Men's Pelvic function and dysfunction
If it’s not working like you want it to, you’re in the right place. Whether it’s wetness or dryness when it shouldn’t be, pain between the legs or difficulty in the bedroom, we can get you confident again.
Pelvic Health for Men on the Northern beaches
Historically called “Pelvic Floor” Physiotherapy but more aptly called “Women’s, Men’s and Pelvic Health” these days, this encompasses pain, injury, and dysfunction to both the internal and external urogenital and reproductive organs for men, women, and transgender folk. At Fixio this is exclusively practiced by our expert practitioner in Pelvic Floor Physiotherapy, Mason Neal.
what is pelvic health physiotherapy?
Pelvic Health Physiotherapy deals with everything internal and external between your legs, including issues in the bathroom and bedroom, as well as pelvic and genital pain experienced day-to-day, rehabilitation after surgery below the belt, and persistent pain conditions that cause pain deep in the abdomen and the pelvis.
Management of pelvic conditions varies depending on the kind of presentation – in some cases, traditional exercises prescribed in a deliberate manner can be a mainstay in pain management, but in other cases, exercises specific to the pelvic floor region, manual therapies, and relaxation exercises alongside behaviour change and addressing psychological or social factors can be crucial to resolution of symptoms.
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Pelvic health for blokes
Historically, people think of Pelvic Health for Men being for the elderly who have leakage or incontinence because of their prostate – and, fair, we do see both pre-surgery and post-surgery prostate cancer patients to restore bladder and pelvic muscle function, but Pelvic Health goes far beyond that.
Most things (apart from acute presentations of STIs) that feel wrong between the legs in blokes can be assessed, addressed, and treated with physiotherapy, including:
- Pre/post prostate surgery
- Incontinence (it can happen as early as in your 20s)
- Erectile Dysfunction
- Premature Ejaculation
- Overactive bladder syndrome
- Orchialgia / Scrotal Content Pain
- Pelvic Myalgia
- Penetrative Dyspareunia
- Peyronie’s Disease
- Hard-Flaccid Syndrome
Typically, initial assessments are external only unless there is specific pain in the back passage, which may require digital internal examination – otherwise everything stays external. Examination and assessment of the pelvic region is performed to determine how to best progress and treat, so having a support person or partner present can be useful for comfort and so that everyone understands what is going on.
Generally an injury will have a memorable moment where you did something to it!
Ensure that you book your appointment with Mace.
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What does a Men's pelvic health physio session involve?
Pelvic Health Physio is not wholly different from a typical physiotherapy session – at the start we discuss what has been going on, the history and effects of the issues, anything in your history that could contribute or make things better or worse, and some questions about your social and personal life, medications, and other health conditions.
The primary difference is that, as the name suggests, assessment involves the pelvic region. This is typically an external examination, however in men with penetrative dyspareunia and internal-specific pain, and women with vaginismus, pelvic myalgia, and pelvic floor weakness, internal examinations may be required to better understand your condition. This will be discussed with Mace through the session and separate consent will be required due to the nature of the assessment compared to traditional physiotherapy.
Please ensure that when booking your appointment that you request to see Mason Neal, our expert physio in Men’s Health.
Treatment depends on the nature of your condition, however common treatment strategies for pelvic health presentations include:
- Education and behaviour or habit changes
- Massage and manual therapies to surrounding muscles
- Mobility and flexibility exercises to the back, hips, and groin
- Pelvic floor strengthening or relaxation exercises
- Bladder training and bladder and bowel (including food and fluid) diaries
- Sex-specific exercises before and during to assist with dysfunction
- Gender-specific strategies to assist with improving co-ordination and sensation of pelvic floor muscle utility
- Scar massage and desensitisation
- Progression of loading and activity to return to work, gym, and sports
FREQUENTLY ASKED QUESTIONS
Yes!
Female Pelvic Health Physiotherapy is what people traditionally thing of when they think of below-the-belt issues – ranging from pregnancy-related pain in the back and pelvis, prenatal physiotherapy to assist with changes in body size, pelvic dynamics, and bladder and bowel changes, and post-pregnancy rehabilitation to restore normal bladder and bowel function, reduce puerperal (post-delivery) pain and sensations of weakness or “instability” around the pelvis, and return to day-to-day life including work, gym, and sport.
Outside of pregnancy-related conditions, Pelvic Health Physiotherapy addresses both painful and frustrating conditions that can affect day-to-day life and bedroom endeavours, including:
- Endometriosis and PCOS
- Urinary Frequency and Urgency
- Proctalgia Fugax
- Pudendal Neuralgia
- Pelvic Myalgia
- Vaginismus and Penetrative Dyspareunia
- Vulvodynia, Vestibulodynia, Vaginodynia, and Culpodynia
- Pelvic Mesh and Fibroid Removal Rehabilitation
- Persistent Genital Arousal Disorder
Some of these conditions require external (and in some cases, internal) examination of the pelvic region during the initial assessment to adequately determine how to proceed and treat, so it is recommended to bring a support person or partner for the initial session to help with comfort and so that everyone involved understands what the rehabilitation may entail.
Yes!
To assist with minimising gender dysphoria, physiotherapy is involved in the care of transgender people both before and after gender-affirming surgeries, as well as those who identify as transgender but don’t elect for surgeries. Transgender-affirming services offered include:
- Chest binding best practice and pain minimisation
- Tucking best practice and pain minimisation
- Chest feminisation surgery rehabilitation
- Chest masculinisation surgery rehabilitation
- Neovaginoplasty rehabilitation and dilatation
- Phalloplasty (particularly Radial Free-Flap Phalloplasty) rehabilitation
This is in addition to the gender assigned at birth conditions mentioned in the male and female sections above that may occur. Because some of these transgender-specific and other pelvic health conditions can be dysphoric, it is recommended to have a support person through the sessions for comfort, as well as bring any support or structured garments you regularly use.
Pelvic Health Physio sessions are 60 minutes typically for the initial session, and then depending on the complexity of the case, follow-ups can be 30 or 45 minutes, however Mace will discuss in the initial session what the follow-ups will entail and how long they’ll take
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