hey guys it’s Hina Sheth here at Rebalance physical therapy and wellness and today I want to focus this video around male pelvic pain what it is who fits in that category what kind of symptoms that you might be feeling and what is it that we basically do for this now male pelvic pain is one of these things that it you know not many people understand what we often see here at rebalance when we have a lot of men come in is that I went to my urologist I went to my colorectal doctor I’ve been to my gastroenterologist and I’ve even seen
you know a number of other wellness practitioners and no one seems to be understanding why I’m having this condition and so that’s kind of what we hear and so what I’m gonna start with is when we talk about male pelvic pain where is it in the body and then like I said what does it entail and what we’re gonna do about it so I’m gonna show you a lot of pictures today some of you guys who already know a lot of this you know I have to simplify this video for some people that don’t even understand
anatomy and for some of you guys that totally understand anatomy but you’re really just wanting to know what we’re gonna do for you but sorry guys you got to kind of sit through the whole thing unless you want it fast-forward through the video so this is a model of the human skeleton okay this right here alright right where I’m circling my fingers and this is the back of the skeleton right where I’m circling my fingers okay it’s basically the pelvis so when we talk about pelvic pain it’s
usually somewhere around here it incorporates not only the bones but the muscles that go on top and all the organs that go inside okay so this is the region that we’re talking about and all the musculature that can be involved in this area oftentimes when we treat here at rebalance we’re treating the whole person so for the sake of this video I just want to show you some of the main muscles around the pelvis so if we if we kind of start layering muscles on top of that skeleton and the pelvis okay here’s the pelvis again there’s the
pubic bone in the front right around here okay all of this is all the musculature deep deep on the deeper layers that you typically don’t see you know or think about when you’re thinking about regular muscles around the pelvis okay so there’s a lot a lot of muscles that cross from the spine into the pelvis down into the hips okay so that’s the front and then in the back you also have a musculature there and this shows you some of the big muscles the glute muscles that most of you guys have heard
about but then there’s a bunch of other deeper muscles if you take this and cut it out there’s a bunch of other deeper muscles then through there too now if we layer back through the front you know we kind of showed you the deeper musculature but in the front most of you guys have heard of these muscles these are abdominals you know some of your quad muscles that go on top okay but this layers on top of that other deeper musculature so again pelvic pain can involve any of that but if we even look deeper okay and
we again think about more organ related stuff okay you are going to find that there’s another layer of musculature deep inside the pelvis and I’m gonna talk about the organs in a second right here this is called your pelvic floor musculature so this is deep inside of this pelvis so inside here if you can kind of look down through there that’s what we’re looking at in this picture and this is the muscles of the pelvic floor now these muscles can start to get involved for many many different reasons
it can involve structural issues because your alignment is off it can be because certain muscles aren’t coordinated and working right and so then these muscles get involved so this is just another muscle there just like any of the other musculature that I’ve showed you it’s just this is so deep inside the body that you typically can’t see this from the outside well you’re not gonna see this from the outside but you typically can’t feel most of the musculature from the outside and so the only real way to assess it is
by an internal exam which we’ll talk about in a little bit but if you then if you think about other or other structures that lie in this area and the pelvis okay outside of just the bones the muscles as well as you know ligaments and things like that we’re also looking now here at a cross-section okay this is if you split the body in half from the side these are all the organs the main organs that sit inside the pelvis okay so for the male you’ve got your rectum you’ve got the bladder you’ve got your prostate and you’ve got
you know all the other sexual organs down here which on here you can’t see this scrotum and the testicles and all that kind of stuff yeah maybe you can alright so basically any any issues in this area including symptoms that you potentially had in the rectum the bladder feels like it’s the prostate the penis the scrotum the testicles any of the musculature or in the joints like the groin the lower abdominals the you know the gluteals the hips all of that in in in in the world of male pelvic pain that’s what it all
encompasses so it actually there’s a lot of different things that can happen when you think about male pelvic pain okay and symptoms can be anything like I said from a musculoskeletal origin to an organ related organ so what are some of the symptoms that males have and I’m just gonna go through some of them but we have a complete list at the bottom of this but you know things like I said scrotal pain testicular pain penile pain pain with ejaculation pain after having a bowel movement feeling you like you
have heaviness or a golf ball in your rectum like I said lower abdominal pain feeling like you have a hernia but no one’s been able to find one feeling like there’s something wrong with the prostate or you have an inflammation of the prostate or maybe you were told you had a prostatitis but it’s not really a prostatitis because they’ve done all the lab workup and they haven’t been able to find anything sometimes it can feel like a urinary tract infection but again lab work shows that you don’t have it again
you know groin pain such as even sports hernias and sports hernias and even like pubic symphysis pain some of you guys may have heard of this term sacroiliac joint pain maybe pain with sitting that you feel pain that feels like it’s a hemorrhoid but again you’ve seen your colorectal doctor and it’s not really a hemorrhoid so again these are just some of the things that you feel and again more organ related structures could also be difficulty having a bowel movement urinary retention feeling like you have
to go to the bathroom all the time feeling like you’re waking up in the mellah night and going feeling like you have to urinate all the time and this is an absence of a prostate issue a specific prostate issue like your prostate is getting enlarged okay so if you’ve had a urologist you’ve followed up with one you find like hey your your prostate is actually fine but you’re having these symptoms then chances are this is a musculoskeletal a little musculoskeletal issue meaning that either the muscles the bones and you
know a lot of other structures in the area are getting involved that someone like us can actually help with because it’s involving a lot of the musculature so what do I mean by that and let me see if I can clarify a little bit and I’m sure some of you guys have seen some of our other videos so basically what can happen let me go ahead my pictures here what can happen here is the body can basically form lots of different and for different reasons okay why do you have pelvic pain there could be a million
different reasons and actually I should probably go through some of those so why does somebody get this it could be anything from sports injuries it can come on all of a sudden it can come on very gradually you know it can happen and runners and bikers and people that are sedentary and settle eyed it can have in you know teenagers it can happen in little kids it can happen all the way until you’re 70 again from lots of various reasons Falls trauma surgery stress you know weird just all sorts of weird injuries that you may have had
that maybe started in one place but they feel like they’ve kind of like worked their way up or worked their way down so there could be a lot of different reasons why you develop this and the reasons why this happens is because your body compensates really really well so again I told you these pelvic floor muscles are just like any other muscle so they can start to overwork or under work or a combination of the two to compensate for other issues in coordination in the body or other injuries that have happened either local
or outside of that area okay so we see that a lot so basically when that happens and what’s going on is that muscles in and around the pelvis and they start to develop knots and they be cut they can come knots in specific areas of the muscle and you can have them in many many different muscles all at the same time they develop knots and when that knot has formed okay you don’t have good blood flow going through that area the musculature if you don’t have good blood flow it’s kind of like you’re cutting
off nutrient into that muscle because now there’s not good blood flow there’s not good oxygenation that muscle can’t repair it can’t function right so that can set up like a irritation and pain within that area and that’s this knot that becomes painful is known as a trigger point so I have a quick photo here and many of you guys have probably experienced you know a trigger point right here in your upper trap where if you feel it you feel like oh there’s a knot there but it feels good if I kind
of press on it sometimes you may press that you’re like oh that’s so painful that’s typically a trigger point and so what you see is that you know if this is part of the muscle part of that muscle it doesn’t have to be the whole entire muscle part of that muscle you kind of zoom in on it you can get these little trigger points in here and when you get those trigger points that is what can become painful within the muscle and those trigger points can then actually give you localized pain or it
can actually refer pain to other areas here is a trigger point that you know is in the glute muscle you say you can have a tight trigger point in through here and it can actually refer pain down all the way into the lower leg now you’ve got a tunnel muscles in the body hundreds and hundreds and hundreds of muscles more than 600 muscles in the body each of those muscles can end up having trigger points so you can imagine in and around this pelvis you can definitely because I showed you there’s a lot of musculature in that area you
can develop trigger points in any of that musculature including the pelvic floor and when you start having trigger points in and around that area they can start giving you all sorts of pain all sorts of symptoms especially those pelvic floor muscles can actually give you organ type pain so this is where those muscles can actually start giving you symptoms of leg pain in your bladder pain in your prostate scrotum testicles testicular you know all the ones that I basically mean before and you can have a combination of all of these things it’s
not unusual for men to come into our clinic and they actually tell us that they have 10 of these symptoms going on it’s not uncommon and so you know I’m making this very simple in the sense that I’m saying all of this is coming from musculature but you have to also realize there’s a lot of other tissue including something called fashio there’s also nerves there’s lots of blood vessels and veins that go in through this area that can also be affected by tight musculature okay so I keep going back to the muscles because a
lot of it that we see in our clinic result revolves around muscle and fashio and then they can influence a lot of the nerves and and things like that in this area okay so basically so that’s kind of you know why in a nutshell it happens what kind of symptoms you might be experiencing and kind of what’s going on so now how do we treat this here at rebalance so we kind of use a holistic approach what do I mean by that holistic is kind of just thrown around everywhere well holistic means exactly what it means is that
you’re looking at the whole person you’re you know what we have seen often times as that men will go again you’ll you’ll many of you guys can relate to this you went to a urologist they don’t really know what’s going on so they say well it’s it’s not your bladder it’s not your prostate is none of this we’re not really sure what’s going on you know and so they’re specifically looking at that one area then you may go to your gastrointestinal doctors because maybe
you also have some GI issues going on and then they say well there’s nothing really going on with your gi maybe you’ve got some IBS but that’s what you have and then you may go to your colorectal doctor and complain about hey something goes off in the rectum and they’re like yeah you have some hemorrhoids we can give you some meds for that but I don’t think that’s what’s really causing your pain then you may go perhaps some of you have already gone to a physical therapist that treats stuff
in this area um or maybe you’ve gone to a general physical therapist because you are having hip pain and back pain and so they’re looking at your hip and your back but what we do is we kind of look at all of these things together and say hmm how is this related to this related to this area lose that’s how is all of this working together cuz your body does not work on its own it doesn’t work in pieces it works as a whole Symphony as a whole Orchestra to make you function okay kind of like an orchestra it takes
a whole Orchestra to play a really beautiful piece okay so it’s the same idea with the body the body including every single you know nerve and muscle and bone and organ they all work together so when we are evaluating someone we basically look at all of these things so it’s not unusual for us to want to find about your dietary history it’s not unusual for us to find about all of your other past history and traumas and surgeries and things like that it’s not unusual for us to ask you hey what’s your digestion like what is your
bladder and your urinary pattern like how is that you know how did that affect your hip or how does your hip affect that or when did your hip injury start and when did your bladder symptoms start so we kind of look at all of this and create a really nice timeline and a nice picture to really figure out what’s going and then that along with our evaluation which we’re gonna check sometimes everything from head to toe if necessary but really honing in on the area that we really need to focus on to get your
symptoms down but then to kind of take a step back and look at the whole picture again the holistic picture to see hey where else do we have to work because the body doesn’t look like it’s coordinating right either and then when we start to treat you we kind of have a sequencing of how these things need to be fixed sometimes it’s an order of what’s most important for you and what function you need to get back to sometimes it may be like hey I know you want to get back to these things but we really gotta treat this first in order
for the second piece to work so that you can go back to what you want to do and so it’s every person is very individual and I tell this to everyone that comes into our clinic if I have three people with the same three symptoms they will have three completely different plans of care depending on factors for the patient what they want to get back to what their lifestyle is what their dietary influences what they do for a living how much they take care of their kids I mean it could be a number of different factors to how their body type
is are you skinny are you a little big-boned do you have tight joints do you have really loose joints what else is going on in your you know what else is going on in your history sometimes we may even have to say hey does your mom have this did your dad have this do your kids have this and that helps us put in a big picture so as far as the specific treatments that we use again on our website we have lots of different specifics on what we do but honestly we’ve got so many tools in our tool bag as far as what we do some many of much
of it is evidence-based and some of it is not evidence-based because honestly pelvic pain and the treatment of pelvic pain through a physical therapy approach it’s still in it’s not in its infancy as much anymore but it’s still relatively new and we are still learning so much every single day so sometimes things that we find that hey this actually worked for another client of ours and sometimes our patients are our teachers my patients have definitely taught me a lot and so I take that and I use it as a tool to help
treat some of my other clients and that’s not unusual so it’s a combination of evidence-based as well as clinically what we have found that works for a lot of our patients a lot of our treatment initially is a lot of hands-on work and then a lot of Education on teaching you how you can empower yourself to improve these conditions so you know we’re gonna teach you all the things that are supportive to the treatment that we do during our session and then how you can hopefully maintain a lot of it in
between and then like I said our goal is always to make progress from one session to the next we have also aligned ourselves with with a lot of other great amazing wellness practitioners as well as healthcare practitioners medical practitioners that are you know that have that also work with us to get a lot of conditions better so I hope that’s helpful to any of you who are wondering hey what’s our approach to male pelvic pain is this that is this a place that I actually want to go to I’ve already had
physical therapy or maybe I haven’t do they know what they’re talking about hopefully I’ve convinced you of that but so I hope that’s helpful if you need specific details you can see in the body of the text below that we’ll have lots of other detail on this video and I hope to see you soon take care
