PELVIC PAIN: IT’S NOT JUST FOR FEMALES

Dr. Nicole Freitas, PT

Females are not the only individuals that experience pelvic pain, in fact many males do as well. Some diagnoses that cause pelvic pain in males include: prostatitis, post prostatectomy or radiation for prostate cancer, pudendal neuralgia, coccydynia, levator ani syndrome, interstitial cystitis, and pelvic floor muscle spasms. These diagnoses are fear provoking in nature, however a pelvic physical therapist sees roughly 50% of males each day that are suffering from impairments like you. It is common for a male experiencing pelvic pain to feel nervous, confused, embarrassed and frustrated with their symptoms, but just like females that have great success with pelvic physical therapy, men do as well!

Some common symptoms experienced along with pelvic pain in males include difficult, painful or frequent urination, urinary incontinence, pain in the bladder, groin, scrotum, rectum, and/or abdomen, difficulty achieving and maintaining an erection, and painful ejaculation. This can be worsened with sitting, stressful situations, and after surgery; pelvic pain can be seen in men of all ages.

Pelvic physical therapy is a conservative treatment route one can take to improve their pelvic pain. Here are a few techniques a pelvic physical therapist can provide to assist in decreasing your pelvic pain today!

• Just like any other muscle in the body, the muscles surrounding your penis can become aggravated, leading to tightness and pain.
  • Although the pelvic floor may seem of primary concern, many hip muscles attach to the pelvis, contributing to pain and tightness of the pelvic floor. There is even a hip muscle that attaches internally, alongside the pelvic floor muscles, and when this muscle is restricted it refers pain to the pelvic region.
• A pelvic physical therapist specializes in the evaluation and treatment of these muscles and can come up with a treatment plan directed towards your individual needs. Every patient it different, however treatment to resolve your pelvic pain will be tailored around:

1. Soft tissue mobilization- to target those aggravated pelvic and hip muscles, bring blood flow to the area, and send signals to your nervous system that these muscles should not be pain provoking.
2. Relaxation techniques- for both the pelvic muscles and your entire nervous system.
3. Strengthening- to restore the optimal function of the pelvic, and possibly hip muscles that are contributing to your pain.
4. Evaluation of the hip muscles- unhappy hip musculature can contribute to pelvic pain. Sometimes pelvic pain stems simply from hip dysfunction. Relaxing the hip musculature can contribute to decreased pelvic pain.
5. Use of equipment- such as biofeedback and e-stim for relaxation or strengthening assistance.

Things You Can Do Right Now to Decrease Your Pelvic Pain

• Reverse Kegels- many individuals hear about performing kegel exercises to strengthen their pelvic floor musculature. However, they are not always the answer. Sometimes your pelvic floor muscles may be too tight or shortened and that can be causing pressure, pain or discomfort in your pelvic region. In order to increase blood flow and healing, Reverse Kegels can be performed to elongate the already tight pelvic floor muscles. Here’s how to perform a Reverse Kegel:
  • Lay down in a comfortable position.
  • Inhale through your nose allowing your abdomen to rise and your diaphragm and pelvic floor to expand. Think of your pelvic floor muscles lengthening and widening with each inhalation.
  • Breathe out through your mouth and allow the pelvic floor to return to resting state.
  • Practice this exercise 3 times per day for 3 to 4 minutes at a time.
• Stretches for pelvic pain- pelvic pain can be caused by tightness of the pelvic floor muscles, try these simple stretches to improve pelvic tightness!
  • Happy baby pose
    1. This stretch targets and lengthens the pelvic floor and hip muscles to relieve tension in the target area
  • Piriformis stretch (lying on your back or sitting upright)
    1. The piriformis is an important pelvic stabilizer, attaching to the front of the sacrum and inserting at the femur. Commonly, a tight piriformis causes pelvic pain
  • 3 way leg stretch
    1. The hamstrings, adductors and abductors of the hip attach to the pelvis. Not only are the pelvic muscles important to lengthen to improve pelvic pain, but relieving tension in these muscles are essential as well
  • Deep squat stretch
    1. Similar to the happy baby pose, a deep squat stretch improves pelvic pain by stretching pelvic pain and allowing for relaxation
  • Adductor stretch
    1. The adductors run along the medial thigh and attach to the pelvis. Targeting this area relieves unnecessary stress on the pelvis
  • Lacrosse ball release to target the deep hip rotators
    1. The deep hip rotators attach from the sacrum to the lateral hip and are commonly a cause of pain due to its close proximity of the pelvis. Using a lacrosse ball to target tension in these muscles allow you to apply mild to moderate pressure to the area to communicate to your nervous system to relax

Don’t be hesitant about beginning pelvic physical therapy to address your impairments! the PTs here at Inner Dynamics Physical Therapy see male and female patients every day and our goal is to get you back to doing the things you love, without difficulty or discomfort.