Pelvic Floor Therapy for Chronic Prostatitis

By Erica Mitchell, PT, DPT

Have you received a diagnosis of prostatitis for your pelvic pain or urinary dysfunction and ruled out infection? You may be in the category of ‘chronic prostatitis/chronic pelvic pain syndrome’ (CPPS) and could benefit from an evaluation by a pelvic floor physical therapist. We’ve covered that men have pelvic floors too (see previous blog post), but what does chronic prostatitis feel like and what can be done through physical therapy?

Below are the possible symptoms of chronic prostatitis: bladder urgency, frequency, hesitancy, weak or interrupted stream, pain with voiding, bowel frequency, pain with bowel movement, constipation, erectile dysfunction, pain with ejaculation, pain in testicles or penis.

Men with chronic prostatitis need to be able to relax and lengthen the pelvic floor muscles. Tension in these muscles can cause irritation in the nerves in the region. These tight muscles may have trigger points that are causing pain. All muscles need to be able to contract and relax. If pelvic floor muscles are not fully contracting and relaxing, it can be a contributing factor to symptoms of chronic prostatitis.

How can pelvic floor therapy help?

Pelvic floor physical therapists are specially trained in evaluation and treatment of pelvic floor dysfunctions and musculature. An evaluation can identify specific limitations or causations of discomfort and be treated with breathing exercises, relaxation techniques, education on toileting and bladder habits, as well as manual interventions to decrease tension and pain. The Physical Therapist will not just be looking at the pelvic floor, but also spinal mobility, hip mobility, posture, gait, among other things. Your head and neck posture and even the mobility of your big toe can be affecting your pelvic floor function! Pelvic Floor Physical Therapists should be providing extensive education on your specific symptoms and dysfunction. We will show you ways to help relieve these symptoms and ultimately improve your quality of life.

At Magic City Physical Therapy, we are here to listen and validate that your chronic prostatitis and pelvic pain is valid. We work with men dealing with chronic pelvic pain on a day to day basis. Often, pelvic floor physical therapy is an integral part in helping you to start to feel like you can return to activity like you used to and live a more pain-free life. We don’t want people just living with these symptoms and think there’s nothing that can be done to help!

If you feel like you may be experiencing chronic prostatitis, give us a call to schedule a 5 minute discovery phone call to start your healing journey.

Safe Return to Exercise after

The structural and hormonal changes that happen during pregnancy don’t just disappear as soon as your baby is delivered, and overdoing it after pregnancy can result in urine or bowel leakage, pelvic discomfort, joint pain and even injury. You may have had a vaginal delivery and you might be recovering from stitches; or you might have delivered via cesarean birth, which involves an incision through the abdomen which cuts through many layers of tissue and muscle. Seeing a pelvic floor physical therapist prior to returning to activity can help address your symptoms and provide guidance on returning to exercise safely while your body is still in recovery. All women heal differently following childbirth, so seeing a Pelvic Floor PT for an assessment of your current state of healing and function can give you great insight on your road to recovery.

The six-week mark is typically when you’ll have your postpartum checkup with your healthcare provider. Any questions about your body, how it’s healing or how you are feeling should be addressed at that visit. The postpartum checkup is also critical for identifying any post-birth conditions like diastasis recti (abdominal muscle separation, a condition that affects 60% of people six weeks after birth and 30% at one year after birth) or incontinence (which can affect one-third of first-time moms and be an indicator of pelvic prolapse), both of which can be treated by a pelvic floor physical therapist conservatively.

Early postpartum 0-3 week exercises will include: Deep breathing with gentle abdominal wall tightening, ankle pumps and foot/ankle circles while you are sitting or lying down, and walking.

3-8 weeks postnatal: it is recommended you wait until your six-week postnatal check before starting a group exercise program or going back to the gym. Exercises can progressively include: walking, pelvic floor and core exercises (but not just kegels!), and progressive body weight exercises.

8-12 weeks postnatal exercises will include: Gym program (maintain posture, light weights, no breath holding), pelvic floor exercises. Visit a pelvic floor physical therapist for a postnatal abdominal muscle check and pelvic floor muscle

testing before returning to high-impact exercise, running, sport or abdominal exercise programs.

As you start exercising, start small and progress slowly. Monitor for any abnormal symptoms. Some “red flags,” to look out for: bleeding during/after exercise, pelvic/vaginal heaviness or pressure, incontinence (either urinary or bowel), low back pain, pelvic pain, doming or gap in the abdominal wall. These red flags mean you would greatly benefit from a Pelvic Floor PT consultation!

Sit ups, curl ups, planks, hovers and mountain climbers are not recommended exercises for postnatal moms, as they can place pressure on the lower abdominal wall and the recovering pelvic floor. A pelvic floor and postnatal abdominal check is recommended before undertaking these intense core exercises.

Are you a postpartum mom wondering where and how to begin exercise following childbirth? Contact us!