We can help men to get moving

 

Men’s health is a relatively new area for the physiotherapy profession, and community campaigns such as Movember are helping reduce the stigma and silence around many topics inherent in men’s health. As a physiotherapist specialising in men’s health, I am often confronted by the vulnerability men display when approaching this area of need for possibly the first time in their lives.

Issues such as erectile dysfunction and urinary and bowel incontinence following treatment for prostate cancer, and sexual dysfunctions such as premature ejaculation, Peyronie’s disease (curvature of the penis) and chronic pelvic pain can have a profound impact on physical and psychological wellbeing. It should be comforting to learn, however, that there are a growing number of Australian physiotherapists skilled to help address these pelvic health conditions. And it is knowledge we should share.

For males who are overweight, obese, diabetic, have cardio-vascular disease, high cholesterol, high blood pressure, are stressed, depressed, anxious, unfit, tired, in pain, stiff and sore or unmotivated, the answer may also lie with movement. 

Movember marks a time to look at the big picture in men’s health. Across the world, men are living five years less than women. The causes for this are multifactorial, although poor lifestyle choices are often to blame. Obesity, lack of exercise and sedentary living contribute to this startling statistic. With 67 per cent of our population overweight or obese, the ‘exercise is medicine’ mantra is now more important than ever. So where does physiotherapy sit among all this? The answer could be in just one word—movement.

In my practice, this mostly relates to pelvic floor muscle training, but movement generally is also recommended. The goal, as always, is to personalise treatment strategies to the clinical presentation of the individual. Complex presentations such as post-prostatectomy incontinence and climacturia (leakage of urine during sexual activity) may requiring an ‘up- training’ regimen of repeated contraction and relaxations of the pelvic floor to hypertrophy the sphincters responsible for controlling urine output. For a man with erectile dysfunction, performing the same regimen will also assist in regaining penile blood flow and improve penile rigidity. The evidence for this is now well founded.

For a patient with chronic pelvic pain, pelvic floor exercises with an emphasis on the relaxation component (ie, ‘down-training’ the pelvic floor) will generally be more appropriate, so as to improve mobility of tight musculature. Given the age group of males presenting with such conditions, anywhere from 10 to 95 years in my experience, it is also an optimal time to review activity levels as many patients will have a range of co-morbidities that may be assisted by more exercise.

For males who are overweight, obese, diabetic, have cardio-vascular disease, high cholesterol, high blood pressure, are stressed, depressed, anxious, unfit, tired, in pain, stiff and sore or unmotivated, the answer may also lie with movement. As little as five minutes  a day walking (building to 150 minutes over a week) will tick the boxes. Add two to three hours of more intense exercise each week and you’ll achieve the recommended protocols.

Movember aims to raise awareness about prostate and testicular cancer, men’s mental health and suicide prevention. Moving in Movember might just help with the rest—and every physiotherapist can help with that.

 

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