In order to understand what the cure for male pelvic floor dysfunction is, we first need to understand WHAT pelvic floor dysfunction really is. Most individuals look at their location of pain or issue as the source of the problem while it may likely be a result of an issue elsewhere. Pelvic floor dysfunction is a complex condition that when subtle in symptoms, most consider it a different issue and disregard the need for attention based on the severity of the symptoms.
In my experience, most men visit my clinic because their pain or limitations involves their penis, scrotum, or groin area. They typically ignore the issue until the pain is severe or it involves their sexual function. In this blog, I will go over:
- The simple anatomy of the area
- Explain what to look for in pelvic floor dysfunction
- And explore the comprehensive treatment options that I present to my patients with pelvic floor dysfunction
I strongly suggest that you visit my blog page for the most commonly asked questions and related topics.
Where Are The Pelvic Floor Muscles?
As stated in my blog, Are pelvic floor exercises the same as Kegel, ” The pelvis consists of the floor and the wall…”
Pelvis bones (courtesy of orthoinfo.aaos.org/)
Pelvic Floor
“The pelvic floor muscles line the bottom and the wall of the pelvis and are more than what is along the vagina or penis. The floor itself consists of 3 layers and the mistake in treating pelvic floor dysfunction is that the majority if not the full focus is on the floor but the floor does not sustain itself alone and is attached to the wall and influenced by what is attached to the pelvis. Focusing just on the floor is the reason why benefits from pelvic floor treatments don’t last long.”
Pelvic Wall
“On the inside, the pelvic wall consists of 2 primary muscles the piriformis and obturator interns which are hip stabilizer muscles. When working internally on the pelvic floor, the piriformis is not accessible and the obturator internus may be reached. Frankly, with the internal manual work, the length of the examiner’s index finger determines how far and well these muscles are reached. Working on the muscles of the floor should NOT be first on the order of treatment as strengthening the pelvic floor muscles without the pelvis being strong, and without addressing the ‘influencers’, its stability is a waste of time long term!”
If pelvic floor dysfunction was the name of a book, it would have many chapters and in our society and most of the world, most ‘chapters’ are often looked at as their own ‘book’. So let’s find out what the subtle and not-so-subtle signs and symptoms of pelvic floor dysfunction are.
What Are The Common Signs And Symptoms of Pelvic Floor Dysfunction?
As stated in my blog, the following are what most people think of when it comes to pelvic floor dysfunction:
- “Urinary incontinence
- Fecal incontinence or Bowel incontinence
- Prolapse of uterus
- Bladder prolapse
- Bladder pain syndrome or Interstitial Cystitis
- Hemorrhoid
- Feeling pain in the pelvic area with or without going to the bathroom
While the not-so-obvious sign and symptoms are:
- Lower back pain
- Pain in the back joints of the pelvis (SI Joints)
- Pain in the front pubic area
- Arched lower back
- Slouched lower back
- Slouched mid-back or hunchback
- Military posture with the chest pushed out
- A V-stance where the torso is positioned behind the hip joints on the side view
- Chronic forward neck
- Inability to bend down below the knees
- Habitually standing on one leg with the other leg bent
- Chronic one-sided pain in the lower extremity
- Hip pain on one or both sides”
Can Male Pelvic Floor Dysfunction Be Cured?
The best remedy to all issues is prevention and when it comes to pelvic floor dysfunction, regardless of gender, the ‘cure’ depends on the complexity of the problem, the length of time the dysfunction has existed, what tissues are damaged at an irreparable level, and how in- depth the treatment has been. Unfortunately, from my experience working with patients with musculoskeletal conditions, I see most if not all treatments focus on the area of pain and ‘malfunction’ and not address the cause AND the feeders of the cause!
As stated in my blog, Is Pelvic Floor Dysfunction Painful, ” The treatment of pelvic floor dysfunction regardless of the cause must include:
- Behavior modification which is always part of the solution list to all issues (your behavior about life changes how you do everything in life), is not going to correct any dysfunction fully but addresses some of the feeders of the problem.
- Postural Neurology: Movement is like a concert and the body parts are like the musicians; in that the musicians not only need to know their part but to know when to chime in and phase out. That means the pelvis and pelvic floor need to know how to ‘play’ with the rest of the body if they are to sustain their strength and integrity. This is what Postural Neurology is all about.
- Functional Movement: Common sense says that the most authentic way to move is the way babies move. After all, all babies from all over the world go through the same developmental stages of movement (Developmental Kinesiology) which means that we are hard-wired to move that way. So if the issue is movement-related or supported, then we should see how we compare to the way we moved as babies. All discrepancies are then highlighted and can be corrected through Dynamic Neuromuscular Stabilization (DNS) exercises which are baby movements.
- Kegels? There are machines like the Emsella Chair that do 400 Kegels per minute involving all of the muscles of your pelvic floor and not the ones that you hope to be engaging. Note that Kegel exercises are not for all types of incontinence and pelvic floor muscle issues.
- Breathing is what babies do automatically and that is what we need to do in order to sustain the bottom of the breathing apparatus, the pelvic floor!
- Internal manual work which ideally should be done to assess the muscles inside the pelvis BUT does not have to be done in all cases.”
Lifestyle and habits are factors to consider when it comes to all musculoskeletal and biomechanical issues. There are many blogs I have written on this subject that I encourage you to look into.
Dr. Shakib
Recommended Reading:
