Bowel and rectal function rely on a coordinated system of pelvic floor muscles, abdominal pressure regulation, and autonomic nervous control. Dysfunction in any part of this system can result in constipation, fecal urgency, incontinence, or rectal pain. Many men hesitate to report these symptoms, but they are both common and treatable — especially when pelvic floor dysfunction is the underlying cause.
At the Performance Medicine Institute, we evaluate the full spectrum of bowel and anorectal complaints through a functional, multidisciplinary lens. We assess pelvic floor coordination, rectal tone, abdominal wall function, dietary contributors, and nervous system balance. Our treatments include pelvic floor physical therapy, breathwork, dietary coaching, behavioral retraining, dry needling, laser therapy, and collaborative care with gastroenterology when indicated.
We treat a wide range of bowel and rectal conditions, including:
Chronic Constipation
Persistent difficulty passing stool may be related to pelvic floor dyssynergia, colonic motility issues, or paradoxical muscle contraction during defecation. We provide advanced lab testing, retraining of bowel habits, fiber and hydration optimization, and pelvic floor therapy using biofeedback and manual techniques to normalize muscle patterns.
Fecal Urgency and Incontinence
Loss of stool control or sudden urges may result from pelvic floor weakness, nerve dysfunction, trauma, or previous anorectal surgery. We strengthen sphincter control, enhance neuromuscular timing, and apply laser therapy to promote tissue resilience and confidence in bowel control.
Rectal Pain / Levator Ani Syndrome
Pain in the rectum or tailbone, or in the perineum, may result from pelvic floor muscle spasm or nerve entrapment. We provide indirect muscle release (which often avoids the need for internal manipulation), pelvic floor downtraining, and neural mobilization, laser, dry needling, and medication management to reduce chronic tension and improve comfort.
Proctalgia Fugax
This condition causes sudden, severe rectal pain episodes that resolve within minutes to hours. Though benign, it can be distressing and often linked to autonomic imbalance or pelvic hypersensitivity. Treatment focuses on nervous system regulation, breath training, and pelvic floor relaxation techniques. Pain relief is often rapid once beginning our treatment program.
Incomplete Bowel Emptying / Tenesmus
A persistent sensation of incomplete evacuation can be caused by impaired coordination between abdominal pressure and pelvic outlet relaxation. We retrain defecatory mechanics using biofeedback, neuromuscular drills, and manual therapy to reduce straining and improve efficiency.
Pain with Anal Intercourse
Many men who engage in receptive anal intercourse experience pain in their rectum. This can detract from sexual enjoyment, and lead to chronic pain syndromes and bowel incontinence over time. Our treatment approach not only reduces pain with intercourse, but also makes the prostate more sensitive and intercourse more pleasurable. We use a combination of advanced medications like oxytocin along with pelvic floor physiotherapy, non-invasive pelvic floor muscle training, soft tissue mobilization, myofascial release, and laser therapy to alleviate pain and improve sexual enjoyment.