Secret men’s business
Physiotherapists are known for treating sporting and work related injuries, rehabilitation of orthopaedic and neurological issues, even cardiothoracic illness. We are less known for treating and rehabilitating men, women and children with bladder and bowel problems. Physios often rehabilitate the pelvic floor muscles as part of this treatment.
A man’s pelvic floor muscles are similar to a woman’s. They are skeletal muscles, voluntary muscles, with fast and slow twitch fibres that perform a variety of roles including:
A man’s pelvic floor muscles can become weakened for a number of reasons. Sedentary lifestyle, chronic coughing, obesity and chronic constipation have all been shown to be risk factors for weakened pelvic floor muscles. In women a big predictor of pelvic floor weakness is multiple vaginal deliveries. Blokes are spared from this but not necessarily from the need to strengthen pelvic floor muscles for other reasons.
Most patients being treated for low back pain would be taught pelvic floor muscle engagement. Another reason for reason being that the man with an enlarged prostate gland, whether malignant or benign may have spent a considerable amount of time straining and pushing out the urine prior to diagnosis and surgery. Another is that the nerves and blood vessels assisting control of bladder and bowel function may be damaged, usually temporarily, as a result of surgery.
Current prostate surgical methods are designed to “spare” the nerves and blood vessels to the muscles and other tissues in the area (just below the bladder) as much as possible. Pelvic floor muscle training is designed to strengthen the muscles and facilitate the return to continence.
There are other reasons a man may have problems with bladder and bowel control. The physiotherapist will take a history and perform a physical assessment to diagnose the source of the problem.
Real-time ultra sound enables the physio and the patient to see the pelvic floor muscles activating correctly.
With the patient’s permission the physiotherapist will liaise with the GP and/or surgeon.