Introduction: The Hidden Side of Physiotherapy
When most people hear the term “physiotherapy,” they picture joint pain, sports rehab, or post-surgical recovery. But there’s a whole world of physiotherapy that people are unaware of, and that often gets completely overlooked – men’s health physiotherapy.
This area of Physiotherapy care focuses on supporting individuals with bladder and/or bowel dysfunction, sexual health concerns, and recovery from prostate surgery.
Often, it’s only after seeing a GP, urologist, and undergoing extensive medical testing that they’re finally referred to a physiotherapist.
Key Takeaways
- Men’s health physiotherapy addresses bladder, bowel, and sexual dysfunction, and aids prostate surgery recovery.
- Early intervention is key; stigma often delays help, leading to worse outcomes.
- Physiotherapy uses tailored exercises, biofeedback, and ultrasound to strengthen pelvic floor muscles, vital for continence and sexual function.
But what if physio came first?
Despite its importance, this field is still hugely under-recognised, and many men delay seeking help due to stigma, embarrassment, or simply because they don’t know that physiotherapy can help them.
In this blog we want to change that, and shed some light on this incredibly important topic.
Why Is Men’s Health Physio So Overlooked?
While women’s pelvic health is routinely addressed (e.g., during and after pregnancy), the male equivalent has only started gaining more traction and recognition in the past 5 to 10 years. Historically, male patients haven’t been encouraged to seek support unless something had already gone seriously wrong.
Many men are reluctant to seek advice on health issues due to a combination of social stigma, traditional views of masculinity, and fear of appearing vulnerable. There’s often pressure to “tough it out” or downplay symptoms, especially when it comes to men’s health issues.
Many men wait years before addressing issues with bladder control, erectile function, or pelvic pain.This can lead to delays in diagnosis and treatment, causing poorer outcomes. Earlier intervention from a Physiotherapist could reduce symptoms faster, prevent deterioration, and support long-term recovery.
Encouraging open conversations and normalising these issues are key to changing this narrative.
What Does Men’s Health Physio Cover?
Physiotherapists play an important role in both diagnosing and treating men’s health issues, particularly those related to pelvic health, sexual health, and recovery after surgery.
They are trained to assess movement, strength, and function, helping to identify underlying problems that may contribute to issues such as pelvic pain, incontinence, or sexual dysfunction.
A men’s health physiotherapist focuses on the following key areas:
1. Bladder Health
- Urinary urgency
- Stress or urge incontinence
- Post-void dribbling
- Frequent nighttime urination
2. Bowel Function
- Constipation or incomplete emptying
- Urgency or leakage
3. Sexual Function
- Erectile dysfunction
- Pain during or after ejaculation
- Pelvic pain related to arousal or climax
The Role of the Pelvic Floor
The male pelvic floor is a group of muscles, ligaments, and connective tissues that span the base of the pelvis, supporting the bladder, bowel, and reproductive organs.
Key muscles work together to control continence, support pelvic organs, and contribute to core stability. The pelvic floor also plays a crucial role in sexual function, helping with erections and ejaculation.
The main role of the pelvic floor muscles include:
- Maintaining continence
- Supporting pelvic organs
- Enabling pain-free sex and erections
When these muscles are underactive or overactive, due to surgery, injury, chronic straining, or stress, it can lead to issues such as urinary leakage, pelvic pain, or erectile dysfunction.
Strengthening and relaxing these muscles through physiotherapy can significantly improve symptoms and overall pelvic health.
Underactive vs Overactive
- Underactive pelvic floor: Can lead to leakage, erectile dysfunction, and poor support post-surgery.
- Overactive pelvic floor: Often seen in athletic men (e.g., runners, gym-goers) who hold tension in these muscles, leading to pain in the groin, perineum, or anal region.
Bladder Health
Male dysfunction and incontinence is more common than many people realise, and can occur for a variety of reasons, including prostate surgery, ageing, nerve damage, or pelvic floor dysfunction. It often results in leakage when coughing, sneezing, exercising, or experiencing a sudden urge to urinate.
While it can be distressing, pelvic health Physiotherapy can significantly help you to manage and improve symptoms, by strengthening the pelvic floor muscles, improving bladder control, and retraining healthy bladder habits.
Bowel Function
The pelvic floor muscles play a key role in bowel control, supporting the rectum and helping to coordinate the process of elimination. When these muscles are too weak, too tight, or poorly coordinated, it can lead to bowel symptoms such as constipation, faecal incontinence, and incomplete emptying, that significantly impact daily life.
Targeted treatment – such as pelvic floor exercises, relaxation techniques, biofeedback, and education on posture and toileting habits, to help restore normal bowel function and improve your quality of life.
Erectile Dysfunction
Erectile dysfunction (ED) is a common condition where a man struggles to achieve or maintain an erection, and while it can have various causes; such as vascular issues, hormonal changes, or psychological factors, the pelvic floor muscles also play a key role.
These muscles support the base of the penis and help maintain blood flow during an erection by compressing veins and enhancing rigidity. Weakness or poor coordination in the pelvic floor can contribute to ED, particularly after prostate surgery.
Strengthening these muscles has been shown to improve erectile function by enhancing pelvic support, blood flow, and muscle control.
Tools and Techniques Used in Men’s Health Physio
Individualised Pelvic Floor Exercise Plans
Pelvic floor exercises are an important part of men’s health, particularly for managing all the issues previously mentioned.
A key concept is learning to correctly identify and isolate the pelvic floor muscles – often described as the sensation of stopping the flow of urine or preventing passing wind – then practising gentle contractions and relaxations with good breathing and posture.
These exercises need to be performed regularly and with consistency, over a number of weeks in order to make noticeable improvements in function and confidence.
At Complete Physio, we ensure each plan is tailored to the patient’s condition: whether they need to build strength, reduce tension, or improve control.
Here are six effective exercises to try:
- Basic Contractions – Sit or lie down comfortably. Tighten the muscles you would use to stop passing urine. Hold for 5 seconds, then relax for 5 seconds. Repeat 10 times, 3 times a day.
- Quick Contractions – Tighten and release the pelvic floor muscles quickly. Aim for 10 repetitions in a row to build speed and responsiveness.
- Bridge with Pelvic Floor Activation – Lie on your back with knees bent and feet flat. As you lift your hips into a bridge, contract your pelvic floor muscles. Lower slowly. Repeat 10 times.
- Heel Slides – Lie on your back, knees bent. Slide one heel away from your body while engaging the pelvic floor. Return and switch sides. Repeat 10 times each side.
- Standing Holds – Practice holding your pelvic floor muscles for 5–10 seconds while standing or walking to increase endurance.
- Cough Control Practice – While standing, gently contract your pelvic floor muscles just before and during a cough or sneeze to train reflex control.
Ensure you are breathing normally throughout and not using your buttocks, thighs, or abdominal muscles to compensate.
If you’re unsure you’re doing them correctly, a pelvic health physiotherapist will be able to give you good guidance on your technique.
Verbal Cueing and Biofeedback
Cueing and biofeedback are valuable tools in pelvic floor rehabilitation, helping men learn to correctly activate and relax the pelvic floor muscles.
Many people find it difficult to identify these muscles, especially after surgery or injury, so verbal cues, such as “lift and squeeze” or “imagine stopping the flow of urine”, can help give you some guidance on improving your technique.
Biofeedback takes this a step further by using real-time visual or auditory feedback, often through ultrasound or sensors, to show how the muscles are working. This not only improves accuracy and confidence but also helps track progress over time, making pelvic floor training more effective and personalised.
Real-Time Ultrasound
At Complete Physio, we also use real-time ultrasound to:
- Visualise pelvic floor contraction
- Provide biofeedback
- Guide patients through correct activation techniques
Real-time ultrasound is a valuable, non-invasive tool used by physiotherapists to assess and retrain pelvic floor function in men, particularly in the management of incontinence.
Our Physios are able to use a transabdominal or transperineal approach to visually assess pelvic floor activity. By providing a live visual of the pelvic floor muscles and bladder, it allows both clinician and patient to see how these muscles are working during contraction and relaxation.
This immediate, visual feedback is especially helpful in ensuring correct technique during pelvic floor exercises, which can be difficult to feel or coordinate without guidance.
For men recovering from prostate surgery or struggling with stress or urge incontinence, ultrasound-guided training helps improve muscle control, boost confidence, and accelerate recovery.
By combining visual tools and expert verbal cueing, physios help men target specific areas of the pelvic floor and ensure exercises are done correctly.
Post-Prostatectomy Physiotherapy
A prostatectomy is a surgical procedure to remove all or part of the prostate gland, most commonly performed to treat prostate cancer. The surgery – particularly a radical prostatectomy – can affect the pelvic floor muscles, which lie just beneath the prostate and help control bladder and bowel function.
Because these muscles may be weakened or disrupted during surgery, men often experience post-operative symptoms such as urinary incontinence, bowel dysfunction and, less commonly, difficulty with sexual function, especially erectile dysfunction in the weeks or months following the procedure. This can be very distressing and impact quality of life. Fortunately targeted physiotherapy can have a significant impact on recovery.
Physiotherapy plays a key role in recovery after prostate surgery, particularly in helping men regain control over their bladder and improve pelvic floor function. Specialised pelvic health physiotherapists can assess how well the pelvic floor muscles are working and guide patients through tailored pelvic floor exercise programs to rebuild strength, coordination, and endurance. Techniques such as biofeedback and real-time ultrasound can be used to ensure correct muscle activation.
Starting physiotherapy soon after surgery, or ideally even beforehand, can improve outcomes, reduce recovery time, and help restore confidence and quality of life for men navigating the physical and emotional challenges after prostate surgery.
A tailored physio programme can rebuild strength, particularly in the muscles that support the urethra.
Why Awareness Needs to Improve
Too often, men are referred to physiotherapy only after they’ve seen every specialist, and undergone invasive testing. By the time they see a physio, their symptoms may be worse, their confidence and mental health low, and their quality of life significantly affected.
Earlier access to men’s health physiotherapy could save time, money, and emotional distress.
We need more open conversations about these topics, because men’s pelvic health is just as important as women’s.
FAQs
Do I need a referral to see a men’s health physio?
No. You can book directly with a men’s health physio at Complete Physio.
How do I know if my pelvic floor is weak or tight?
Symptoms like leakage or erectile dysfunction often point to weakness. Pelvic pain or discomfort may indicate tightness. A physio assessment will clarify this.
What happens during the first appointment?
We’ll talk through your symptoms, health history, and perform a non-invasive assessment. Real-time ultrasound may be used to assess your pelvic floor activation.
Is men’s health physio just for older men?
No. Athletes, younger men with pelvic pain, and those recovering from surgery can all benefit.
Can physiotherapy help after prostate surgery?
Absolutely. Post-prostatectomy physio is one of the most important times to strengthen your pelvic floor.
Take the First Step Towards Recovery
Conclusion: Getting Men Back in the Driving Seat
Men’s health physiotherapy is an essential, evidence-based option for treating bladder, bowel, and sexual dysfunction – but it remains underused.
The sooner men seek support, the better their outcomes.
If you’re experiencing symptoms, don’t wait until it’s “bad enough.” Book an appointment with our expert team and take the first step towards recovery.
Book a Men’s Health Physiotherapy Appointment at Complete Physio
References
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