The pelvic floor is a complex group of muscles, connective tissues, and nerves that support the pelvic organs, stabilize the core, and control urinary, bowel, and sexual function. Dysfunction in the pelvic floor — whether from weakness, overactivity, trauma, or coordination issues — can lead to a wide range of symptoms including pain, incontinence, erectile or ejaculatory dysfunction, constipation, and pressure sensations. These symptoms often overlap and may be misdiagnosed as urologic or gastrointestinal disorders.
At the Performance Medicine Institute, we specialize in the diagnosis and treatment of pelvic floor dysfunction in men. We use comprehensive assessment tools including internal and external pelvic floor evaluation, real-time ultrasound, digital rectal exam, pressure mapping, and neurologic screening. Our treatment model incorporates pelvic floor physiotherapy, neuromuscular retraining, breathwork, behavioral support, and advanced tools such as laser therapy, dry needling, and ultrasound-guided injections when needed.
We treat a wide range of pelvic floor conditions, including:
Pelvic Floor Muscle Hypertonicity (Tightness)
Excess tension in the pelvic floor muscles can lead to pain in the perineum, rectum, testicles, or base of the penis. It may contribute to erectile dysfunction, premature ejaculation, urinary urgency, or pain during defecation. Treatment includes downtraining techniques, myofascial release, diaphragm-to-pelvic floor coordination, and laser therapy to reduce neural and muscular sensitivity.
Pelvic Floor Weakness / Incoordination
Poor activation of the pelvic floor muscles can lead to urinary leakage, fecal incontinence, poor orgasmic control, and feelings of pelvic instability. We guide patients through non-invasive biofeedback-based training, functional strengthening, and integrative movement strategies to restore pelvic stability and voluntary control.
Chronic Pelvic Pain Syndrome (CPPS)
CPPS is a non-infectious, multi-system condition characterized by persistent pelvic, perineal, or genital pain often accompanied by urinary or sexual dysfunction. Our multidisciplinary approach includes musculoskeletal and neurologic evaluation, pelvic floor therapy, autonomic regulation, and laser therapy to address central and peripheral pain generators.
Levator Ani Syndrome / Puborectalis Spasm
Pain in the rectum or tailbone, or in the perineum, may result from pelvic floor muscle spasm or nerve entrapment. Increased resting tone or spasms in the levator ani or puborectalis muscles can lead to deep pelvic pain or difficulty with bowel movements. Treatment focuses on pelvic muscle relaxation, trigger point release, manual therapy, and techniques to normalize pelvic floor reflexes.
Proctalgia Fugax
Proctalgia fugax 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.
Pudendal Neuralgia
Compression or irritation of the pudendal nerve can cause burning, tingling, or electric-like pain in the genitals, anus, or perineum. Symptoms may worsen with sitting and improve when lying down. We use a combination of nerve glides, pelvic floor release, laser therapy, postural rebalancing, and ultrasound-guided hydrodissection to relieve neural irritation.
Post-Surgical or Post-Trauma Pelvic Dysfunction
Scarring, muscle guarding, or nerve injury following pelvic, prostate, or abdominal surgery can contribute to persistent pelvic floor dysfunction. We address this with scar mobilization, reinnervation strategies, functional retraining, and patient education on managing post-surgical sensitivity and performance.