Men’s Pelvic Floor Health: An Overlooked Crisis

Expert reveals common activities that can lead to debilitating pain and dysfunction.

What began as unexplained pelvic pain and erectile dysfunction for **Chad Woodard** in his early thirties was a mystery he never connected to his intense cycling regimen. Now, as an assistant professor, he educates others on a critical aspect of male health that’s often ignored.

Unveiling Pelvic Floor Dysfunction

The pelvic floor, a crucial network of muscles, nerves, and ligaments supporting the bladder, bowels, and reproductive organs, can cause significant issues when imbalanced. Both excessive tightness and laxity in these muscles can lead to urinary incontinence, sexual health problems, and discomfort in the scrotum, rectum, or groin.

Dr. Woodard, who now specializes in pelvic physical therapy, discovered his own condition after a urologist’s inquiry sparked his research. I had heard passing mentions of the pelvic floor during my training, but I had no idea what pelvic floor physical therapy was, he recalled. After successfully treating himself with exercises, he dedicated his career to helping other men reclaim their lives.

The Silent Suffering of Men

While women’s pelvic floor health has gained recent visibility through advocacy and digital health platforms, men’s issues in this area remain largely under-recognized by medical professionals. Some estimates suggest that up to ten percent of men in Ireland may contend with a pelvic floor disorder. Conditions like incontinence, erectile dysfunction, and chronic pain can easily be misdiagnosed as prostate infections, STIs, or even cancer, according to **Dr. Amin Herati**, a urology professor at Johns Hopkins Medicine.

Understanding the Causes

Pelvic floor disorders often stem from muscles that are either too tense or too weak. For men, a tight pelvic floor, characterized by muscles held in a near-constant state of contraction, is more common. This restricts mobility, potentially weakening the muscles and impairing bladder control, erections, and ejaculation.

Stress is a significant contributor to pelvic floor tightness, leading to unconscious clenching. Other common culprits include chronic constipation, habitually holding urine, and prolonged sitting. Even activities like cycling and heavy weightlifting can contribute to this tightness.

Conversely, overly lax pelvic floors in men are frequently linked to surgeries for prostate cancer. Such procedures can weaken the pelvic floor’s muscles and ligaments, often resulting in incontinence and erectile dysfunction. Damage to the pudendal nerve, which runs through the pelvic floor, from injuries sustained in sports like kick-boxing, cycling, or squatting can also cause dysfunction.

Seeking and Finding Relief

If you’re experiencing bladder or bowel issues, erectile dysfunction, or pelvic pain, the first step is always to consult a doctor to rule out any underlying infections or diseases. For many, physical therapy offers a path to recovery. Treatment typically involves manual therapy to release muscle tension and fascia, alongside targeted stretching and strengthening exercises. Diaphragmatic breathing techniques are also frequently recommended.

Proactive Pelvic Floor Care

Maintaining pelvic floor health doesn’t require a diagnosis of dysfunction. Simple, proactive steps can prevent future problems.

• Embrace Deep Breathing: Practicing diaphragmatic breathing, where your abdomen expands with air, helps keep the pelvic floor both relaxed and robust. Deep breathing is like a stretch from the inside out, explains pelvic floor physical therapist **Alicia Ferriere.
• Stretch Regularly: Maintaining mobility in the hip flexors, groin, quadriceps, glutes, and hamstrings is crucial. This is particularly important after activities like powerlifting and cycling, which can cause pelvic floor muscles and tissues to tighten, according to **Ferriere.
• Mindful Kegels: Unless a professional has diagnosed an overly lax pelvic floor, it’s generally advised to avoid intentional Kegel exercises. Many individuals perform them incorrectly, which can worsen pelvic floor tightness.
• Don’t Delay Seeking Help: If you suspect a pelvic floor issue, address it promptly. The sooner you start addressing symptoms in your pelvic floor muscles, the better, advises **Sullivan**, comparing it to treating any other muscle injury.

A 2023 study published in the journal *Urology* found that men undergoing prostate cancer treatment reported significant improvements in urinary incontinence and erectile function after participating in a targeted pelvic floor muscle exercise program (source: PubMed Central, 2023).