Continuing our Education: Treating Pain in Individuals with Male Anatomy

Fiona McMahon PT, DPT

One of the requirements for maintaining your license as a physical therapist, is to take continuing education classes. The amount of classes you are required to take will vary from state to state. Many physical therapists take the option to do the bare minimum required to maintain their license. This is not the case with the PTs at Beyond Basics Physical Therapy, whom also do a ton of in house training, in-services, case studies, and journal clubs in addition to formal classes. Many of our physical therapists exhaust their continuing education days and continuing education budget and chose to attend continuing ed on their own time and dollar, because they love it so much. Even though, they are well beyond satisfying their requirements for licensure. It is something that makes the physical therapists at Beyond Basics really special and in the top of their field.

As practicing pelvic floor physical therapists, we have extensive experience, but the truth of the matter is we can always know more. For many of us, before we arrived at Beyond Basics, we learned to treat pelvic pain on individuals with male anatomy by avoiding the penis all together. To be honest, we can get a lot of patient’s better by treating the muscles of the pelvic floor internally, but as a group, we were eager to be able to learn and treat issues of the penis directly. We just wanted to be able to get patients with issues like Peyronie’s disease (a bend in the penis, due to dysfunction in the fascia), erectile dysfunction and incomplete bladder emptying better on a much quicker time scale.

We were lucky to have Sara Sauder, PT, DPT and Kelli Wilson, PT, DPT, FAAOPPT, OCS come up to visit us in NYC one cold Saturday in January to help us expand our physical therapy tool boxes for individuals suffering from the following conditions, amongst others:

  • Erectile Dysfunction
  • Post Vasectomy Pain Syndrome
  • Prostatitis
  • Urinary Pain
  • Urinary incontinence
  • Pain following Hernia Surgery
  • Circumcision Scarring

In the class we covered a broad range of factors influencing the health and function of male reproductive anatomy, including the interplay of hormones, scar tissue from old surgery, restrictions in the fascia of the penis or scrotum, and hernia. We learned hands on techniques to improve the movement of tissues around and blood flow to the penis and scrotum.

Speaking for all of us, I would say, that Sara and Kelli helped us to better treat our male patients. It is clear as physical therapists, we continue to grow and learn long after physical therapy school. We at Beyond Basics Physical Therapy hold our continuing education close to our hearts and truly believe it is what sets us apart from other physical therapy clinics.

If you are interested in learning more about what we can do for pelvic floor conditions of the male anatomy, check out our other articles here!

All About Testicles

Prostatitis What it is and What to do About it

Also for more information on how manual physical therapy can help pain conditions of the male anatomy, check out this article:

Anderson R, Wise D, Sawyer T, et al. Integration of myofascial trigger point release and paradoxical relaxation training treatment of chronic pelvic pain in men. J Urol. 2005; 174(1): 155-60

 

You can read the full abstract here

A Pelvic Health Weekend with Lila Abbate

By Amy Stein, DPT

This week, I assisted Lila Abbate at Touro College in New York in a Bowel Course through Herman and Wallace. The BBPT pelvic floor experts–Stephanie Stamas, Corey SIlbert and Melissa Stendhal–also attended, along with over 40 others from the U.S. and Canada.

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It’s exciting how the world of pelvic floor PT is advancing.  When I started only Holly Herman and Kathe Wallace were teaching separate classes and only one time per year.  Now there are over 100 classes taught between APTA Women’s Health and Herman and Wallace.

Lila discusses differentiating from bowel motility issues and pelvic floor muscle dysfunction. The biggest take-home messages are:

– none of the tests for PFMD replace palpation and findings with your expert finger
– the bowel is a slow learner and does not like change
– there’s a big link between the bowel and the nervous system.
-medications can effect bowel habits and the patient may have to adjust their lifestyle
– positioning on the toilet can help with the anorectal angle
– abdominal bracing can help
-the diaphragm assists with urination and defecation
-pelvic floor muscles are passive with defecation and abdominal muscles are active
– you need to set responsible expectations

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Even two years after a surgery or traumatic injury, bowels are still sensitive. Take a good history and do a bowel diary to help with your differential diagnosis.  Is the patient drinking enough water, drinking too much coffee, too much alcohol and dehydrating their system? Are they eating too much fiber or taking too many laxatives? Do they have constipation or bowel leakage because of this?  Do they need to bulk their stool vs. add more water and soluble or insoluble fiber? Almost all patients who have had a bowel surgery have difficulty with dairy and fatty foods, so eliminating this from their diet can help. Doing an p to two yeelimination diet can help. Lila also discussed how you can have the patient eat corn and see how long it takes to pass as a precursor to the Sitz marker test.

Bowel issues can arise uI highly recommend this class and all of the Herman and Wallace and APTA Women’s Health classes to advance your learning in pelvic health. Also, for more information on nutrition for PTs, Jessica Drummond teaches and has a certification for PTs and nutrition.

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