If you’re a man with what feels like pain in your pelvic area, you probably feel like you’re in trouble.
You have a musculoskeletal problem in an area that no one wants to touch (including you, because it reminds you too much of the dreaded prostate exam when you turn 40).
But this is exactly what the problem is in the majority of cases: your pelvic floor muscles are tight and they are causing rectal pain, testicular/penile pain, urgency, frequency, erectile dysfunction and constipation/diarrhea.
You have been treated in a silo (aka everything separately), mostly based on urology consults.
Because of where your symptoms are located, you’ve probably been put on endless rounds of antibiotics for an infection that has never “cultured positive.”
What men need to know about their pelvic health
My name is Carolyn Vandyken and my job involves listening to my patient’s story about both who they are and how pain has started to (or currently does) dominate their life. My role is to help them get their life back by understanding what tissues are affected, the context of their life, and the emotional pieces that circle their particular problem.
I have worked as a neuro, orthopaedic and a pelvic health physiotherapist. Despite my varying positions in the field, my patients have taught me to stop thinking in silos. Again and again I’ve seen the value in simply treat the person in front of me, including the messy emotional, social, and physical pieces.
The time has come where the evidence states that we can no longer draw a dotted line between the pubic bone, tailbone and ischial tuberosity’s and ignore the most important emotional and physical real estate in our bodies: the pelvic floor.
This specific area is what inspires me to wake up every day and pour my energy into my amazing calling. In order for us to have our basic needs met, sex, bowels movements, voiding, eating and drinking need to be normalized and pleasurable. Helping men and women normalize these all too common but overlooked problems ensures wellness in what is arguably the most important components of our lives.
“How did you get to this point? It started with stress, physical tension in your pelvic floor muscles that went unchecked, and some normal reflexes in your body that continue to sensitize the bladder, prostate and bowels.”
This old story
If you’ve experienced pelvic pain for a while now, I’ve heard your story hundreds of times. This is often how it goes:
Where to go from here
How did you get to this point? It started with stress, physical tension in your pelvic floor muscles that went unchecked, and some normal reflexes in your body that continue to sensitize the bladder, prostate and bowels.
To treat it, both the stress and physical tension in your pelvic floor needs to be addressed, as well as the sensitization of your entire system.
A biopsychosocial approach is the key to resolution. You can normalize your system again!
Unfortunately, the statistics for male pelvic pain are highly unreliable, since this is such an under-reported problem.
When it is reported, men often end up in endless urology clinics who fail to provide significant relief because it is not a primary urology problem; the bladder gets involved because the nervous system is hard-wired to talk to all of its neighbours in the pelvis—the muscles, bladder, prostate and bowel.
Coordination and teamwork are essential in this area, and when one area gets “messed up” (it usually starts with tension and the pelvic floor muscles) the other areas experience issues as well.
You’re not alone
It is estimated that one in six men have pelvic pain and one in nine men struggle with incontinence.
Approximately 50 per cent of men will have a diagnosis of prostate pain or infection in their lifetime, even though the prostatic fluid has never been positively cultured.
Work stress, relationship stress, and our fast-paced society are all major contributors to these problems. From an evolutionary perspective, we are hard-wired to protect our pelvis’ for the purpose of procreation and survival of the species.
It is time to recognize that this is not a frightening, overwhelming place to be but a natural progression from low grade, chronic stress in our lives.
This issue can be reversed and changed with appropriate strategies to manage stress, tension in your pelvic floor, and appropriate lifestyle changes, such as exercise and good diet.
A physiotherapist can help with all of this.
We get people moving, help them to make good lifestyle changes and treat the bits and pieces that are sore and overworked.
A healthy pelvic floor is an integral part to any man’s survival kit in today’s demanding world.
Don’t suffer any longer. Speak to a physiotherapist who has done extensive training in pelvic health rehabilitation.
Carolyn Vandyken is a pelvic-health advocate, author, educator and researcher who practices physiotherapy in Huntsville, Ontario. She teaches multidisciplinary audiences internationally about the importance of normalizing pelvic floor health in orthopaedic practice, urology practice, gynaecology practice, midwifery practice and nursing practice.