is used to create a permanent change in the muscles’ ability to respond to and function in their daily tasks. A patient can see on the computer screen the muscle activity with video/audio confirmation of a desired response such as a muscle contraction. Surface electrodes are placed on the pelvic floor and on the abdominals to assess muscular compensation. This is NOT electrical stimulation. You will not feel anything but will learn and see with the physical therapist if your muscles are very weak or in muscle spasm. EMG/Biofeedback is used to measure muscle activity and record muscle strength progression during rehabilitation.
Incontinence refers to the involuntary loss of feces or urine against your will. Along with leakage there may be other symptoms which include:
Urgency: a strong desire to urinate even when the bladder is not full. This is sometimes followed by pelvic discomfort or pressure.
Frequency: Urinating more that six to eight times a day or more than once every two hours with normal fluid intake.
Nocturia: awakening from sleep because of the urge to urinate. This is abnormal if it occurs regularly more than two times per night.
Stress Incontinence refers to sudden involuntary loss of urine when you sneeze, cough, walk, laugh or exercise. Urge incontinence occurs as soon as you get the urge to go to the bathroom. The sensation is over-whelming and your bladder muscle, the detrusor, contracts at the wrong time and you can’t control your urine. Fecal Incontinence includes the involuntary leakage of feces and gas. Weak pelvic floor muscles can contribute to the body’s inability to “tighten and close” the opening to the rectum. A careful muscle evaluation can identify the dysfunction and with proper muscle retraining bladder and bowel control and pelvic floor muscle strength can improve.
Saddle numbness can occur from excessive pressure applied to the pudendal nerve in the pelvis. Sitting for prolonged periods or trauma from forceful pressure can cause intermittent numbness or pain in the pelvic region. Physical therapy addresses these symptoms with a thorough evaluation of spinal and pelvic alignment and flexibility and muscle strength in the low back and pelvis. A combination of modalities with manual therapy and a home exercise program will promote decreased symptoms and increased function. Our specialists offer a bike fitting program which will ensure proper bike seat fit and joint mechanics.
Men often experience slow urine stream and difficulty initiating urine stream when diagnosed with an enlarged prostate. If diagnosed with prostate cancer and surgery is planned, men are going into a surgery with a pelvic floor dysfunction and are at a higher risk of urinary incontinence and impotence following the surgery. Physical therapists can assist with a pelvic floor muscle assessment PRIOR to surgery to prescribe an appropriate pelvic floor strengthening program for proper voiding mechanics. After surgery when the catheter is removed another assessment is made with EMG/Biofeedback to combat pelvic floor muscle atrophy following disuse after the prostatectomy. A detailed protocol and functional progression of a home program can help prevent urinary incontinence.