Nutting Out Men’s Health

It’s Men’s Health Week!

Men’s Health is a topic rarely discussed and severely undertreated. It’s not until something goes wrong that we think about having an assessment and seeing what can be done, however the stumbling block is the first appointment. Knowing who can help and what can be done is difficult, but there are options - and physiotherapy is one of them.

What is Men’s Health?

Men’s health refers to any condition relating to the male pelvis, pelvic organs and pelvic floor. This includes the pelvic floor, bladder, bowel, prostate, penis and testes. A men’s health appointment can be booked for a variety of areas, including pre-/post-prostatectomy, erectile dysfunction, incontinence, pelvic pain and return to exercise.

The Nuts and Bolts - Anatomy of The Package

The male urinary and reproductive systems are very closely linked, and as such can be hard to understand how all of the parts link together.

The main male pelvic organs include:

• Bladder - a stretchable, muscular sac that stores and expels urine into the urethra

• Prostate - sitting just below the bladder, the prostate creates a fluid that mixes with sperm cells to form semen. It also contracts to help with ejaculation

• Urethra - a pipe-like connection that extends from the bladder, through the prostate and down the length of the penis. Both urine and seminal fluid travel through this tube

• Testes - creates and stores sperm cells, which is transported to the urethra via the vas deferens and epididymis

• Penis - the main male reproductive genitalia, which houses the urethra

• Bowel - for storage and excretion of faeces

The male pelvic floor has a few functions - erection, ejaculation and stopping the flow of urine or wind. When it contracts, the pelvic floor lifts in a few different directions which ultimately help to kink the urethra and close the bowel. If you’d like to give it a go, a few cues to help you get the right lift are:

• Stopping the flow of urine

• Holding in wind

• “Nuts to guts”

• Try to shorten the length of the penis

What Happens in a Men’s Health Assessment?

Deciding to seek help from a physio for your men’s health problems can be daunting at first, so this post will discuss what happens as part of an initial assessment. Keep in mind, every session will vary depending on the person and what their goals and needs entail – so take this as a general overview!

The “Chat”

All our men’s health sessions take place in a private room, so you can feel comfortable having a private discussion on your condition.

We will first ask about what has made you decide to book the consult, whether by recommendation of your GP or if you have particular concerns you wish to discuss. Once we understand your own personal goal for your rehab, we then ask about the history of your condition, what steps you and your doctor (or other health professionals) have already taken and your current condition.

We then ask questions regarding how your condition affects your personal and day-to-day life, in order to figure out where to begin management so that we have the best impact. We ask about the basics – what you do for work, your hobbies/activities, exercise habits and your home life. We also delve into more sensitive topics such as bathroom habits, incontinence and sexual activity. While we do understand that it can be an uncomfortable conversation, the details help us better understand your individual condition and assists us to form a comprehensive management plan.

The Exam

Your physio may ask to perform an assessment of your bladder control muscles, or pelvic floor. Don’t panic! This is done externally through underwear by palpating (or feeling) the perineum just behind the testes. This will allow us to confirm you are correctly able to activate your pelvic floor muscles and give further information as to the strength and endurance of these muscles. If you’ve never tried contracting your pelvic floor before we make sure to take the time to walk you through it. This test will only be done if you give consent.

From there we look at your body as a whole. We assess for muscle strength, length and postural control. We may also feel for tension or trigger points around the hips, pelvis and groin to ascertain whether they are contributing to your condition.

The Plan

This one is harder to answer, as your plan is modelled to fit your individual presentation. It can include muscle release techniques, stretches, mobilisation of the lower back, hips or pelvis, breathing exercises and postural retraining. You will most likely also receive a specialized exercise program for your pelvic floor and supporting structures. At all stages, your physio will educate you on the why’s and how’s of The Plan so that you stay motivated to keep on track.

And that’s it! The first step in the Men’s Health action plan.

If you have any questions or would like to see what we can do for you, we are more than happy to answer all your questions and get you booked in for your initial consult.