Pelvic pain is often thought of as a condition that primarily affects women, but many men experience chronic pelvic pain that can significantly impact daily life, exercise, work, and relationships. If you experience pain in the pelvis, groin, tailbone, testicles, lower abdomen, or penis, or urinary urgency, painful urination, constipation, or discomfort during sitting and exercise, it may be time to seek help. Unfortunately, many men suffer in silence or struggle to find effective treatment options.
Rachel Chirichella PT, DPT, CSCS, our Pelvic Floor Physical Therapist in Centennial, Colorado, offers a comprehensive, evidence-informed approach to treating men’s pelvic pain by addressing the muscles, nerves, fascia, and nervous system that contribute to symptoms.
How We Treat Pelvic Pain in Men
There are three main components we use to target pelvic pain in men: manual therapy, nervous system regulation, and therapeutic exercises.
Manual Therapy
Manual therapy is an effective treatment to target tight, overactive pelvic floor muscles. This tension, along with compensatory daily movement patterns, can create trigger points and nerve irritation that perpetuate pain.
As a pelvic floor specialist, Rachel uses both external and internal pelvic floor mobilization techniques to reduce muscle guarding, improve tissue mobility, and restore normal pelvic floor function. External techniques may target the hips, abdomen, adductors, glutes, and low back. With consent, internal pelvic floor mobilization allows for direct treatment of deep pelvic muscles that are difficult to access otherwise. Additional manual techniques such as dry needling and cupping can also be valuable tools in reducing pain and improving mobility.
Nervous System Regulation
Another critical piece of recovery is nervous system regulation. Chronic or even acute pelvic pain is not just a muscular issue. Because of the close connection between the pelvic floor and the nervous system, keeping the body in a constant state of tension and threat may heighten symptoms.
At The Performance Shift, we examine your daily habits, including sleep, stress, diet, and lifestyle, to create a personalized plan of care that targets not just the pelvic floor, but the whole body.
Therapeutic Exercises
In addition to hands-on treatment, specific exercises can help reduce pelvic tension and improve mobility. Here are three simple exercises Rachel commonly recommends for men with pelvic pain.
1. Side-Lying Diaphragmatic Breathing
You will need a pillow for this exercise. Place a pillow underneath your ribcage and lay on your side. Bend your knees toward your chest and bring your left hand to your left ribs. Begin breathing into your left hand to expand your diaphragm laterally. Perform 10 deep breaths, then repeat on the other side. The goal is to breathe from your abdominal cavity, not your chest.
2. Adductor Rock Backs
Begin on your hands and knees with one leg extended out to the side. Slowly rock your hips backward while keeping your spine neutral until you feel a stretch in the inner thigh. Perform 10–15 repetitions on each side.
3. Pudendal Nerve Glides
The pudendal nerve can become irritated in men with pelvic pain. Gentle nerve glides may help reduce sensitivity and improve mobility.
Hold onto a sturdy table or chair and come into a wide stance. Squat low toward the floor, with heels on the ground, and look up toward the ceiling. Stand up into a calf raise with your chin tucked toward your chest. Repeat 10 times.
