By Jolie Koesters | Therapy Services

Dr. Lili Wells, PT / Clinic Manager

One out of five Americans, both men and women, suffers from some type of pelvic floor dysfunction. Muscle tension or weakness in the pelvic floor muscles can contribute to issues that prevent people from living their best lives. The majority of these cases go untreated.

Pelvic health therapy is a real need in our community and a challenge to find  – particularly for men. By adding men’s pelvic health to my physical therapy specialties, I am able to make a difference. My patients see a good success rate and enjoy an improved quality of life after treatment.

What are some symptoms to watch for?

Patients who are dealing with some of the symptoms below could benefit from pelvic floor therapy:

  • Incontinence
  • Abdominal or groin pain
  • Chronic bladder, rectal or testicular pain
  • Hip, sacrum or tailbone pain
  • Painful intercourse
  • Difficulty with bowel movements or urination

Maintaining muscle strength in the male pelvic floor area is critically important to sexual function, urinary continence and lower back health. To perform well, these muscles must be trained like any other muscles in the body such as glutes, calves or biceps.

When pelvic floor muscles are affected by surgery, trauma or repetitive stress, a qualified physical therapist can help. Men may be treated for premature or painful ejaculation while women may seek pelvic floor therapy for treatment of endometriosis or vaginismus.

What causes pelvic health issues?

Pelvic health problems are typically caused when muscles in the pelvis become too tense or overactive. For men, overly tight muscles can irritate or compress the bladder, urethra and bowel. This often leads to decreased blood flow and restricted/compressed nerves which can cause painful trigger points.

Other potential causes include:

  • High impact sports
  • Low back, hip or abdominal pain
  • Weakness in other muscles causing over-compensation
  • Stress, anxiety and other traits which result in clenching of pelvic muscles

Pelvic surgeries or chronic constipation can also contribute to pelvic floor weakness resulting in erectile dysfunction or involuntary leaking.

How can physical therapy help?

As a pelvic health specialist, I can do hands-on therapy that includes both internal and external treatment.

Since internal therapy does not appeal to some people, therapists are usually sensitive to the needs of every individual and do not begin with internal therapy until a patient is ready.

External therapy techniques include nerve release, trigger point therapy, myofascial release, skin rolling and joint mobilization.

Internal techniques may involve using specialized instruments or targeted trigger point therapy.

What exercises should be done for pelvic floor pain or weakness?

People often think Kegel exercises – which can be done by men and women – is the solution for all pelvic floor issues. These may actually hurt more than they help. To determine if you are doing these properly or if you even need them at all, I highly recommend an assessment from a physical therapist.

Proper pelvic floor exercises can help men who have undergone prostate surgery to have speedy recovery, reduced risk of rectal prolapse and improved bladder and bowel control.

This type of treatment is also beneficial for women with a lower risk of vaginal prolapse, bowel and bladder issues, as well as those recovering after childbirth.

Ongoing benefits

Not only can physical therapy help with pelvic disorders, but physical therapy in general can help men return to exercising consistently.

Why is this relevant? Exercise is shown to boost testosterone which is particularly important for male health. It can help prevent the effects of low testosterone including:

  • Decreased sex drive
  • Decreased energy
  • Weight gain
  • Feelings of depression
  • Thinner bones

If you feel you may have a pelvic floor disorder or limitations preventing you from living fully, physical therapy is a great place to start.


Dr. Lili Wells, PT has received specialized training in the treatment of pelvic health issues affecting men. Schedule an appointment by calling RehabVisions Fairfield at 641-469-3130. 

June 17, 2021