Male Pelvic Pain (aka “Man Cramps”) and How Pelvic PT Can Help You
Something you may not have known is that pelvic health physical therapists can help men, because yes men do have a pelvic floor and they can also have pelvic floor issues! As a pelvic physical therapist, I’ve helped many men who have presented with months to years of mysterious pain in their pelvic floor and genital area…we can call this pelvic pain, pelvic muscle spasms, or “man cramps”. Some common things I’ve heard from men who are dealing with pelvic pain issues include:
“I feel a stabbing pain in my butt”
“It’s like a Charlie horse in my private parts”
“Feels like I’m sitting on a golf ball in my butt”
“It really hurts to sit, if I sit longer than 20 minutes the pain spreads to my tailbone and legs”
Often times, these patients have seen doctors and urologists who have performed a number of medical tests, which have all turned out negative (testing everything from infections in the bladder or prostate, STIs, MRIs, x-rays, etc) and are stumped as to the source of the pain. When other medical issues have been ruled out, then the pelvic floor may be to blame! If the pelvic floor muscles are a driver to pain, we call this “pelvic floor muscle dysfunction.” So many men don’t know what a pelvic floor is or that they even have one.
Pelvic pain can seem to strike out of nowhere and often targets (but not always) high-achieving, type-A, higher-stress, athletic men. These symptoms often baffle doctors, and it can take men up to 7 years to receive an accurate diagnosis of chronic pelvic pain and pelvic floor muscle dysfunction. Here are some common symptoms of pelvic pain that can be due to pelvic floor muscle issues:
Intermittent or constant pain (dull pain, cramping, spasming, tightness, sore, burning, etc) in the tailbone, perineum (space between the anus and scrotum), the scrotum, penis, testicles, lower abdomen, low back, and/or around the groin or anal area.
Pain or burning after ejaculation
Pain, soreness, or spasms following intercourse
Urinary urgency and frequency (feeling like you need to pee super often)
The varying locations and descriptions of pain can often throw doctors off when it comes to diagnosis, and many patients may be misdiagnosed as having an infection of the prostate or a prostate-based issue, when the problem is not coming from the prostate at all. Male pelvic pain is not only confusing and frustrating, but can significantly impact quality of life and mental health. Pelvic pain can make someone: feel depressed or anxious, avoid certain activities out of fear of flaring up pain, have trouble sleeping, have difficulty with sitting, or have trouble staying focused and present at home or at work. The good news is that you CAN heal pelvic pain and having the right tools and practitioners on your team can make all the difference.
Why Pelvic Pain Happens:
It is always important that we fully rule out any “medical reasons” for pain. This means working with your urologist or primary care doctor to rule out issues such as infections of the bladder or prostate, sexually transmitted diseases, trauma from a surgery or biopsy, low back/hip/orthopedic causes, etc. If you do receive a diagnosis from your medical doctor that doesn’t feel quite right to you or you are not getting better, it is important to seek out another opinion with a provider that is well versed in pelvic pain (IPPS search)
Once you have been cleared medically, it’s important to look at other triggers to pain. A huge culprit to pain is chronic stress or anxiety. Almost all of the men that I have worked with self-report that they have a long standing history of anxiety, challenges coping with stress, a racing mind, and even panic attacks. Some of us carry our stress in areas such as our shoulders, neck, and jaw, but some of us carry stress and tension in their pelvic floor muscles!
If your pelvic floor muscles are repeatedly being clenched and activated every time you are stressed or anxious, it may set off a viscous cycle of pain, stress, more clenching and tension, and reflexively guarding/tensing even more to further guard the area from pain. This tension places strain on the muscles, nerves, ligaments, and fascia around the pelvis and genitalia, resulting in pain such as soreness, tightness, spasms, or burning. This is where a pelvic floor physical therapist can help you.
How a Pelvic Floor PT can help you Treat Pelvic Pain
After working with your medical doctor, getting a thorough screening, and we know that there is nothing going on medically, then a pelvic floor physical therapist can help you identify and treat the many triggers + causes to pelvic pain. We work to empower you with tools and strategies to help you learn to manage and resolve your pain.
During pelvic PT sessions, we take into account and discuss the various factors that contribute to pelvic pain including mental health/stress/anxiety, posture, poor sleep or diet, exercise, and self-care. Pelvic PT sessions consist of:
Manual therapy to help release tight and dysfunctional muscles
Teaching body awareness and exercises to calm the nervous system
Stretches and mobility exercises to restore optimal movement at the hips, low back, and pelvic floor
Behavior modifications
Addressing tension in other parts of the body that may be contributin to pain
Stress and anxiety reducing skills to help reduce tension in the muscles
Educate on strategies to “break the tension” (meditation, aerobic exercise, gentle yoga, deep breathing, etc)
If you are reading this and can relate, know that there is help and you CAN overcome pelvic pain. Empowering you with the right tools and strategies to help you heal is what we love to do at Awake Pelvic Health & Wellness.
Come see us in our Woodbury, MN pelvic floor physical therapy clinic or work with us virtually. Contact us here to learn more!
