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Corner Clinic: Male Pelvic Exercises, a New Polio-Like Illness and Germs in the Gym


By UC San Diego Health Experts   |   February 25, 2019

Our experts answer your questions on everything from headaches to tummy aches. This month, our experts discuss male pelvic rehab, the new polio-like illness and germs in the gym.


  1. Should men do Kegels?
  2. What should parents know about the new polio-like illness?
  3. How can I prevent infections while at the gym?
Vanessa True

Should men do Kegels?
Vanessa True, physical therapist, UC San Diego Health

Contrary to popular belief, pelvic floor dysfunctions are not seen only in female patients.

Pelvic floor issues involve the muscular base of the abdomen, attached to the pelvis, and can result in problems like constipation or leakage. Though more often an issue for affected women, men are not immune and UC San Diego Health offers a variety of relevant physical therapy services for male patients, too. Our program is staffed by experts able to help men restore strength and flexibility of the muscles in order to improve quality of life.

Some symptoms that might lead to a male pelvic floor disorder diagnosis are:

  • Prostatitis — an inflamed, swollen or tender prostate
  • Chronic pelvic pain, including scrotal and penile pain
  • Urinary incontinence
  • Fecal incontinence
  • Post-void dribbling
  • Constipation
  • Post-surgical dysfunction, including adhesion
  • Pain with ejaculation
  • The pelvic floor muscles and associated fascial system are part of what makes up our core that serve as support for the organs and keeps us upright as we move through our day. The pelvic floor muscles work together with other core stabilizers in the abdomen and lumbar region. Many factors can weaken the pelvic floor in males, including the surgical removal of the prostate or a TURP procedure, which treats urinary problems due to an enlarged prostate.

    If the male patient has pelvic floor weakness, pelvic floor strengthening known as Kegels, can help with bowel, bladder and sexual dysfunction. In order to learn how to perform a pelvic floor contraction correctly, it is best to seek out the expertise of a pelvic floor physical therapist because the exercise is not intuitive and requires specific verbal and tactile cueing.

    If you want to see if you can identify the pelvic floor muscles, you can perform The Stop Test. When you start to urinate, see if you can stop the flow. The pelvic floor muscles are what you use to perform this activity. This is a test you can perform once a month to assess your pelvic floor. However, it is not to be performed as an exercise as it can interfere with the voiding reflex system.

    But strengthening is not the only type of treatment related to male pelvic floor dysfunction.

    Other remedies vary by individual, but include progressive home exercise programs, manual therapy, education on behavior modifications to influence diet, fluid intake and bowel/bladder habits, biofeedback — a mind-body technique that uses various forms of monitoring devices to create conscious control over physical processes that are normally under automatic control of the body — and electrical stimulation to facilitate muscle activation.

    Robert Coles

    What should parents know about the new polio-like illness?
    Robert Coles, MD, pediatrician at UC San Diego Health

    The first things to know about the new polio-like illness known as acute flaccid myelitis (AFM) is that it is not polio and it is a rare condition. There was a spike in 2018 with 200-plus cases reported in the United States, and most of these cases were in children. It affects the nervous system and can cause polio-like symptoms, such as weak muscles and paralysis, which can appear suddenly. However, most patients have a mild respiratory illness or fever consistent with a viral infection before developing the polio-like illness. It has also been noted that most cases have occurred in late summer and fall.

    The cause of polio-like illness is not known, but we do know that it is not caused by polioviruses. Other viruses (specifically an enterovirus) may play a role and environmental toxins and genetic disorders are other possible causes.

    According to the Centers for Disease Control and Prevention, there is no specific treatment for AFM, but there are things parents can do to help protect their children and prevent them from contracting this and other, less serious conditions.

  • Wash hands frequently with soap and water
  • Avoid touching the face with unwashed hands
  • Cough and sneeze into tissue or upper shirt sleeve, not hands
  • Keep household surfaces, including toys and doorknobs, clean by sanitizing and disinfecting
  • Keep sick children at home
  • Avoid close contact with people who are sick
  • Stay up to date on routine immunizations
  • While polio-like illness sounds frightening, remember that it is very rare. The chances of getting it are less than one in a million. However, if your child has sudden weakness of an arm or leg, a loss of muscle tone, a droopy face, difficulty moving the eyes or drooping eyelids or difficulty swallowing or speaking, you should seek professional advice immediately.

    And you should always feel free to contact your local pediatrician whenever you have any questions or concerns regarding your child’s health.

    Amruti Borad

    How can I prevent infections while at the gym?
    Amruti Borad, DO, primary care physician at UC San Diego Health

    The last thing you want is an infection, in particular a skin infection, from your favorite local gym. These include fungal infections, like athlete’s foot and jock itch; bacterial infections such as methicillin-resistant Staphylococcus aureus (MRSA); and viral infections, such as human papillomavirus infection (HPV) that can lead to warts. You do not have to be a victim of these microorganisms if you take the right, simple precautions.

    • The gym should be cleaned at least once daily with EPA-approved products.
    • Gym equipment should be intact. If not, report it to the manager.
    • Disinfecting wipes should be available to wipe down equipment before and after you use it.
    • The locker rooms should have plenty of hand soap or hand sanitizers to wash your hands before and after spending time at the gym.
    • Cover up any cuts or scraps you may have with adhesive bandages.
    • Place a towel on any equipment you may be using.
    • Wear shower shoes (simple flip flops will work).
    • Shower not only after exercising, but also after swimming or using the sauna.
    • Throw your dirty clothes in a plastic bag to separate them from your gym bag, and then wash them as soon as possible.
    • Don’t share personal items like razors, make-up, towels, etc.

    Sometimes, however, even with these efforts you may still get an infection. If this happens, please make an appointment with your physician to assist you in making the right treatment choices.

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