Forum / Let's Discuss! / Male Pelvic Floor Issues

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On: February 18, 2016 16:03 PM
I have come across a few men who struggle with making a connection with their pelvic floor post prostatectomy. They have usually had a urethral catheter for a week or so, then suffer with incontinence afterwards - usually just "dribbles". Do you have any advice for starting the conversation - I'm reluctant to just use the term "nuts to guts" etc - and this is such a sensitive area for men to discuss with anyone - let alone their female Pilates instructor! Perhaps this subject could be a Pilates Show episode... Thanks so much, First-time Poster, Kathy
On: February 19, 2016 14:34 PM
Hi Kathy! This is an excellent question! I find that approaching talking about any client's pelvic floor demands confident and direct cueing, that takes the apprehension out of the situation. We have a plastic pelvic model that can be so helpful in understanding the complex dynamics of the pelvic network. The truth is we all have a pelvic floor if we are lucky, and it is just as important to male health as it is to women's health. If your client is already talking to you about post treatment symptoms, this is an excellent time to jump in with an anatomy lesson. I have dealt with this situation with a family member and I found that talking about the pelvic floor much like the respitory diaphragm was helpful. Also their doctor has prescribed them different exercises to help get control and sensation in the area which is vital to healthy functioning. First thing to do is get them in a good neutral pelvis in the seated position. This helps to open the posterior pelvic floor which a lot of men need. Then start to cue from the anatomy. I generally ask them to traction the rectum up the sacrum. Or ask them to try and pull their urethra to the bladder. Then I ask them to do both ends at the same time. This gives a healthy full contraction... Just watch out for glute gripping! Another awesome way to work the pelvic floor is in quadruped position on the Cadillac. You will see a Pilates Show very soon with this set up that Jen taught for menopause health. You can do the same thing for men! Because you go into the kneeling position on the forearms, it creates a gentle inversion that tractions the abdominal contents and pelvic floor forward. This is a great way to take the pressure off the PF in a supportive manner. And as always with the pelvic floor, or any muscle for that matter, it is only as strong as it is flexible! So no over cueing the contraction! Healthy belly breath and even sitting on a half inflated overball is essential to the expansion of this area! The name of the game is to be confident in what you are saying to your client. Know that you are absolutely increasing their quality of life for the better by talking about the pelvic floor if they are interested. There are some people, men and women alike, who you can feel are closed off to the conversation, and that's ok. But for others, your knowledge and expertise is so helpful. Men in general do really well with direct, mechanical verbal cues. Keep it simple. And if it feels weird to talk about it, put them in planes of gravity like what is listed above and let nature do the rest! Hope that helps! Much Love, Casey Marie
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