Interview with Craig Allingham

To acknowledge the 2020 concurrence of Men’s Health Week and National Continence Week I was asked by Fiona Rogers of Pelvic Floor Exercise to have a casual chat about men’s health, how I got there, what I am doing and (at the end) to reveal a surprising and unknown fact about myself.

The conversation was recorded and is now available on Fiona’s You Tube channel. To view the 30 minute fig-side chat (we don’t do fires here on the Sunshine Coast in Australia so we did it by a fig) simply click on the link below.

And remember to go the distance to discover my surprise reveal…..

6 Home Exercises for Older Men to Stay Strong in a Pandemic Lockdown

Not much else to say really. I made this video for my training clients who are all blokes and over the age of 60. The pandemic has closed our gym spaces and it is vital for their muscle mass, mental health, bone mass and functional strength to stay as strong as possible. These six exercises include variations for current ability and key teaching points for safe execution. Like all physical training programs they only work if you do them. Regularly. Add them to your walking or cycling program.

Click Here to see the video.

We Are All On Active Surveillance

One of the treatment options following a diagnosis of low-volume or low-risk prostate cancer is Active Surveillance. Briefly this means deferring any intervention such as surgery, radiation, hormones or chemotherapy and keeping a watchful eye on key markers of prostate cancer progression until it demonstrates a change in nature and threat. Your urologist will order regular PSA tests, physical examinations and/or imaging of your prostate to provide comfort (no progression) or early warning that something now needs doing.

Active Surveillance (AS) has a much wider role than this. For example, because my Dad died from prostate cancer I regularly have PSA and physical checks on my prostate with no cancer evident as yet. So I am on AS pre-diagnosis.

Around 8000 men in Australia may well be on AS post-diagnosis.

Then there are men who have undergone treatment for prostate cancer (removal, zapped, drugged) and are still monitoring their PSA to detect any secondary cancers from rogue prostate cells that escaped the procedure. These men are on post-treatment AS.

Active Surveillance is simply a man taking a pro-active, risk management approach to his prostate health. Whether he be screening, deferring treatment or monitoring ongoing status following treatment we are all on our own journey.

One thing we all share, is the hope that we can avoid or suppress the progress of prostate cancer wherever we are on the scale. That is where the ‘Active’ part of AS comes into play. Every man can actively sabotage prostate cancer no matter his risk factors or diagnosis. The challenge for every man however, is – can he and will he make the sustained lifestyle choices that make his body hostile to prostate cancer instead of a receptive host? Could you?

To answer this question you need to understand the commitment involved. You need to be prepared to give up things that you enjoy (not all) and adopt other behaviours that may not seem so attractive. Yes, you have to make an effort and get out of your comfort zone. Not all men can do this. Not for a week or a month, but from now on. For as long as you want your prostate gland to behave.

Some examples, are you prepared to –

  • Reduce dairy consumption
  • Get more physical training
  • Eat less red meat
  • Keep drinking coffee
  • Increase water consumption
  • Reduce stressful aspects of your work, life, family
  • Maintain a waist girth of less than 95cm?

Even a couple of ‘yes’ responses on this list is a win. You don’t necessarily have to do them all, certainly not at once.

If you want more information and specific strategies to resuce the onset, progression and recurrence of prostate cancer you can find it in my book – The Prostate Playbook. This is available online by clicking here. For less than $20 (AUD) you can have your own playbook with heaps of ways you can defend against prostate cancer.

Written by a men’s health physiotherapist it is based on science, evidence and clinical sense.

All the best,

Craig Allingham
A/Prof. Bond University, School of Physiotherapy & Exercise Science
Men’s Health & Sports Physiotherapist

  • Prostate Recovery MAP
  • The Prostate Playbook

Male Physios in Men’s Health

Historically, in Australia, men’s health physiotherapy evolved from physios practicing women’s health where the common element was the management of incontinence. Unsurprisingly, these practitioners were predominantly female and the idea that the management of male incontinence following prostate cancer surgery was supplied by female physiotherapists. And for the most part they were very proficient.

I recall a meeting of women’s health physiotherapists in Australia where they were debating the merits or otherwise of expanding their group title to include ‘men’s health’ and/or ‘pelvic health’. As one of the very few man delivering men’s health continence and pelvic pain services at the time I was invited to speak and supported the inclusive concept but with the rider that men’s health was more than pelvic health. More men die from cardiovascular disease than incontinence. More people suffer from male mental health issues than do from constipation. The re-titling and a pathway of education was subsequently upheld and the latter is still in development.

Despite this awkward beginning, male physios in Australia and elsewhere have been moving into men’s and pelvic health. I have been delivering education in this area for five years along with colleagues Peter Dornan, Jo Milios and Stuart Baptist. We have educated around 200 physios in Australia under the Mastering the Martians brand, and many participants were male.

I arrived from elite level sports physiotherapy including four Olympic team representations. So did Peter Dornan, an ex-Wallaby physio. Other male physios have applied their musculoskeletal and orthopaedic or neurological skills to men’s health. It is typically a career extension where we take one set of skills and extend them into a new scope of practice.

Men’s Health Physiotherapy is an ideal vehicle for male physios to extend their role into a new market – men who are experiencing muscle dysfunction, pain and disability following a diagnosis of prostate cancer and perhaps treatment as well.

If you are a male physio I strongly recommend you undertake an introductory course with an experienced practitioner to see if it is a good fit for your skills, workplace and career path.

You can start with me in the UK during September 2019 at two Nutting Out Men’s Health Physiotherapy events. Each of these costs only £140 for a one day event.

Glastonbury, Somerset, September 21 2019 – click here for more info or to register

London, St Georges Hospital, Sept 28, 2019 – click here for more info or to register


Technically this term refers to an inflammation of the prostate gland which causes pain in the pelvis and perhaps on passing urine, obstruction of the urethreal urine flow and voiding problems like frequency, urgency and hesitancy. The inflammation may be due to a bacterial infection in which case it responds well to a course on an appropriate antibiotic medication.

However, most cases labeled as prostatitis are non-bacterial where the man has no signs of a urinary tract infection (fever, positive pathology of a urine sample, smelly urine, etc.). As it turns out, many of these cases are not primarily related to the prostate, and the assumption by medical staff that it is prostatitis may result from substandard evaluation of the patient, a misunderstanding of the term or an assumption that it will sort itself out and the antibiotics won’t do any harm (1). All three of these errors on their own have the potential to cause harm and when applied together the damage and/or delay to access appropriate treatment can be significant for the health and quality of life of the man involved.

Yet since 1999, the expert panels on diagnostic criteria for this condition acknowledged that non-bacterial prostatitis would be more accurately described as ‘chronic pelvic pain syndrome’ (1). A later review further recommended that the use of antibiotics should be withheld until a second culture yielded the same bacterial profile (1).

Chronic pelvic pain in males (as for females) is a complex problem often involving physical, functional, psychological and co-morbiity issues. Everything from a possible history of sexual trauma, chronic bladder/bowel dysfunction, lower back or SIJ injuries, pelvic surgery or recurrent bladder or urinary tract infections.

As such, no one type of practitioner can reliably assess for all the related factors that may be causative or barriers to recovery. Let alone treat them all. So a multidisciplinary approach is considered best practice. Acknowledging there is no gold standard to treamentn Smith (3) reviews 16 treatment options and concludes that a multidisciplinary approach with multi-modal therapy appears to give the best outcome for patients. His list includes physiotherapy for myofascial trigger points.

Every man with a diagnosis of non-bacterial prostatitis is a man with chronic pelvic pain syndrome. The role of pelvic physiotherapists is to include or exclude mechanical, biomechanical and myofascial contributions to his condition and manage them in a reasonable and accountable time frame using objective outcome measures. This may occur while the patient is being treated by other practitioners who may be pursuing a pharmaceutical, nutritional or psychosocial approach.

Physiotherapy evaluation and treatment will include spinal segments from T12 to S4, lumbar and pelvic articulations, the hip joint, deep pelvic and anterior abdominal muscles, neural pathway restrictions and sensitisation, pelvic floor muscle function and myofascial trigger points at the least.

  1. Potts, J.M., 2015 Male pelvic pain syndrome: escaping the snare of prostatocentric thinking. Curr Bladder Dysfunt Rep 10:75-80.
  2. Barampwslo A, Mandeville A, Edwards S, Brook S, Cambitzi J, Cohen M. 2013. Male chronic pelvic pain syndrome and the role of interdisciplinary pain management. World J Urol 31:779-784
  3. Smith C, 2016. Male chronic pelvic pain: an update. Ind J of Urol 32:34-39

Coffee, Vitamin D & PCa

Two new pieces of research have confirmed the information contained in The Prostate Playbook. The danger of publishing health advice is that more recent research might not support the advice given. When it does support my book, however, I am really chuffed. Two research projects published in the International Journal of Epidemiology have confirmed that coffee consumption is not linked to prostate cancer (2019), and circulating levels of Vitamin D are likewise not linked to the incidence of prostate cancer (2018).

So my advice in the book remains current and once again supported by published research.

Body Fat & Fatal Prostate Cancers

New research published in the Journal of Cancer suggests that where body fat is deposited is more critical than how much in regards advanced and fatal prostate cancer.

Men who deposit fat in their thighs and around their abdominal organs (visceral fat) were more at risk than those who deposited fat elsewhere in their bodies, or (better still) did not have much fat at all. Leaner men, those with a lower body mass index (BMI) were more at risk of advanced prostate cancer if their small excess fat was visceral in an otherwise lean body.

Body fat is stored energy. The body will use it to fuel activity, exercise and training when the easily accessible blood sugar is used up. You see where I am going with this.

To reduce your risk of prostate cancer you should reduce your stored fat, especially around your organs. Your waist measurement (girth) is a reliable indicator of this and if you can get it below 95cm that would be brilliant. Or if that seems to big a step, start with trying to reduce it by 5 or 10 cm as every bit helps.

How to lose it? Here we go again – smaller food portions, replace red meat with white meat or fish, don’t snack between meals except on fruit, avoid sugary foods and drinks, yada, yada, yada.

You already know this but maybe haven’t been sufficiently motivated by fear, vanity or desperation to make changes. So here we go, if you don’t want to die from prostate cancer and suffer the nasty side-effects of treatment (impotence and incontinence) AND you would like to look slimmer AND you would like to have more energy, sleep better and have lower blood pressure – lose your GUT FAT over the next 6 months. Be strong.

Brain Smarts

There is plenty of research on how what you eat can influence your cognitive function and perhaps stave off brain decline such as dementia and Alzheimer’s disease. Wondrously, they are similar to the prostate saving strategies in The Prostate Playbook –

  • Reduced added sugar, including artificial sweeteners
  • Focus on ‘good’ fats: olive oil, avocado, nuts, omega-3 fatty acids from fish
  • Anti-inflammatory spices: turmeric, cinnamon, thyme,
  • Ensure good quality sleep – manage apnoea, adequate time and comfort
  • Exercise – aerobic and resistance but it should not be stressful in its own right
  • Avoid environmental toxins – pesticides, heavy metals, arsenic
  • Socialise – engaging with others face-to-face if possible

Source: The Food Sleuth, Melinda Hemmelgarn, Investigative Nutritionist, Columbia, MO.

Book Launch Event Sunshine Coast

Click here for a video highlight reel of this event – Craig speaking about the new book and why it is important for all men.

Saturday June 8, 2019 from 2pm. I will be at the fabulous Harry Hartog Book Store in the Sunshine Plaza at Maroochydore. A short talk about men’s health then you will have the opportunity to purchase my new book (or my previous one – The Prostate Recovery MAP) and I will sign it for you.

Come along if you can, buy whatever books take your fancy in the store (or not) and let’s get a big crowd to show that men’s health is important and generates interest.

Nutting Out Men’s Health – Perth & Adelaide

As part of A/Prof. Craig Allingham’s national book launch tour there are two events coming up in early May 2019

Perth – Monday May 6, Leederville Sporting Club, 7pm – 9pm
This is a two hour event comprising an entertaining and informative presentation from Craig on Men’s Health, followed by a guided tour of his new book The Prostate Playbook.

Adelaide – Wednesday May 8, Duke of Brunswick Hotel, 207 Gilbert Street, Adelaide, 7pm – 9pm
Same gig, different city. Click on the second image for the Adelaide registration.

Click above for Perth event