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38

physiotherapy.asn.au

Pelvic floor physiotherapists assess and manage persistent pelvic

pain and conditions such as incontinence and sexual dysfunction.

While such treatment of female pelvic health is well entrenched,

men’s pelvic health is a sub-discipline fewer practitioners choose

to focus on, a trend coupled with the relative absence of male

practitioners specialising in this area. Peter Dornan is one of

Australian’s most prominent practitioners in sports, lumbopelvic and

men’s health physiotherapy. He is a trailblazer in the diagnosis and

treatment of pelvic pain, sexual dysfunction and other symptoms

stemming from pudendal neuralgia, a pain problem relating to the

pudendal nerve.

‘I was actually the first male pelvic floor physio in Australia. When

I was diagnosed with prostate cancer 20 years ago, I established

a pelvic floor exercise program to treat male incontinence. The book

I wrote,

Conquering Incontinence

, also covered the other two major

side-effects of prostate cancer treatments, erectile dysfunction and

depression,’ Peter tells InMotion. ‘When I first became involved in

treating pelvic pain there were very few physiotherapists in Australia

who knew anything about pelvic pain, and I don’t believe many

medical specialists did either.

‘My interest in the subject began as somewhat of an accident.

About 13 years ago, I treated a urologist who complained of

a painful low back after executing a split-squat with weights

at the gym. I diagnosed him as having a sacroiliac joint strain,

manipulated the joint and prescribed some exercises. He was very

excited that, as well as treating his back pain, he reported I’d also

cured his scrotal pain, a symptom he had not disclosed earlier. He

had consulted Brisbane’s leading surgeons and was about to have

surgery. He challenged me to find what nerve goes to that area and

how had I taken the pain away.’

For the next 10 years, including five at the University of Queensland,

after dissecting the pelvis and examining the pathomechanics of

the sacroiliac joint, Peter found there were many lumbar and sacral

nerves which could give pain to the pelvis, but the most commonly

presenting signs, symptoms and conditions are ones that relate

to compromise of the pudendal nerve.

Awareness of physiotherapists' contribution

to pelvic pain and pelvic health is increasing

inside the profession and among the broader

health sector. Leading men's health advocate

and APA member Peter Dornan AM speaks with

David Hull about his own work and emerging

opportunities for fellow practitioners.

TREATING

PELVIC

PAIN