r/PelvicFloor Jul 05 '25

RESOURCE/GUIDE The Pelvic Floor: Pelvic Pain & Dysfunction 101: NEW? Start here!

116 Upvotes

Work in progress. To be continuously updated.

Subreddit Rules:

  1. Be respectful (no bullying or harassment)
  2. No "all or nothing" cures, causes, or suggesting that only one thing will help
  3. DON'T suggest kegels as treatment for a hypertonic pelvic floor (it's bad advice)
  4. NO FETISHIZING or sexualizing someones health condition. DON'T BE CREEPY.
  5. No NSFW Photos
  6. No SPAM (includes link farming, affiliate marketing, personal promotion)
  7. No "Low Effort" posts - we can't help if there's no detail

>> QUICK START <<

✔ READ SUCCESS STORIES: Simply swipe left or right on the main page in the Reddit mobile app until you hit the green "success story" post flair | DESKTOP: Use the "Flair Filter" right sidebar to filter posts

Ladies who don't want to see posts about male parts: use the filters:

✔ FILTER POSTS BY SEX: Simply swipe left or right on the main page in the Reddit mobile app until you hit the pink or blue post flairs. AMAB/AFAB also available | DESKTOP: Use the "Flair Filter" right sidebar to filter posts

✔ USE THE SEARCH FUNCTION: Enter keywords into the search bar at the top to filter posts/comments on specific subjects or symptoms

✔ CHECK OUR USER SUBMITTED PELVIC PT DIRECTORY

✔ BOTHER & SISTER COMMUNITIES

  1. r/prostatitis (male pelvic pain & dysfunction/CPPS)
  2. r/Interstitialcystitis (IC/BPS, men and women)
  3. r/vulvodynia (women and AFAB experiencing Vaginismus & Vestibulodynia too)

ESSENTIAL INFORMATION: PELVIC FLOOR

The pelvic floor muscles are a bowl of muscles in the pelvis that cradle our sexual organs, bladder, and rectum, and help stabilize the core while assisting with essential bodily functions, like pooping, peeing and having sex.¹

They can weaken (become hyp-O-tonic) over time due to injury (or child birth), and even the normal aging process, leading to conditions like incontinence or pelvic organ prolapse.¹

And, the pelvic floor can tense up (guard) when we:

  1. Feel pain/discomfort
  2. Get a UTI/STD
  3. Injure ourselves (gym, cycling, slip on ice)
  4. Have poor bowel/urinary habits (straining on the toilet often - constipation) or holding in pee/poo for extended periods (like avoiding using a public toilet)
  5. Have poor sexual habits (edging several hours a day, typically this is more of guy's issue)
  6. Get stressed or anxious (fight or flight response), due to their connection with the vagus nerve (and our central nervous system). READ MORE HERE
  7. Have a connective tissue disorder

Over time, prolonged guarding/tensing can cause them to become hyp-E-rtonic (tight and weak). Sometimes trigger points in the muscle tissue develop that refer pain several inches away. The tensing can also sometimes irritate nerves, including the pudendal nerve. Helping the pelvic floor relax, and treating these myofascial trigger points with pelvic floor physical therapy can lead to significant relief for many, along with interventions like breathwork - notably diaphragmatic belly breathing - and gentle reverse kegels.

Sometimes, feedback loops also develop that can become self-perpetuating as a result of CNS (Central Nervous System) modulation. ᴮ ⁷

Basic feedback loop:

Pain/injury/infection > pelvic tensing > more pain > stress/anxiety > more pelvic tensing > (and on and on)

Examples of common feedback loops that include the pelvic floor:

Source: NHS/Unity Sexual Health/University Hospitals Bristol and Weston. A pelvic floor feedback loop seen in men after STI.

An example of this pelvic floor feedback loop (guarding response) as seen in a woman with a prolonged (awful) UTI:

A trigger point is an area of hyper-irritability in a muscle, usually caused by a muscle that is being overloaded and worked excessively. How does this affect an IC patient? Unfortunately, we do not always know what comes first; the chicken or the egg. Let’s assume in this case we do. A patient who has never had any symptoms before develops an awful bladder infection, culture positive. She is treated with antibiotics, as she should be. Symptoms are, as we all know, frequency, urgency and pain on urination. Maybe the first round of antibiotics does not help, so she goes on a second round. They work. But she has now walked around for 2, maybe 3 weeks with horrible symptoms. Her pelvic floor would be working very hard to turn off the constant sense of urge. This could create overload in the pelvic floor. A trigger point develops, that can now cause a referral of symptoms back to her bladder, making her think she still has a bladder infection. Her cultures are negative.

- Rhonda Kotarinos, Pelvic Floor Physical Therapist

Above we find a scenario where the UTI was cleared, but the pelvic floor is now in a tensing feedback loop, and complex processes of neural wind up and central sensitization - ie CNS modulation - are likely occurring

Diagrams of the male and female pelvic floor:

Bottom view. The levator ani is the main "hammock" of the pelvic floor, and includes both the PC (pubococcygeus) and PR (puborectalis) muscles
Side view showing the pelvic floor cradling the bladder, sexual organs, and rectum. And its attachments at the coccyx (tailbone) and pubic bone.

SYMPTOMS OF PELVIC FLOOR DYSFUNCTION

The majority of the users here have a hypertonic pelvic floor which typically presents with symptoms of pelvic pain or discomfort ² (inc nerve sensations like tingling, itching, stinging, burning, cooling, etc):

  1. Penile pain
  2. Vaginal pain
  3. Testicular/epididymal/scrotal pain
  4. Vulvar pain
  5. Clitoral pain
  6. Rectal pain
  7. Bladder pain
  8. Pain with sex/orgasm
  9. Pain with bowel movements or urination
  10. Pain in the hips, groin, perineum, and suprapubic region

This tension also commonly leads to dysfunction ² (urinary, bowel, and sexual dysfunction):

  1. Dyssynergic defecation (Anismus)
  2. Incomplete bowel movements
  3. Urinary frequency and hesitancy
  4. Erectile dysfunction/premature ejaculation

This pinned post will mainly focus on hypertonia - tight and weak muscles, and the corresponding symptoms and treatment, as they represent the most neglected side of pelvic floor dysfunction. Especially in men, who historically have less pelvic care over their lifetimes as compared to women.

But, we also commonly see women with weak (Hyp-O-tonic) pelvic floors after child birth who experience urinary leakage. This often happens when coughing, sneezing, or lifting something heavy. Luckily, pelvic floor physical therapists are historically well equipped for weak pelvic floor symptoms, as seen commonly in women.

But, this historical emphasis sometimes bleeds into inappropriate care for men and women who have hypErtonic pelvic floors, and do not benefit from kegel exercises

CLOSELY RELATED CONDITIONS & DIAGNOSIS

These typically involve the pelvic floor as one (of many) mechanisms of action, and thus, pelvic floor physical therapy is an evidence-based intervention for any of these, along with behavioral interventions/mind-body medicine, medications, and more.

  1. CPPS - Chronic Pelvic Pain Syndrome - example feedback loop above
  2. IC/BPS - Interstitial Cystitis/Bladder Pain Syndrome - example feedback loop above
  3. Vulvodynia
  4. Prostatitis (non-bacterial)
  5. Epididymitis (non-bacterial)
  6. Pudendal Neuralgia
  7. Levator Ani Syndrome
  8. Coccydynia

COMMON COMORBID CONDITIONS

For people who experience symptoms outside the pelvic region, these are signs of centralization (somatization/nociplastic mechanisms) - and indicate a central nervous system contribution to symptoms, and must be treated with more than just pelvic floor physical therapy: READ MORE

(Ranked in order, most common)

  1. IBS
  2. Chronic Migraines
  3. Fibromyalgia
  4. CFS/ME (chronic fatigue syndrome)

These patients also had higher rates of depression and anxiety (even BEFORE THE SYMPTOMS) as well as greater symptom severity - https://www.auanet.org/guidelines-and-quality/guidelines/male-chronic-pelvic-pain

CENTRALIZED/NOCIPLASTIC MECHANISMS:

Many people with a pelvic floor diagnosis - and at least 49% who experience chronic pelvic pain/dysfunction - also experience centralized/nociplastic pain ¹³ localized to the pelvic region. Centralized/nociplastic pelvic pain can mimic the symptoms of pelvic floor hypertonia. To assess if you have centralization as a cause of your pelvic symptoms, read through this post.

NOTE: This is especially relevant for people who have a pelvic floor exam, and are told that their pelvic floor is basically "normal" or lacks the usual signs of dysfunction, trigger points, or hypertonia (high tone), yet they still experiencing pain and/or dysfunction. This also equally applies to cases that have done extensive amounts of pelvic floor PT 6-12mo) with no improvement.

Centralized/Nociplastic pain mechanisms are recognized by both the European and American Urological Association guidelines for pelvic pain in men and women, as well as the MAPP (Multidisciplinary Approach to the Study of Chronic Pelvic Pain) Research Network.

TREATMENT: High tone (HypErtonic) Pelvic Floor (tight & weak)

Pelvic floor physical therapy focused on relaxing muscles:

  • Diaphragmatic belly breathing
  • Reverse kegels
  • Pelvic Stretching
  • Trigger point release (myofascial release)
  • Dry needling (Not the same as acupuncture)
  • Dilators (vaginal and rectal)
  • Biofeedback
  • Heat (including baths, sauna, hot yoga, heated blankets, jacuzzi, etc)

Behavioral change: * Lay off frequent or chronic masturbation habits (including edging) * Take a break from intense compound exercises, like CrossFit or HIIT * Sit less and stand more. This may also include using a standing desk * If you're an avid cyclist, take a break from cycling

Medications to discuss with a doctor:

  • low dose amitriptyline (off label for neuropathic pain)
  • rectal or vaginal suppositories including: diazepam, gabapentin, amitriptyline, baclofen, lidocaine, etc
  • low dose tadalafil (sexual dysfunction and urinary symptoms)
  • Alpha blockers for urinary hesitancy symptoms (typically prescribed to men)

Mind-body medicine/Behavioral Therapy/Centralized Pain Mechanisms These interventions are highly recommended for people who are experiencing elevated distress or anxiety, or, noticed that their symptoms began without an injury, but with a stressful event, big life change, or, that symptoms increase with stress or difficult emotions (or symptoms change when distracted, focused , or on vacation) - full list of criteria to rule in centralized/nociplastic mechanisms.

  • Pain Reprocessing Therapy (PRT)
  • Emotional Awareness & Expression Therapy (EAET)
  • CBT/DBT
  • Mindfulness & meditation
  • TRE or EMDR (for Trauma)

TREATMENT: Low tone (Hyp-O-tonic/weak)

Pelvic floor physical therapy focused on strengthening muscles:

  • Kegels
  • Biofeedback

This is a draft. The post will be updated.

This is not medical advice. This content is for educational and informational purposes only. NONE OF THIS SUBSTITUTES MEDICAL ADVICE FROM A PROVIDER.

Sources:

OFFICIAL GUIDELINES:

A. Male Chronic Pelvic Pain - 2025 (AUA) https://www.auanet.org/guidelines-and-quality/guidelines/male-chronic-pelvic-pain

B. Male and Female Chronic Pelvic Pain - (EUA) https://uroweb.org/guidelines/chronic-pelvic-pain/chapter/epidemiology-aetiology-and-pathophysiology

C. Diagnosis and Treatment of Interstitial Cystitis/Bladder Pain Syndrome (2022)" AUA - https://www.auanet.org/guidelines-and-quality/guidelines/diagnosis-and-treatment-interstitial-of-cystitis/bladder-pain-syndrome-(2022))

MORE:

  1. Cleveland Clinic: Pelvic Floor Muscles

  2. Cleveland Clinic: Pelvic Floor Dysfunction

  3. Diaphragmatic belly breathing - https://www.health.harvard.edu/healthbeat/learning-diaphragmatic-breathing

  4. Trigger points and referred pain - https://www.physio-pedia.com/Trigger_Points

  5. Equal Improvement in Men and Women in the Treatment of Urologic Chronic Pelvic Pain Syndrome Using a Multi-modal Protocol with an Internal Myofascial Trigger Point Wand - PubMed https://share.google/T3DM4OYZYUyfJ9klx

  6. Physical Therapy Treatment of Pelvic Pain - PubMed https://share.google/92EQVDnQ1ruceEb23

  7. Central modulation of pain - PMC https://share.google/p7efTwfGXe7hNsBRC

  8. A Headache in the Pelvis" written by Stanford Urologist Dr. Anderson and Psychologist Dr Wise - https://www.penguinrandomhouse.com/books/558308/a-headache-in-the-pelvis-by-david-wise-phd-and-rodney-anderson-md/

  9. What if my tests are negative but I still have symptoms? NHS/Unity Sexual Health/University hospitals Bristol and Weston - https://www.unitysexualhealth.co.uk/wp-content/uploads/2021/05/What-if-my-tests-for-urethritis-are-negative-2021.pdf

  10. Vulvodynia" a literature review - https://pubmed.ncbi.nlm.nih.gov/32355269/

  11. The Effects of a Life Stress Emotional Awareness and Expression Interview for Women with Chronic Urogenital Pain: A Randomized Controlled Trial - https://pubmed.ncbi.nlm.nih.gov/30252113/

  12. Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain - https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2784694

  13. Clinical Phenotyping for Pain Mechanisms in Urologic Chronic Pelvic Pain Syndromes: A MAPP Research Network Study - https://pubmed.ncbi.nlm.nih.gov/35472518/


r/PelvicFloor Dec 03 '24

RESOURCE/GUIDE RESEARCH: Pain Mechanisms Beyond The Pelvic Floor

37 Upvotes

"Clinical Phenotyping for Pain Mechanisms in Urologic Chronic Pelvic Pain Syndromes: A MAPP Research Network Study" https://pubmed.ncbi.nlm.nih.gov/35472518/

UCPPS is a umbrella term for pelvic pain and dysfunction in men and women, and it includes pelvic floor dysfunction underneath it, as well as symptoms like bladder dysfunction, IC/BPS, and more. This study discusses the pain mechanisms found. They are not only typical injuries (ie "nociceptive") - They also include pain generated by nerves (neuropathic) and by the central nervous system (nociplastic). You'll also notice that the combination of neuropathic + nociplastic mechanisms create the most pain! Which is likely to be counterintuitive to what most people would assume.

At baseline, 43% of UCPPS patients were classified as nociceptive-only, 8% as neuropathic only, 27% as nociceptive+nociplastic, and 22% as neuropathic+nociplastic. Across outcomes, nociceptive-only patients had the least severe symptoms and neuropathic+nociplastic patients the most severe. Neuropathic pain was associated with genital pain and/or sensitivity on pelvic exam, while nociplastic pain was associated with comorbid pain conditions, psychosocial difficulties, and increased pressure pain sensitivity outside the pelvis.

Targeting neuropathic (nerve irritation) and nociplastic/centralized (nervous system/brain) components of pain & symptoms in recovery is highly recommended when dealing with CPPS/PFD (especially hypertonia).

All of those involved in the management of chronic pelvic pain should have knowledge of peripheral and central pain mechanisms. - European Urological Association CPPS Pocket Guide

And the newest 2025 AUA guidelines for male pelvic pain echo this:

We now know that the pain can also derive from a neurologic origin from either peripheral nerve roots (neuropathic pain) or even a lack of central pain inhibition (nociplastic), with the classic disease example being fibromyalgia

This means successful treatment for pelvic pain and dysfunction goes beyond just pelvic floor physical therapy (alone), and into new modalities for pain that target these neuroplastic (nociplastic/centralized) mechanisms like Pain Reprocessing Therapy (PRT), EAET, and more. Learn more about our new understanding of chronic pain here: https://www.reddit.com/r/ChronicPain/s/3E6k1Gr2BZ

This is especially true for anyone who has symptoms that get worse with stress or difficult emotions. And, those of us who are predisposed to chronic pain in the first place, typically from childhood adversity and trauma, certain personality traits (perfectionism, people pleasing, conscientiousness, neuroticism) and anxiety and mood disorders. There is especially overwhelming evidence regarding ACE (adverse childhood experiences) that increase our chances of developing a physical or mental health disorder later in life. So much so, that even traditional medical doctors are now being trained to screen their patients for childhood trauma/adversity:

Adverse childhood experience is associated with an increased risk of reporting chronic pain in adulthood: a stystematic review and meta-analysis

Previous meta-analyses highlighted the negative impact of adverse childhood experiences on physical, psychological, and behavioural health across the lifespan.We found exposure to any direct adverse childhood experience, i.e. childhood sexual, physical, emotional abuse, or neglect alone or combined, increased the risk of reporting chronic pain and pain-related disability in adulthood.The risk of reporting chronic painful disorders increased with increasing numbers of adverse childhood experiences.

Further precedence in the EUA (European Urological Association) guidelines for male and female pain:

The EUA pathophysiology and etiological guidelines elucidate further on central nervous system and biopsychosocial factors in male and female pelvic pain/dysfunction:

Studies about integrating the psychological factors of CPPPSs are few but the quality is high. Psychological factors are consistently found to be relevant in the maintenance of persistent pelvic and urogenital pain [36]. Beliefs about pain contribute to the experience of pain [37] and symptom-related anxiety and central pain amplification may be measurably linked, and worrying about pain and perceived stress predict worsening of urological chronic pain over a year [36,38] - https://uroweb.org/guidelines/chronic-pelvic-pain/chapter/epidemiology-aetiology-and-pathophysiology

Pelvic pain and distress is related [43] in both men and women [44]; as are painful bladder and distress [38]. In a large population based study of men, CPPPS was associated with prior anxiety disorder [45] - https://uroweb.org/guidelines/chronic-pelvic-pain/chapter/epidemiology-aetiology-and-pathophysiology

Here are the 12 criteria to RULE IN centralized, (ie neuroplastic/nociplastic) pain, developed by chronic pain researcher Dr. Howard Schubiner and other chronic pain doctors and pain neuroscience researchers over the last 10+ years:

  1. Pain/symptoms originated during a stressful time

  2. Pain/symptoms originated without an injury

  3. Pain/symptoms are inconsistent, or, move around the body, ie testicle pain that changes sides

  4. Multiple other symptoms (often in other parts of the body) ie IBS, chronic migraines/headaches, CPPS, TMJD, fibromyalgia, CFS (fatigue), vertigo/dizziness, chronic neck or back pain, etc

  5. Pain/Symptoms spread or move around

  6. Pain/symptoms are triggered by stress, or go down when engaged in an activity you enjoy

  7. Triggers that have nothing to do with the body (weather, barometric pressure, seasons, sounds, smells, times of day, weekdays/weekends, etc)

  8. Symmetrical symptoms (pain developing on the same part of the body but in OPPOSITE sides) - ie both hips, both testicles, both wrists, both knees, etc

  9. Pain with delayed Onset (THIS NEVER HAPPENS WITH STRUCTURAL PAIN) -- ie, ejaculation pain that comes the following day, or 1 hour later, etc.

  10. Childhood adversity or trauma -- varying levels of what this means for each person, not just major trauma. Examples of stressors: childhood bullying, pressure to perform from parents, body image issues (dysmorphia), eating disorders, parents fighting a lot or getting angry (inc divorce)

  11. Common personality traits: perfectionism, conscientiousness, people pleasing, anxiousness/ neuroticism - All of these put us into a state of "high alert" - people who are prone to self-criticism, putting pressure on themselves, and worrying, are all included here.

  12. Lack of physical diagnosis (ie doctors are unable to find any apparent cause for symptoms) - includes DIAGNOSIS OF EXCLUSION, like CPPS!

[NEW] 13. Any family history of chronic pain or other chronic conditions. Includes: IBS, chronic migraines/headaches, CPPS, TMJD, fibromyalgia, CFS (fatigue), vertigo/dizziness, chronic neck or back pain, etc

HOW TO TREAT centralized (neuroplastic) pain and symptoms?

PRT - Pain Reprocessing Therapy:

Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain - https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2784694

EAET - Emotional Awareness and Expression Therapy

Emotional Awareness and Expression Therapy vs Cognitive Behavioral Therapy for Chronic Pain in Older Veterans https://pmc.ncbi.nlm.nih.gov/articles/PMC11177167/

Psychological Therapy for Centralized Pain - An Integrative Assessment and Treatment Model: https://pubmed.ncbi.nlm.nih.gov/30461545/


r/PelvicFloor 11h ago

General Belly breathing doesnt even move my pelvic floor

25 Upvotes

I see everyone here talk about belly breathing and reverse kegels.

Well when I belly breathe my pelvic floor wont relax, lenghten, drop even a little bit.

Im not sure why or whats going on.

Anyone have same ? Can anyone help me out


r/PelvicFloor 12h ago

General Urgency

9 Upvotes

Guys I really need your help.
Can a feeling of not being fully relieved after urinating, along with a persistent urge to urinate, be related to a tight (hypertonic) pelvic floor? Has anyone experienced this?


r/PelvicFloor 6h ago

Female 360 breathing and core engagement tips?

3 Upvotes

Hi all! I dealt with a hypertonic pelvic floor last year which, thankfully, responded well to medical treatment. I’m back to strength training again but I’m still stumped on how to 360 breathe and engage my core. I can’t “zip” from the bottom up, and I seem to be an upper ab gripper. I know what I’m supposed to do—and what it is supposed to look like—but I can’t execute at all because I’m so disconnected from my core😢

PFT was SO expensive last year, I’m really not keen on going back, especially now that I’m no longer in pain. But I know my core is the missing piece to lasting pelvic floor health…Can anyone recommend some online courses (or even YT videos!) that have helped them in this area? I’d much rather pay $30/month vs $200/week💀 Thanks!

Also happy to answer any questions about my experience!


r/PelvicFloor 4h ago

Male Uro-Pelvic Floor

2 Upvotes

My primary doctor has sent a referral to a Uro-Pelvic Floor specialist which I looked up to the doctor and she is a Urogynecology. How will this work for me as I am a 34 male? Because of course gynecologists are for women, I believe so correct me if I'm wrong. But my primary doctor and my PFPT have suggested it's time to look into an implant and I just been dismissed from PFPT because she has used all her resources to try to help me.


r/PelvicFloor 2h ago

Female How to engage the inner core properly

1 Upvotes

Hello! I have a hypertonic pelvic floor with an anterior pelvic tilt. My PT gave me deep core exercises to do. I feel they are helping me so much with overall body alignment, but my pelvic floor is so much tighter when I do them. I can’t afford to see my PT anymore or else I would ask her this question lol. But how do you engage the core without tightening ur butthole?? Please help


r/PelvicFloor 4h ago

Success Story Tight hip from Pelvic floor problems?

1 Upvotes

Basically I’ve had a very tight pelvic floor and started to do exercises 4-5 years ago. It’s been a slow progress but now I feel like its not a huge problem anymore.

1.5 years ago I started to feel numbness in my lower body and couldn’t sleep for more than 2 hours for over a year, a PT revealed I did have a loss of sensation in my lower body as well and started to think I got neuropathy but after many tests it turned out everthing was fine.

I started doing very hard stretching 1 month ago on my hip and from nowhere I started to fel a LOT better. Now I’ve been doing it for 1 month straight and sleeping better than I ever have been before. For the first time in my life I have a feeling of being ”relaxed” and have more energy than ever.

I was seeing my pelvic floor therapist today and she said she can’t really explain it and don’t know if the pelvic floor was the root cause of this.

Anyone got any ideas? I’m just happy I’m feeling better than ever now, but I’d really like to identify whats the cause.


r/PelvicFloor 10h ago

Male Something weird that happens with me

1 Upvotes

My problems are that it take a while for the stream to begin and weak streams.

However when I have to go bad and it's urine with a lot of irritants(burning sensation in bladder) I can urinate like there's no problem.

It comes out nearly right away and the stream is consistently and strong.

Does this happen with anyone else and or know why this is?

Thank you


r/PelvicFloor 11h ago

Help Finding PT Is there a connection between the pelvic floor muscles and the cremaster muscle?

1 Upvotes

Do excessively tense pelvic floor muscles cause the cremaster muscle to contract or become overactive? My pelvic floor muscles are tight, and my scrotum is constantly contracted—as if I were in the cold; I don't know if this is due to the pelvic floor muscles or if there is another issue. I would appreciate your help.


r/PelvicFloor 17h ago

Male Does this is a pelvic floor thigthness

2 Upvotes

Ok so before 2 year i got like a sciatica nerve , and i have imbalance in the hips. This year i got a lot of bad things with my gut and ect... that put me in hight alert state , and now i think i have tenesmeus or can t relax during a bowl even if i can and get all things out i still feel somthing there.

And there s another thing that i hate it a lot when i sit and have a bowl after i can t get anything out but the moment i stand up or i walk i start feeling somthing idk somtimes real somtimes fake , and somtimes i got more that the first time.

Now i can t know exactly differnece between trapped gas and stool , and like for people they know they had to use bathroom if the rectum is stretched , but for me no, i know by the discomfort in lower colon and feel stool moving , and somtimes i got no urge even if my colon is not empty , and other time i got big urge for the smallest thing or nothing.

I just want to use toilet once or twice and feel empty. And have a routine.


r/PelvicFloor 17h ago

Male Exercices?

2 Upvotes

Flr people who got problem relaxing pelvic floor during a bowl or have cordination problem.

What are the exercice u do with your physical therepay, did u see any results?

And if i want to do it, i go to any physical therepay told him about symptoms or need one specialized in it or need a gastro advice.


r/PelvicFloor 15h ago

Discouraged Relaxing Core

1 Upvotes

I simply cannot relax my core and in turn my pelvic floor is always up tight. Diaphragmatic breathing is difficult because of this. Anyone have any advice or suggestions?

(Bloated, can’t empty bladder or bowels, can’t pass gas, hard to burp, pain)


r/PelvicFloor 16h ago

Help Finding PT Un año 4 meses de dolor

1 Upvotes

Un año y 4 meses de cambiar toda mi vida por este dolor, en cama hasta noviembre y desde diciembre funciono un 40% levantada y sufriendo.
Soy Mamá de 3 adolescentes, eso ya es rudo.
No tengo ayuda domestica mas que ellos y mi esposo, pero no les da el tiempo tampoco, y he dejado de trabajar un 80%.
En abril del añp pasado estuve hospitalizada por el dolor, no me lo bajaban ni cln tramadol a la vena… a los 8 días pedí el alta voluntaria porque no sabian que tenia y no me dieron bola ni con exámenes, prefirieron decir que era mi cerebro mandando dolor donde no hay daño, y que eso no tenia cura.

Pero hace 1 mes decidí volver a los médicos porque NO DOY MÁS, y fuí a una ginecóloga de piso pélvico, y aunque suene raro alegrarse por esto… me encontró daños reales! 3 puntos gatillos internos, que bajo su perspectiva podían estar presionando el pudendo.
Fuí donde el anestesiólogo para contarle y me dice que con un bloqueo diagnóstico lo sabríamos, que SI ME QUITABA EL DOLOR AUNQUE SEA UNAS HORAS, ENTONCES SÍ ERA. Mi dolor ya lo sentía hacia el lado derecho solamente además del recto ( el PEOR dolor) ssí que bloqueó ese lado… y SE ME QUITÓ TODO EL DOLOR… pero por 18 horas, después vino un dolor casi peor por 3 días… qué pasó después? Volvió casi el mismo dolor, lo que incluye al recto ( EL PEOR) y la zona media del gluteo izquierdo, pero el lado derecho donde estaba uno de los mas fuertes ya mo dolía, así que a los 10 días vuelvo al anestesiólogo y le cuento todo, me confirmó que por el hrcho de eliminar el dolor por unas horas podemos confirmar neuralgia del pudendo, y además me explocaba que ahora que no estaba el dolor 1 aparece el dolor 2 que estaba siendo opacado por el dolor 1, y quedamos en que bloquearía el lado izquierdo, y que lo correcto ahora es aprovechar esa ventana analgésica para hacer kine de piso pelvico oara soltar las contracturas internas.
Amigos, el dolor en el recto es INVALIDANTE, de verdad siento que me DISCAPACITÉ que de verdad soy un ser humano anulado y ya recuerdo mi cuerpo ni mis movilidad normal, el dolor NO ME ABANDONA NUNCA, solo lo alivio con agua de bolsa caliente que me quema ( elijo eso para no sentir lo otro), la peor parte es disponerme a dormir…. No hay forma de acomodarme, el dolor es para llorar, asi que tomo un hipnotizante carísimo.

Es neuralgia al pudendo?
Es sicologico?
Es algo dentro del recto? ( ya me hice una colonoscopia y no salió nada)

Dato nuevo:
El protcogel oara hemorroides me alivia el dolor del recto!.

Necesito ayuda!!!!

Denme opiniones
Hagannme peeguntas

DENME TIPS!
Hasta de sus terapias para el dolor.

Y si alguien ha tenido al menos 6 meses de dolor CUENTAMELO TODO PORFAVOR 😩😩🙏🏽🙏🏽🙏🏽.

Y SI TE SANASTE, PORFAVOR CUENTAMELO TODO TAMBIÉN.

Me hago el bloqueo izquierdo?

Que mas puedo hacer???

Es realmente neuralgia al pudendo??

Ayúdenme! Necesito levantarme ! ( no es que esté acostada, sino que semi sebtada toda deformada para mo apoyar todo el cuerpo y cambiando de posición todo el tiempo, siempre quemándome con una bolsa de agua caliente).

Soy de Chile 🇨🇱


r/PelvicFloor 1d ago

Female Why is it all so complicated?

43 Upvotes

To all of the physical therapists out there and anyone well versed in pelvic floor therapy-- why does it seem so complicated and counter intuitive. I feel like (feelings not facts) it shouldn't be this hard. I don't even have a huge issue, but the constant awareness of the pelvic floor and how you are sitting/standing/breathing. It becomes all consuming. Is there any easy pelvic floor therapy? Like I don't want to think about this all of the time.


r/PelvicFloor 1d ago

Male Dyssynergic Defecation / ibs ?

3 Upvotes

Hi guys i been questioning whether i have Dyssynergic Defecation these days, and i want to know whether people with this condition have that thing where they can't pass gas after a bowel movement?

Also i noticed that if stool gets into my rectum i can pass it without problems but , that's the problem because the structure above the rectum seems somehow to be closed and doesn't let stool down in a normal way , i noticed that stool would accumulate over 3 to 4 days then it gets to the rectum...

And not a per day thing where i would have a bowel movement each day

stool comes thin and loose and after pooping that above the rectum structure becomes spasmed and tight for some reason

Does this sounds like it ?

Also i think that i have some ibs type of thing in which after an antibiotic use caused my intestines to become hypersensitive to pretty much everything and my intestines cramp and spasm too

At this point i don't know whether i have ibs or dyssynergic Defecation, it’s pretty hard to distinguish


r/PelvicFloor 1d ago

General Has strengthening fixed your pfd

8 Upvotes

I’ve heard most cases a tight weak pelvic floor is caused by imbalance/weak of other muscles like glutes hips etc?

Just wondering how many of you were able to see significant improvement after starting to strengthen the surrounding muscles and did u often face flares?


r/PelvicFloor 1d ago

Male Pelvic floor issues

2 Upvotes

Hi guys, I've been struggling with pain in my lower abdomen and rectum for about 2 months now, and sort of assumed it was ibs (based on my GP and google). But after reading through this sub I'm starting to think it may be a pelvic floor issue? I'd greatly appreciate if you guys could weigh in so I don't feel like a crazy conspiracy theorist haha...

My biggest symptoms are:

  • pain in my rectum and abdomen around 10-15 min after going number 2
  • associated urgency and never feeling completely empty, alongside not being able to fart like I used to (?)
  • before going on low FODMAP, bloating especially at night time
  • general discomfort when I'm sitting down and not walking around

these symptoms have been going around for about 2 months, and low FODMAP, gluten free etc haven't had any major effects in 2-3 weeks. Do you guys think this might be PFD? It all started overnight, after I had a huge pizza and some weed all to myself.

any advice would be amazing!


r/PelvicFloor 1d ago

Female After pt flare??

2 Upvotes

Does anyone here get flare after pt ( 3 lesson so far )


r/PelvicFloor 1d ago

Male Pelvic floor assessment

3 Upvotes

I have an appointment at a pelvic therapy for my first assessment. What are the types of questions I should be asking? I had a pelvic floor/genital trauma injury that was very significant when I was younger. I have a random sharp sting in my groin area randomly when I'm physically active then I sit down and go to stand up.

I'm also going to ask a urologist for a scan to my genitalia and pelvic floor area, is there anything I should be asking for this as well?

Thank you anyone who is able to help me out here. I'm just not sure if anything that I'll be forgetting to ask, could help me understand more.

Currently going for pelvic floor dysfunction, lifelong premature ejaculation and erectile dysfunction.


r/PelvicFloor 1d ago

General I think I have pelvic floor dysfunction

2 Upvotes

(18 Male) Ive been dealing with a lot of different symptoms for the past 3 years of my life that have gotten worse over time. (e.g. trouble peeing, constipation, pelvic pain, uncomfortableness, feeling of tightness, leaking, etc) Ive went to many different doctors and urologists to try and figure out the problem and they never find anything psychically wrong. After doing a lot of research myself, I feel the most likely problem is pelvic floor dysfunction, because all of my symptoms are common symptoms of it.

So for anyone who has or had pelvic floor dysfunction, I want to ask some questions.

  1. Were you able to cure it permanently? (if so how long did it take)

  2. What were the things you did to cure it?

  3. Did the doctor diagnose you with pelvic floor dysfunction, or did you figure it out yourself?

  4. What were your symptoms?

I would like to hear from anyone who has had or is just knowledgeable on the topic, any info is appreciated. I’m really sick of living like this and I feel like none of the doctors I go to are really helping.


r/PelvicFloor 1d ago

Female When to seek a different PT

2 Upvotes

At the first appointment I asked for any relaxing exercises I could do at home and the PFPT said they don't work and it's better to just focus on deep breathing throughout the day. And sure this has helped quite a bit at times but 5 sessions in I've not gotten any more than that and I hoped that at this point I would have something more to do at home. (Okay she also said I should buy a gym ball and make large and small circles on it in both directions once a day but 4 weeks in and it's not done anything and most times its just painful to sit like that and it feels more triggering than helping) At the sessions we mostly do exercises in which she asks me to make a certain movement and then tell her which muscles I can feel and then she will tell me to relax certain parts. I guess the point is to make me aware of the unnecessary extra tension I sometimes create in unnecessary muscle groups. And I can relax a leg muscle, sure. But at most times I physically cannot relax my pelvic floor and I'm getting no instruction on how to actually do that.

I have the worst flare ups when I'm on my period, I always had terrible cramps but nowadays I can feel my pelvic floor and right glute is also joining the cramp party and my pain will be a 10/10 for at least the first two days of period and need about 5 days to calm down to my normal 5/10 pain again.

I told my PT this, about the unbearable cramps and the right glute muscle that joins in and how no amount of breathing or ball rolling or stretching (that I found on the internet) releases it. And she said she didn't understand where that tension would come from. So now I seriously doubt her knowledge on this... How long would y'all give it before trying to find another PT?

Edit to add: I bought a pelvic wand and taught myself how to do internal release kind of, sometimes it works a charm sometimes it doesn't work at all (like when I'm on my period) but I feel like I've at least done more for myself than my PT has


r/PelvicFloor 1d ago

Male I’m having a nerve block tomorrow

3 Upvotes

A superior hypogastric nerve bilateral and I’m concerned it may cause erectile dysfunction and/or prevent orgasms. I only now just realized. This could destroy my relationship with my girlfriend. Are my fears unfounded? Has anyone had this done?


r/PelvicFloor 1d ago

Male Pelvic floor issue??

2 Upvotes

I had a UTI around a year ago and ever since my sexual performance has been hindered. I used to be able to have sex with my gf several times a day or many times a weekend with no issue. Now I can only have sex once a day or maybe twice a weekend, any more and I have pain in my urethra and sometimes mild testicle aches. I have had multiple STI tests which have come back negative. I have been to urology and had many tests and ultrasounds around that area all coming back normal. After hours googling and asking AI I am convinced I have a resulting pelvic floor dysfunction. Has anyone else had any similar issues? I am unsure what to do?