【Daniel Kirages】For bladder cancer and rectal cancer

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Only relax but also contraction

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Dr.Daniel Kirages Pelvic floor muscle shortness will lead to incontinent or pain. This type of patient needs relaxation. We will use biofeedback and manual therapy to relax them.


ーー  Are you going to palpate even it is very sensitive area?


Dr.Daniel Kirages Of course I palpate. You can’t tell if you don’t palpate the muscle if it is damaged or not. This is same as all the muscle in your body. However, it is a sensitive zone that you have to respect that.

Pelvic floor muscles, such as Urethral sphincter and Anal sphincter are present in whole area at the male genitalia. Some of the people of bladder cancer and rectal cancer have incontinent. Knowing that loosening or contracting such muscles is critical for those patients.

If looking here, you can see the contraction. For example, testis is lifted.

There are three things that you can check contracting anal, contracting scrotum, and lifting testis.

Actually, you will also palpate with palpation at your fingertips. Same as you touching biceps. Also, I will let patient palpate by themselves to confirm the contraction.

There is a camera and monitor in the room, patients can check the anal contraction.

Muscle that can be touched from the outside is such a thing. Other inside of the muscle is verified by putting your finger from the anus. Although I check whether or not they really can shrink before measuring the muscle strength.To the Once found that can be used successfully upgrading the exercise for rising muscle strength.

There are times when you need to relax specific muscles. When the muscles have become hard and excessive tension and need to stretch, it may be performed by putting a finger.

Those people also have to know about contraction. Because if they don’t know how to contract, it cannot be also relax. So even if they are people who are better relax than contractive, I teach them about not only relax but also contraction.


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Daniel Kirages


Dr. Kirages is an Instructor of Clinical Physical Therapy. He has a hybrid schedule of both clinical practice and academic teaching. It is within the private practice of the Division, USC Physical Therapy Associates, where he attends to a diversified patient load, addressing orthopedic and pelvic health disorders. While in the classroom he serves as course coordinator for Basics of Patient Management and as a primary instructor for Clinical Management of Musculoskeletal Dysfunction within the first year of the DPT program.

Dr. Kirages is a Board Certified Orthopaedic Clinical Specialist (OCS) as well as a Fellow of the American Academy of Orthopaedic Manual Physical Therapists (FAAOMPT). He is significantly involved with advanced professional education through his teaching and clinical mentorship within the USC Residency in Orthopedic Physical Therapy. He is also the primary faculty member of theUSC Orthopedic Boot Camp Series which is a comprehensive series of seminars that enables the participant to attain high level skills in examination and treatment procedures for common musculoskeletal conditions.

Dr. Kirages may also be found researching topics associated with pelvic health, teaching continuing education courses or giving lectures at a variety of academic institutions or healthcare facilities nationally and internationally.

Professional Affiliations

Member: APTA, Orthopaedic and Women's Health Sections Fellow: American Academy of Orthopaedic Manual Physical Therapists Member: International Pelvic Pain Society

Faculty Positions

Instructor of Clinical Physical Therapy, University of Southern California Clinical Faculty - Riverside Physical Therapy Orthopaedic Residency and Spine Fellowship Programs, Grants Pass, OR

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【Daniel Kirages】For bladder cancer and rectal cancer

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