Core Massage and Bodywork for Men: Pelvis, Hips, Thighs, Low Back and Abdomen
Core Bodywork for Men
Comprehensive and effective core bodywork requires a deep knowledge of core, pelvic, pelvic floor, and hip anatomy and function; awareness of the relationship between these structures and health, wellness, integrity, and vitality; an understanding of the various pain syndromes and dysfunctions caused by, or related to, core systems and structures; and an array of modalities, strategies, and techniques that can be employed to meet the various needs and treatment goals of each individual client. It also requires attention to detail in order to fully explore, engage, and address the multitude of muscles, the different layers and orientations that they are arranged in, and the many important connective tissues within the core.
By definition, core bodywork usually includes work in areas that can often be sensitive or feel vulnerable, such as the abdomen, pelvis, pelvic floor/perineum, groin, inguinal, and pubic areas. As well, the genitals and anus are located within, or are extensions of, the lower core and have highly integrated structural and functional relationships with it. Work in these areas requires a safe space, a non-judgemental attitude, an informed and sensitive touch, and a respect for boundaries.
Many men can affirm how challenging it can be to find a bodyworker who is not only willing to focus on the core, but is also comfortable, knowledgeable, skilled, and experienced in working with this part of the body. As a result, most men find few opportunities to fully explore and address these crucial areas that are too often inadequately engaged or are entirely omitted. As Myers has emphasized, the core is the foundation of our being and the source of our vitality, security, power, sexual expression, and instinct. "Leaving it out of our work because we are scared of its power is as criminal as bulldozing our way through it because we are unaware of its sensitivity" [1].
The following text is divided into these sections: Goals and Outcomes: Who can Benefit from Core Bodywork? .... Core Bodywork: Modalities, Strategies, and Positioning .... Education, Self-Help Tools, and Resources .... Session Lengths, .... and A Note about Erections.
There are "back to top" links to the right of each section title.
Goals and Outcomes: Who can Benefit from Core Bodywork?Back to top
Core bodywork can be equally rewarding for those men who wish to gain more awareness and insight into their bodies as well as those men who are experiencing specific issues, concerns, discomfort, pain, or other dysfunction within, or relevant to, their core. While this work is most often practiced and experienced on a physical and sensory level, many men may also be open to, and appreciate, concurrent energetic, emotional, psychological, or spiritual shifts that may occur. We humans are multidimensional, and it is useful to keep this in mind.
There are as many potential benefits to receiving core bodywork as there are motivations to seek it out. Men with differing agendas, needs, and goals can be loosely and broadly divided into several groups, though most men will fall into a combination of these:
Explorers
Men who want to explore and learn more about their core in a physical and sensory context, including those areas that are rarely given any attention.
These men are typically open to exploring the vast array of sensation and response that skilled bodywork can elicit, and are interested in experiencing their bodies in new ways. Engaging and interacting with muscles, connective tissues, and sensory nerves via bodywork is an excellent way to explore these tissues in a spirit of curious discovery, fine tune your capacity for internal awareness (interoception), appreciate the relationships and connections within the body and between body and mind, and shift your experience.
A playful yet accurate term to describe men in this group is somanaut, coined by the anatomist Gil Hedley (soma is from the Greek word meaning body). Similar to an astronaut who explores outer space, a somanaut is eager to sense, explore, and interact with the inner landscape of his body.
Sufferers
Men who are seeking an understanding of, and treatment for, their discomfort, pain, dysfunction, or other limitations in the low back, abdomen, pelvis, hips, groin, pelvic floor / perineum, tail bone, or genitals.
The core is susceptible to misuse, overuse, disuse, and abuse, with consequent negative effects that can significantly affect quality of life and daily functioning.
Manual therapy can often provide the missing link in cases where medical evaluations have been inconclusive or negative; diagnoses have been missed or are inaccurate; or treatments have been insufficient or ineffective. Low back pain, abdominal pain, chronic pelvic pain, the catch-all term 'prostatitis', and genital pain are just a few examples of symptoms and conditions that can be difficult to accurately diagnose or may not respond to standard medical care. As well, invasive procedures, including surgery, can sometimes result in chronic pain and dysfunction that can frequently benefit from manual therapy, including specific techniques to soften and reorganize scar tissue, thus making it more pliable, less painful, and more functional. The muscles and connective tissues are the biggest generators of pain in the body, and thus can be key to its resolution.
The core can also be susceptible to the effects of stress — physical, mental, or emotional. Muscular tension, stiffness, restriction, holding, bracing, retraction, and guarding are all terms that describe how stress can adversely affect the body. Core bodywork can be surprisingly relaxing even on a global scale, meaning that all areas of the body — even those not directly included — commonly feel significant benefit. This can be especially true for pelvic floor work, whether it is the main focus or incorporated into core work.
Information specific to sexual pain and dysfunction can be found in the section titled Core Bodywork, Genital Pain, and Sexual Dysfunction from "The Body's Core" page.
Optimizers
Men who are having no specific concerns or issues with their core, but want to maintain a high level of, or improve, its efficiency and effectiveness.
We often take our bodies for granted, and assume that they will continue functioning as they always have. Yet there are a number of things we can do to maintain the good health we may currently be experiencing or to further support and improve it. Core bodywork is one of them. Some men get bodywork regularly as a tune up or periodically as a treat, and the core can benefit from these approaches just as much as other parts of our bodies can.
While abdominal and back exercises are the focus of most core training programs, the pelvic floor and respiratory diaphragm typically get far less attention — or none at all. Men can learn how to sense, recruit, coordinate, and strengthen these critical core components, which can improve the overall function of the core and their general health.
In addition, exercising and strengthening the pelvic floor component of the core can improve erectile quality and endurance, increase the propulsive force of ejaculations, enhance pleasurable sensations and excitement, and intensify the orgasmic experience.
Survivors
Men who are suffering the consequences of trauma or abuse of any kind: physical, mental, emotional, or sexual.
Pain, physical guarding, bracing, protecting, retracting, or numbing — especially in the abdomen, pelvic floor, anal sphincters, and genitals — can be a consequence of traumatic experiences and last for many years after the abusive or traumatic events. Sensitive and gentle core bodywork can be an excellent way to safely get in touch with, explore, release, integrate, and improve function in parts of ourselves that may have become frozen, deadened, or painful in response to past experience.
Connecting to, increasing awareness of, waking up, and bringing vitality to areas that have been a source of sometimes overwhelming pain and suffering can do wonders for those men who are ready to take this step in a safe and supportive environment - one in which they set the boundaries and are in full control of what happens to their bodies. Beyond specific bodywork techniques, the mere act of giving caring attention to long-neglected areas can be powerful therapy and help break the cycle of non-feeling, dysfunction, or dissociation.
Power Users
Physically active men, including athletes, performers, men with physically-demanding jobs, and those who enjoy recreational activities that require substantial physical effort.
The core is the central engine that drives all physical activity, and thus is relevant for all physically active men — that is, anyone for whom the physical body is critical to their work, play, or sport. Weight lifters, personal trainers, runners, swimmers, cyclists, yoga practitioners, hikers, climbers, wrestlers, martial artists, dancers, singers, and construction/trades/delivery workers are just a few of many examples. Ensuring that the core is functioning in support of athletic, recreational, and occupational demands can improve performance, speed recovery, and reduce the likelihood of injury. Should injuries occur, core bodywork can accelerate healing and improve tissue integrity.
I was in the first group of bodyworkers to attain national certification in Sportsmassage and have worked with athletes at all levels — including Olympic athletes — in my private practice and at local, national, and international competitions.
Seekers
Men who are interested in, practice, or teach any of the mental, physical, philosophical, or spiritual systems or disciplines from the East or the West.
Among these are yoga, meditation, martial arts, breathwork, multiple esoteric practices, or any of the hundreds of other self-improvement, personal growth, awakening, contemplative, or transformative practices. Seekers from all disciplines and traditions can benefit from a deep appreciation and felt sense of the structures and energies that are located in the core. The pelvic floor, the pelvic bowl, the abdomen, and the low back are structures that not only generate physical power but are also the structures within which reside several key centers that generate, coordinate, and distribute vital energy. Tuning into, expanding, shifting, and circulating these energies can have major physical, mental, and spiritual benefits, which in turn can deepen one's practice - and core bodywork can facilitate or contribute to this process.
Men for whom this category resonates may also be interested in the information in my section titled The Energetic Core: Concepts, Practices, and Core Bodywork from "The Body's Core" page.
Core Bodywork: Modalities, Strategies, and PositioningBack to top
I employ many modalities when working with the core, including numerous techniques derived from neuromuscular therapy, myofascial release, sportsmassage, trigger point release, deep tissue work, soft tissue mobilization, swedish, shiatsu, and many other approaches. Integrating active or passive movements into the work such as with active engagement, contract-relax, or pin and stretch can be of great benefit in helping to release and open up specific areas and tissues of the core, alleviate pain, and improve function.
In addition to working with the client in the usual prone and supine positions (face down and face up), side lying position enables excellent and direct access to areas such as the IT band on the outside of the thighs, the lateral hip musculature, the lateral abdominals, and the adductors on the inside of the thighs. It is also useful at times for low back, central abdominal, and pelvic floor work. On occasion and for specific purposes, other positions may facilitate access to, and engagement with, certain muscles and tissues.
The judicious application of a lubricant, usually massage oil, is standard when working the core tissues, but there are often times when work without oil can be appropriate or desired. Connective tissue work of all kinds — including techniques specifically targeting the fascia, tendons, ligaments, or scar tissue, for example — are more effective without oil, and there can be some advantages to applying techniques such as cross fiber or trigger point work in a non-oil context as well. In addition, sometimes work without oil is preferred because of skin sensitivities or because of impending work or social commitments.
Pressure, depth, and speed are all adjusted according to the many variables that must be considered, including client preference and tolerance, intent of the technique being employed, which muscles and tissues are being targeted, what the goals of treatment are, and each client's ability and readiness let go, open up, release, and accommodate the work.
The pelvic floor can be integrated into core bodywork or can be the main focus of our work (see malepelvicfloor.com for much more). In addition to the massage and bodywork techniques that comprise the bulk of pelvic floor work, clients who have excess tension or irritability in these tissues can benefit from pelvic floor awareness exercises, specific postures, movements, and breathing techniques that help relax, open, and mobilize the pelvic floor. Clients who have relatively weak or lax pelvic floor muscles, or who are interested in developing a stronger pelvic floor for better core, sexual, or voiding function, can benefit from a strength and endurance evaluation of the pelvic floor muscles and an exercise protocol designed specifically to strengthen them.
Education, Self-Help Tools, and ResourcesBack to top
I am a big fan of education and agency; that is, the more you are armed with accurate information, knowledge, and tools to take care of yourself, the better-positioned you will be to make appropriate decisions regarding self-care as well as when, and what kind, of professional guidance to pursue when necessary. I never hesitate to explain relevant anatomy and function, show high quality graphics from my many anatomy textbooks, discuss possibilities and options, and help each client put all this information in proper and meaningful context. As well, I readily suggest self-help tools, techniques, and strategies that can be incorporated into your daily routine or can be used as-needed. I have many informative and practical books covering a broad range of subjects relevant to all aspects of the core, pelvis, pelvic floor, and the mind-body that may be of interest to many of my clients, and I may also suggest helpful web resources.
Session LengthsBack to top
Core work can include several distinct yet highly integrated areas of the body, including the low back, buttocks, hips, abdomen, groin, and pelvic floor. The degree of attention and thoroughness given to any individual area can vary widely depending on the length of the session, each client's priorities and goals, the rhythm, pacing, and techniques that are most appropriate for each client, and of course the status of the muscles and connective tissues. Effective bodywork benefits from being efficient but not rushed.
Ninety minute or two hour sessions are highly recommended for an initial session. Please note that all appointments are made by phone rather than by email or text.
A Note About ErectionsBack to top
Some men are concerned about getting an erection during a bodywork session, may have felt embarrassed by becoming erect in past sessions, or worse, have actually been shamed by other therapists for getting one. It is important to know that erections can happen, are natural, and are — or should be — a non-issue. The relaxation response, coupled with a response to touch, can prompt spontaneous erections during massage and bodywork sessions because of a shift in the autonomic nervous system (ANS) toward a predominantly parasympathetic state. An effect of the parasympathetic branch is to relax the blood vessels and erectile chambers in the penis, sometimes prompting an inadvertent erection. Erections do not alter or interfere with the work, and my advice is to not judge, worry, self-censure, or tense up if an erection should occur. The larger somatic shifts and openings that allow this to happen are positive, beneficial, and desired — and I suggest that clients simply note and enjoy their body's relaxation, openness, and vibrancy in whatever ways these may manifest.
References
1. Myers T. The Abdominal Balloon, Part 2: Gut-Level Strategies. Massage Magazine. July / August 1998, p. 102-113.
© 2010, revised 2019 ♦
Muscle anatomy images courtesy of MassageNerd.com. Thanks Ryan!