Physiotherapy for PELVIC FLOOR EXERCISES IN MEN


Bismillahirahmanirahim.....


OBJECTIVES

At the end of this lecture every one should be able to describe
·         Why pelvic floor muscles get weak in men.
·         How to check pelvic floor muscles in men.
·         How to perform pelvic floor exercises in men.

INTRODUCTION
The pelvic floor consists of layers of muscle that provide a‘hammock’ or ‘sling’ from the pubic bone at the front to the coccyx at the back. Its function is to support the pelvic organs—the bladder and rectum, helping to keep these structures in the correct position and to keep the bladder and back passage outlets closed. This prevents the leakage of urine or faeces and acts as a safety mechanism in men.

WHY THE PELVIC FLOOR MUSCLES GET WEAK
The pelvic floor muscles can be weakened by:
·         some operations for prostate disease
·         continual straining to empty your bowels, usually due to constipation
·         a chronic cough, such as smoker’s cough or chronic bronchitis or asthma
·         being overweight.
·         persistent heavy lifting
·         Neurological damage (e.g., after a stroke or spinal injury, or resulting from multiple sclerosis or other conditions) can also produce poor pelvic muscle function.

HOW TO CHECK PELVIC FLOOR MUSCLES IN MEN
The following techniques help you to identify your pelvic floor muscles:
1. Imagine trying to stop the flow of urine mid stream (the stop test)
2. Imagine trying to stop passing wind

·         The first thing to do is to identify correctly the muscles that need to be exercised.

·         Sit or lie comfortably with muscles of your thighs, buttocks and abdomen relaxed.


·         Tighten the ring of muscle around the back passage as if you are trying to control diarrhoea or wind. Relax it. Practice this movement several times until you are sure you are exercising the correct muscle. Try not to squeeze your buttocks or tighten your thighs or tummy muscles.

·         Imagine you are passing urine, trying to stop the flow mid-stream, then restarting it. (You can do this "for real" if you wish, but do so only to learn which muscles are the correct ones to use: do not make a practice of it or it may interfere with normal bladder emptying.) If your technique is correct, each time that you tighten your pelvic floor muscles you may feel the base of your penis move up slightly towards your abdomen.

·         If you are unable to feel a definite squeeze and lift action of your pelvic floor muscles (or are unable to even slow the stream of urine as described in point 3), you should seek professional help to get your pelvic floor muscles working correctly

DOING YOUR PELVIC FLOOR EXERCISES
Now that you can feel the muscles working, you can start to exercise them:
·         Tighten and draw in strongly the muscles around the anus and the urethra all at once. Lift them up inside. Try and hold this contraction strongly as you count to five, then release slowly and relax for a few seconds. You should have a definite feeling of "letting go".
·         Repeat ("squeeze and lift") and relax. It is important to rest in between each contraction. If you find it easy to hold the contraction for a count of five, try to hold for longer - up to ten seconds
·         Repeat this as many times as you are able up to a maximum of 8-10 squeezes. Make each tightening a strong, slow and controlled contraction.
·         Now do five to ten short, fast, but strong contractions, pulling up and immediately letting go.
·         Do this whole exercise routine at least 3-4 times every day. You can do it in a variety of positions - lying, sitting, standing, walking.
·          It is important to do both sets of exercises as the slow contractions help build up stamina of the muscle and the rapid exercises help the pelvic floor muscles to respond quickly when needed.


WHILE DOING THE EXERCISES:
1.      DO NOT hold your breath.
2.      DO NOT push down instead of squeezing and lifting up.
3.      DO NOT tighten your tummy, buttocks or thighs.


POINTS TO REMEMBER:

·         Get into the habit of doing your exercises regularly.
·         Watch your weight. As your weight increases the amount of strain on your pelvic floor muscles also increases.
·         You may find the exercises more difficult to do in the evening when you muscles are tired. If you notice this is a problem for you, try to do your exercises in the first part of the day.
·         Avoid constipation and prevent any straining during a bowel movement.
·         Seek medical advice for hay-fever, asthma or bronchitis to reduce sneezing and coughing.
·         Share the lifting of heavy loads.

ADDITIONAL BENEFITS OF PELVIC FLOOR EXERCISES FOR MEN

·         Pelvic floor exercises for men have been found to be highly effective in restoring erectile function according to recently published research. Research at the Faculty of Health and Social Care at the University of the West of England, Bristol, shows that pelvic floor exercises result in the same overall improvement rate seen in a large trial of men taking Viagra.      
      
    Wallahuaklam..

                     







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