Pain in the Back of Shoulder Explained

Pain in the Back of Shoulder Explained

Shoulder pain is one of the most common complaints I hear as a physical therapist. But few things are as frustrating as persistent pain in the back of the shoulder. This type of pain can interfere with reaching, lifting, sleeping, and even simple daily tasks like putting on a shirt. Sometimes the pain is a dull, constant ache. Other times, it radiates, pinches, or worsens with certain movements. No matter how it shows up, one thing is clear: it can affect your quality of life.

It’s important to pay attention to when pain starts. Especially if it worsens or is accompanied by other symptoms, as this can help determine when to seek further evaluation.

In this blog, I’ll walk you through the most common causes of pain in the back of shoulder, highlight related conditions, and provide actionable physical therapy and self-care strategies. My goal is to help you better understand your pain and empower you with knowledge to take control of your recovery.

Introduction

Shoulder pain is a widespread issue that affects millions of people every year, often disrupting daily life and limiting activity. Because the shoulder joint is one of the most mobile and complex joints in the body, it’s especially vulnerable to injury and strain. Common causes of shoulder pain include rotator cuff tears, shoulder blade pain, and referred pain from other areas of the body. Whether the pain is sharp, dull, or radiates down the arm, it can stem from a variety of sources—ranging from overuse and poor posture to acute injuries or underlying medical conditions.

Recognizing the root cause is crucial for effective treatment and long-term relief. If you experience severe pain, numbness, or tingling in your shoulder or arm, it’s important to seek medical attention promptly, as these symptoms may indicate a more serious problem. In this guide, we’ll explore the most common causes of shoulder pain and provide strategies to help you manage and overcome discomfort.

Understanding Shoulder Anatomy

The shoulder joint, or glenohumeral joint, is a remarkable ball-and-socket joint formed by three bones: the upper arm bone (humerus), the shoulder blade (scapula), and the collarbone (clavicle). This unique structure allows for a wide range of motion, making it possible to reach, lift, and rotate your arm in almost any direction. Surrounding the joint are layers of soft tissues—muscles, tendons, and ligaments—that provide stability and support. The rotator cuff, a group of four muscles and their tendons, is especially important for keeping the upper arm bone securely in the shoulder socket and enabling smooth, controlled movement.

However, the very flexibility that makes the shoulder so functional also makes it prone to problems. Overuse injuries, poor posture, and wear-and-tear arthritis can place excessive strain on the surrounding muscles and soft tissues, leading to pain and limited mobility. Conditions like frozen shoulder, bulging or ruptured discs in the neck, and even heart attacks can also cause pain that radiates to the shoulder area. Understanding how the three bones, the rotator cuff, and the supporting structures work together is key to identifying the source of your pain and developing an effective treatment plan. By appreciating the complexity of the shoulder joint, you’ll be better equipped to protect it, maintain good posture, and restore a healthy range of motion.

Pain in the Back of the Shoulder

pain in the back of the shoulder

It is often linked to musculoskeletal issues like muscle strain, rotator cuff irritation, frozen shoulder, or acute injury. It can also arise from spinal problems or even internal conditions that “refer” pain to the area. The sensation may be sharp, dull, burning, or radiating—and knowing the difference helps narrow down the cause.

Localized pain in the back of the shoulder may indicate specific shoulder problems that require targeted evaluation, especially if the pain worsens over time or interferes with daily activities.

Shoulder Blade Discomfort

Pain in the back of the shoulder is often felt around or under the shoulder blade (scapula). This is because the shoulder blade serves as a foundation for many muscles that stabilize and move the shoulder joint. Inflammation of the bursa, a fluid-filled sac that cushions the joint, can also cause pain and restrict shoulder motion in this area. When the joint is stiff or dysfunctional, the scapular muscles overcompensate, leading to tightness and soreness.

Relieve Shoulder Blade Pain

As a PT, I often prescribe gentle, posture-friendly exercises to relieve shoulder blade pain:

  • Shoulder blade squeezes: Sit tall, pull your shoulder blades back and down, hold for 5 seconds, and relax.
  • Wall angels: With your back against a wall, slowly raise and lower your arms like making a snow angel.
  • Child’s pose stretch: Kneel on the floor, reach arms forward, and let the upper back open up.
  • Heat or warm shower: Loosens tight muscles and makes stretching more effective.

These simple movements, done consistently, can help reduce strain and restore balance in the upper back.

Referred Pain

Not all shoulder pain originates in the shoulder. This phenomenon is called referred pain, which refers to pain felt in the shoulder that actually originates from another structure or area. For example, issues in the neck, spine, or even internal organs can radiate into the back of the shoulder. Distinguishing called referred pain from local shoulder dysfunction is critical in developing the right treatment plan.

Frozen Shoulder

Frozen shoulder (adhesive capsulitis) is one of the most restrictive conditions I see. It occurs when the capsule around the shoulder joint thickens and tightens, causing stiffness and limited range of motion. Patients often describe difficulty lifting the arm overhead, fastening a bra, or reaching into a back pocket.

Stages of frozen shoulder:

  1. Freezing: Painful and gradually stiffening (6 weeks–9 months).
  2. Frozen: Less pain, but severe restriction (4–6 months).
  3. Thawing: Motion slowly returns (6 months–2 years).

Physical therapy focuses on gentle mobility exercises, joint mobilizations, and progressive stretching to shorten recovery time and reduce pain in the back of shoulder.

Poor Posture

Posture plays a huge role in shoulder health. Hours of sitting slouched, leaning forward at a desk, or scrolling on a phone contribute to poor posture, which strains the muscles around the back of the shoulder. Over time, this creates imbalances and chronic pain.

PT tip: Strengthening the upper back and core, while stretching the chest, can dramatically improve posture and relieve shoulder blade pain. Make it a habit to practice good posture as part of your daily routine to prevent back and shoulder pain. Small habits—like keeping screens at eye level and using a supportive chair—go a long way.

When Shoulder Pain Could Be a Heart Attack

While most pain in the back of the shoulder is musculoskeletal, sometimes it can be a warning sign of something more serious. Heart attacks can cause pain that radiates into the left shoulder, jaw, or arm. If you notice sudden shoulder pain along with chest pressure, shortness of breath, nausea, or dizziness, seek prompt medical attention immediately. It’s always better to be cautious.

Cervical Herniated Disc

The neck (cervical spine) can be a hidden culprit for back-of-shoulder pain. A cervical herniated disc is a type of bulging or ruptured disc, where the cushioning discs between the vertebrae bulge or rupture, pressing on nearby nerves. This can cause radiating pain that spreads from the neck into the shoulder blade, arm, or even fingers. Symptoms often include tingling, numbness, or weakness.

Physical therapy treatments may include posture training, traction, nerve glides, and gentle strengthening exercises to reduce pressure and improve stability.

Causes of Shoulder Pain

Pain in the back of shoulder can come from many sources. Common causes include:

  • Frozen shoulder
  • Rotator cuff strain or tear
  • Rotator cuff tendon injury
  • Cervical herniated disc
  • Compression fracture
  • Dislocated rib
  • Shoulder dislocations
  • Poor posture
  • Referred pain from internal organs (like the heart)

Because the shoulder is a complex joint, pinpointing the exact shoulder condition often requires a detailed evaluation from a PT or physician.

Compression Fracture

A compression fracture in the spine—often due to osteoporosis—can cause back and shoulder pain. When a vertebra collapses, it alters spinal alignment and strains nearby muscles, sometimes felt as pain in the back of the shoulder. Medical imaging and consultation are necessary here, as treatment may involve bracing or medical management in addition to physical therapy.

Dislocated Rib

A dislocated rib can mimic shoulder blade pain. When a rib slips out of alignment, it can affect the rib cage and surrounding muscles, irritating nerves and creating sharp pain with deep breaths, lifting, or twisting. Manual therapy, breathing exercises, and gentle mobilization are common PT strategies to restore rib alignment and reduce pain.

The Role of Physical Therapy

As a PT, I view physical therapy as the cornerstone of recovery for shoulder pain, especially when dealing with pain in the back of the shoulder. Physical therapy is a key component of pain management for shoulder issues, providing specialized interventions to reduce pain and improve quality of life. While rest or medication may provide temporary relief, PT targets the underlying causes—whether that’s stiff joints, weak muscles, poor posture, or nerve irritation. The goal is not only to reduce pain but also to restore strength, range of motion, and confidence in your daily movements.

Depending on the cause, treatment may include:

  • Gentle stretching: Movements such as pendulum swings, towel stretches, wall climbs, and cross-body reaches help restore mobility gradually. We start slowly, working within your comfort zone, and progressively expand your range as the shoulder adapts.
  • Strengthening: Building strength in the rotator cuff, scapular stabilizers, and postural muscles provides the foundation for healthy shoulder mechanics. This often includes resistance band exercises, light weights, and bodyweight drills that retrain your shoulder to function smoothly and safely.
  • Postural training: Poor posture is one of the most common contributors to pain in the back of shoulder. As PTs, we focus on postural awareness, ergonomic corrections, and exercises to open the chest and strengthen the upper back. This improves alignment and reduces unnecessary strain on your shoulders.
  • Manual therapy: Hands-on techniques like joint mobilization, soft tissue release, myofascial release, and gentle stretching can help relieve stiffness, improve circulation, and restore normal joint mechanics. Many patients notice immediate relief and improved mobility after these sessions.
  • Modalities: Depending on your needs, we may use heat, ultrasound, cold therapy, or electrical stimulation. These tools don’t fix the root cause but create the right environment for healing by calming inflammation and easing discomfort.

What makes PT unique is personalization. No two patients experience pain in the back of the shoulder in the same way.

Prompt Medical Attention

There are situations where shoulder pain requires urgent care:

  • Sudden severe pain after an accident (possible fracture or dislocation)
  • Numbness, tingling, or weakness spreading into the arm or hand
  • Shoulder pain with chest pain, dizziness, or difficulty breathing (possible heart attack)

Never ignore these red flags, and seek treatment from a healthcare professional immediately if you experience any of them.

Herniated Disc vs. Frozen Shoulder

It’s easy to confuse herniated disc pain with frozen shoulder. Here’s a quick breakdown:

  • Frozen shoulder: Dull ache, stiffness, loss of range in all directions.
  • Herniated disc: Sharp, shooting pain, sometimes described as stabbing pain due to nerve involvement, often worsens with neck movement, sometimes with numbness.

A PT assessment can determine the root cause and guide you toward the right care.

Final Thoughts

Pain in the back of shoulder can be overwhelming, but it’s treatable with the right combination of self-care, physical therapy, and lifestyle changes. Whether your pain stems from frozen shoulder, posture, a disc issue, or even something more serious, understanding the source is the first step toward relief.

With time, patience, and consistent effort, most people regain mobility and return to pain-free living. Don’t ignore your symptoms—get evaluated, start treatment, and take control of your recovery.

Take the Next Step with Pelvis NYC

If you’re dealing with persistent pain in the back of the shoulder, don’t wait. At Pelvis NYC, our expert physical therapists provide personalized, hands-on care to address the root cause of your pain. From posture training to targeted exercises, we’ll help you move better and feel better.

👉 Book your appointment with Pelvis NYC today and start your journey to recovery.

How to Relieve Frozen Shoulder Pain | Self-Care & Physical Therapy in NYC

An image holding her shoulder

Suppose you’re struggling with frozen shoulder (also called adhesive capsulitis). In that case, you know how frustrating it can be when simple tasks like reaching overhead, putting on a jacket, or sleeping comfortably become nearly impossible. As a physical therapist, I often hear patients ask: “Is there anything I can do at home for frozen shoulder self-care?”

The shoulder is a ball-and-socket joint, where the upper arm bone (humerus) fits into the shoulder socket (glenoid cavity). This structure allows for a wide range of motion, but also makes the shoulder susceptible to conditions like frozen shoulder.

The good news: Yes. With the right combination of frozen shoulder treatment, shoulder exercises, and self-care strategies, you can gradually restore movement, reduce stiffness, and find pain relief.

This guide covers everything you need to know about frozen shoulder self-care—from recognizing symptoms to managing risk factors and integrating PT-based solutions.

What is Frozen Shoulder (Adhesive Capsulitis)?

Frozen shoulder happens when the capsule surrounding your shoulder joint thickens and tightens, limiting motion. This condition occurs when the shoulder capsule becomes inflamed and adhesions form, leading to restricted motion. The exact cause of frozen shoulder remains unknown, though certain risk factors increase susceptibility. This leads to pain, stiffness, and difficulty moving your arm.

It typically develops slowly and goes through three stages:

  1. Freezing stage – Increasing shoulder pain and limited motion.
  2. Frozen stage – Frozen shoulder occurs as the capsule thickens and synovial fluid decreases, resulting in pain and stiffness. Pain may lessen, but stiffness peaks.
  3. Thawing stage – Mobility gradually returns.

Pain and stiffness are hallmark symptoms, and restricted motion and loss of the shoulder’s range are key features. Reduced synovial fluid in the joint contributes to shoulder stiffness and limited shoulder movement.

You might be interested in reading Pain in the Back of Shoulder Explained!

Frozen Shoulder Symptoms

Common symptoms of frozen shoulder include:

  • Persistent shoulder pain, especially at night
  • Pain that can radiate from the shoulder to the upper arm
  • Stiffness that makes everyday tasks hard
  • Limited range of motion in all directions
  • Difficulty lifting, reaching, or rotating the arm

Frozen shoulder affects about 2-5% of the general population, most commonly adults between 40 and 60 years old.

If you notice these signs, especially combined with risk factors, you may be starting to develop frozen shoulder.

Risk Factors for Frozen Shoulder

Not everyone gets adhesive capsulitis, but some people are more at risk. Key risk factors include:

  • Age (most common between 40–60 years old)
  • Diabetes or thyroid conditions
  • Shoulder immobilization (from injury, fracture, or surgery)
  • Previous rotator cuff injury
  • Sedentary lifestyle or lack of mobility

Frozen Shoulder Treatment: The Role of Physical Therapy

frozen shoulder self-care

While frozen shoulder can sometimes resolve on its own, physical therapy treatment helps speed recovery and prevent long-term stiffness. The primary goals of treatment are to restore motion and reduce pain. As a PT, I typically use:

  • Manual therapy to mobilize the joint capsule, helping regain motion and improve shoulder movement
  • Shoulder exercises for flexibility and strengthening, which also help regain motion and improve shoulder movement
  • Heat or ice therapy for pain relief
  • Education on posture, movement, and self-care at home

Simple treatments like heat, ice, and gentle stretching are often effective for most patients. Symptoms may slowly improve over time, and full recovery can take several months to years, depending on the individual.

Combining in-clinic treatment with a structured self-care routine offers the best results.

Shoulder Treatment Options Beyond Physical Therapy

While physical therapy is often the cornerstone of frozen shoulder treatment, there are additional options available for those who need further relief or whose symptoms persist. One commonly used intervention is a steroid injection into the shoulder joint. This can help decrease pain and inflammation, making it easier to participate in a range of motion exercises and daily activities. Steroid injections are especially helpful during the early, painful stages of adhesive capsulitis.

For some patients, if physical therapy and injections do not provide enough improvement, a procedure called manipulation under anesthesia may be considered. During this treatment, a healthcare provider gently moves the affected shoulder through its full range of motion while the patient is under anesthesia, helping to break up tight portions of the shoulder capsule and improve mobility.

In rare cases where severe stiffness and pain remain despite other treatments, arthroscopic surgery may be recommended. This minimally invasive procedure involves making small incisions in the shoulder and using a camera to guide the release of the tight shoulder capsule and removal of any scar tissue that may be restricting movement. Surgery is typically reserved for those with persistent frozen shoulder symptoms that do not respond to less invasive treatments.

It’s important to discuss all available shoulder treatment options with your healthcare provider. Together, you can determine the best approach to decrease pain, restore range of motion, and help you return to your normal activities.

Frozen Shoulder Self-Care: What You Can Do at Home

Here’s how you can actively participate in your recovery:

Some people find that with consistent self-care, such as gentle stretching and following recommended exercises, pain and mobility may begin to improve within six weeks, although full recovery can take longer.

Additionally, some individuals consider dietary supplements to support joint health, but it is important to consult your healthcare provider before starting any new supplement.

1. Gentle Shoulder Exercises

Safe, consistent motion prevents worsening stiffness. Try these PT-approved frozen shoulder exercises:

  • Pendulum swings – Let your arm hang and make small circles.
  • Towel stretch – Hold a towel behind your back and gently pull upward.
  • Wall walks – Use your fingers to climb a wall, gradually lifting your arm higher.

Once your range of motion improves, adding strengthening exercises can help support your shoulder and prevent future problems.

2. Heat Before Stretching

Apply heat for 10–15 minutes before exercises to relax tight tissues and ease pain. Taking a warm shower before stretching can also help relax the shoulder muscles and prepare them for exercise.

3. Ice After Activity

If your shoulder feels sore, use ice to calm irritation.

4. Maintain Good Posture

Avoid slouching or guarding your arm too much—gentle movement throughout the day supports recovery.

The Rotator Cuff and Frozen Shoulder

Although adhesive capsulitis mainly affects the joint capsule, your rotator cuff muscles often weaken from lack of use. Rotator cuff tears are another common shoulder problem, and sometimes imaging tests like MRI are needed to distinguish between a rotator cuff tear and frozen shoulder. Strengthening these muscles is a key part of long-term shoulder treatment and preventing re-injury.

Pain Relief Tips for Frozen Shoulder

In addition to self-care exercises and therapy, patients often find relief with:

  • Over-the-counter anti-inflammatory medication (if cleared by your doctor)
  • Gentle stretching routines
  • Prioritizing sleep positions that reduce pressure on the affected shoulder

If pain persists or the diagnosis is unclear, a healthcare provider may recommend a physical exam and imaging tests, such as X-rays or MRI, to rule out other causes of shoulder pain. A thorough physical examination is important to assess shoulder mobility and identify the underlying problem.

Preventing Future Episodes of Frozen Shoulder

Once you’ve recovered from frozen shoulder, taking steps to prevent it from returning is essential for long-term shoulder health. Regular shoulder exercises that maintain flexibility and strength in the shoulder joint are key to preserving your range of motion and reducing the risk of developing frozen shoulder again. Working with a physical therapist can help you learn the right exercises and stretches tailored to your needs.

Managing underlying risk factors is also crucial. Conditions like diabetes, thyroid disease, and heart disease can increase your chances of developing adhesive capsulitis, so keeping these medical problems under control with the help of your healthcare provider is important. Maintaining a healthy weight, eating a balanced diet, and avoiding smoking all contribute to better joint health.

If you’ve had a recent shoulder injury or surgery, early movement and gentle rehabilitation exercises can help prevent the shoulder capsule from tightening. Don’t wait for stiffness to set in—consult a physical therapist soon after any shoulder issue to get personalized guidance on safe, effective exercises.

By staying proactive with your shoulder care, you can help ensure your shoulders remain healthy, mobile, and pain-free for years to come.

Final Thoughts on Frozen Shoulder Self-Care

Recovering from frozen shoulder takes patience—but with the right plan, you don’t have to live in pain. A mix of physical therapy treatment and frozen shoulder self-care strategies can help restore movement, reduce stiffness, and give you back your daily function.

If you’re struggling with shoulder pain or think you may have adhesive capsulitis, consider visiting a physical therapist. Together, we can create a plan for pain relief, mobility, and long-term shoulder health.

Take the Next Step with Pelvis NYC

Ready to take the next step in your frozen shoulder recovery? At Pelvis NYC, our expert physical therapists specialize in shoulder treatment, pain relief, and restoring mobility. Don’t let adhesive capsulitis hold you back—book your appointment with Pelvis NYC today

frozen shoulder self-care

FAQs

1. Can frozen shoulder heal on its own?
Yes, but recovery can take months to years. Physical therapy treatment and self-care exercises can significantly speed up healing.

2. What is the fastest way to relieve frozen shoulder pain?
Gentle shoulder exercises, heat before stretching, and ice afterward can provide immediate pain relief.

3. Is frozen shoulder the same as a rotator cuff injury?
No. Frozen shoulder involves the joint capsule tightening, while rotator cuff injuries affect the shoulder muscles and tendons. However, the two can overlap.

4. When should I see a physical therapist for frozen shoulder?
If shoulder pain or stiffness lasts more than a few weeks, see a PT. Early treatment prevents long-term disability.

Related Blog: Left Shoulder Pain: Causes, Symptoms, and Proven Treatment Options

I Can’t Get Rock Hard Anymore: Guide to Erectile Dysfunction and Proven ED Treatments

I Can't Get Rock Hard Anymore: Guide to Erectile Dysfunction and Proven ED Treatments

If you have ever thought to yourself, “I can’t get rock hard anymore,” you are not alone. Many men experience this problem at some point in their lives, and the medical term for it is erectile dysfunction or ED.

In fact, most men will experience erectile issues at some point, making it a common and manageable condition.

i can't get rock hard anymore

What Is Erectile Dysfunction and Why I Can’t Get Rock Hard Anymore

Erectile dysfunction means having trouble getting or keeping a firm enough erection for sexual intercourse. It can happen occasionally, but when it becomes frequent, it is usually a sign of an underlying issue.

An erection depends on a smooth connection between the brain, hormones, blood vessels, nerves, and emotions. If even one part of this system is not working properly, the result can be erection problems.

Causes of Erectile Dysfunction: From Physical Causes to Psychological Treatments

Physical causes of ED

  • Heart disease and cardiovascular disease problems reduce blood flow to the penis, making them major risk factors for ED.
  • Abnormal blood sugar levels, as seen in diabetes, can damage blood vessels and nerves, contributing to erectile dysfunction.
  • Diabetes, obesity, and high blood pressure put strain on blood vessels and are common medical conditions linked to ED.
  • Physical factors such as injuries or surgeries can affect sexual function.
  • Physical problems like hormonal imbalances or chronic illnesses can also lead to ED.
  • Low testosterone and neurological conditions, including damage to the spinal cord or spinal cord injury, can disrupt nerve signals necessary for erections.
  • Certain medications including antidepressants, blood pressure drugs, and antihistamines, may cause ED as a side effect.
  • ED can be a symptom of an underlying medical condition, so identifying and addressing these medical conditions is important for effective treatment.
  • Testosterone replacement may be considered for men with low testosterone levels, but it is most effective when hormone deficiency is present.

Psychological causes of ED

  • Mental health conditions such as anxiety and depression can interfere with sexual function and contribute to erection problems.
  • Relationship problems, including poor communication and unresolved conflicts, can negatively impact sexual performance and overall intimacy.
  • Low sex drive or reduced sexual desire often accompanies erectile dysfunction, especially when psychological factors or hormonal imbalances are involved.
  • Sexual problems can include both erectile dysfunction and issues like premature ejaculation, and these conditions may overlap.
  • Cognitive behavioural therapy and other psychological treatments are effective in addressing these mental health factors.

Lifestyle Changes That Improve Erections and Cardiovascular Health

Healthy living makes a real difference for ED treatment. Doctors often recommend lifestyle changes before or alongside medication. Lifestyle changes are often recommended to treat erectile dysfunction, and treating erectile dysfunction may involve a combination of these strategies. These include:

  • Eating a balanced diet that supports cardiovascular health
  • Exercising at least 30 minutes most days of the week
  • Quitting smoking and limiting alcohol
  • Getting enough quality sleep
  • Reducing stress through mindfulness, meditation, or therapy

These steps improve circulation, lower blood pressure, and enhance energy levels which all support stronger erections.

How Certain Medications and Treatments Can Help You Get Hard Again

When lifestyle changes are not enough, medical support is available.

  • Oral ED treatments like Viagra, Cialis, Levitra, or Stendra improve blood flow and make it easier to get an erection with sexual stimulation
  • Other medications may be used to manage ED, especially when first-line treatments are not suitable or effective, and should be considered with attention to possible interactions and safety.
  • Vacuum erection devices and penile injections provide alternatives when pills are not effective
  • Penile implant is a permanent surgical option for men who have not responded to other therapies; it involves placing a device inside the penis to allow for an erection.
  • Other treatments such as psychological therapies, including cognitive behavioural therapy, sex therapy, or psychosexual counselling, can help address underlying psychological or emotional issues contributing to ED.
  • Sex therapy is a psychological treatment option that can help men and couples address relationship or emotional factors affecting erectile function, often involving techniques like sensate focus and support from qualified therapists.

When to Seek Medical Advice for Erectile Dysfunction

Erectile dysfunction can feel frustrating and even distressing, but you do not have to face it alone. Occasional erection problems happen to many men, but persistent difficulty getting or maintaining an erection means it is time to seek medical advice. A healthcare professional can identify the underlying causes of erectile dysfunction and guide you to the most effective treatment options.

Reach out to a doctor if you suddenly develop erectile dysfunction or if ongoing erection problems disrupt your sex life or relationship. Erectile dysfunction often signals a more serious health condition such as high blood pressure, heart disease, diabetes, kidney disease, or multiple sclerosis. When you address these health problems early, you improve your sexual performance and protect your overall health.

Talk to your healthcare provider if you take certain medications such as beta blockers or other blood pressure drugs, or if you use recreational drugs. These substances affect blood flow and sexual function, and your doctor can help you weigh the risks and explore safer alternatives.

During your visit, your doctor will review your medical history, ask about your sexual activity, and evaluate both physical and psychological factors that contribute to erectile dysfunction. They may recommend erectile dysfunction medications or suggest psychological treatments like cognitive behavioural therapy if emotional issues play a role. In many cases, you can improve blood flow, strengthen cardiovascular health, and enhance your erections by making lifestyle changes such as eating a balanced diet, exercising regularly, and maintaining a healthy weight.

Erectile dysfunction is common and has many possible causes. By seeking medical advice, you take a proactive step toward improving your sexual health, building confidence, and enjoying a more satisfying sex life. Do not wait to reach out. Help is available, and effective treatments can restore your performance and quality of life.

Frequently Asked Questions About Erectile Dysfunction

Can erectile dysfunction be cured naturally?

For some men ED improves naturally through lifestyle changes such as better diet, exercise, and stress reduction. The outcome depends on the underlying cause.

At what age do erection problems usually start

Erectile dysfunction can affect men at any age but it becomes more common after age forty. Research shows that about half of men over fifty experience some degree of ED.

Is heart disease linked to erectile dysfunction?

Yes. Heart disease and other cardiovascular health problems reduce blood flow to the penis which often leads to ED. In fact, erectile dysfunction can be an early warning sign of hidden heart issues.

Can anxiety or stress cause ED?

Absolutely. Mental stress triggers adrenaline which restricts blood flow and prevents an erection. Psychological treatments such as therapy or counselling can be very effective.

What is the best ED treatment available?

The best treatment depends on the cause of erectile dysfunction. Many men respond well to oral medication. Others find that lifestyle changes, therapy, or a combination of treatments is most effective.

Key Takeaway

Thinking “I can’t get rock hard anymore” can feel discouraging, but it does not mean the end of your sex life. Erectile dysfunction is common; it is not your fault, and most importantly it can be treated. By making lifestyle changes, understanding the causes of erectile dysfunction, and exploring the right ED treatments, you can restore confidence and enjoy intimacy again.

Take the Next Step

If you are ready to address erectile dysfunction and take control of your sexual health, the team at Pelvis NYC is here to help. Our specialists focus on personalised care for men dealing with erection problems, cardiovascular health issues, and related conditions.

i can't get rock hard anymore- How Pelvis NYC can help?
👉 Schedule a confidential consultation with Pelvis NYC today and start your journey back to stronger, healthier erections.

Prostatectomy Pain: What You Should Know About Recovery

Prostatectomy Pain: What You Should Know About Recovery

If you’re preparing for a prostatectomy or have just had one, you’re probably wondering: “How much pain will I feel—and how long will it last?” That’s a very normal question. A prostatectomy, often used to treat prostate cancer, is a common surgery that can be life-saving. But like any major operation, it comes with its own recovery process.

The good news is this: while prostatectomy pain is part of healing, most men find it gets better more quickly than they expect. Let’s walk through what recovery usually looks like, what side effects are common, and how tools like physical therapy can help you get back on your feet.

Why Prostate Surgery Happens

Doctors most often perform prostate surgery to treat prostate cancer. The procedure removes the prostate gland, and when caught early, it can be very effective. Certain risk factors, such as underlying health conditions like diabetes or autoimmune diseases, may influence the decision to proceed with surgery or additional treatments. In some cases, doctors may also add treatments like hormone therapy or radiation to ensure they address all cancer cells. If there are remaining cancer cells or complications after surgery, further treatment such as radiotherapy or hormone therapy may be necessary to achieve complete eradication of the disease.

While surgery is an important step in treatment, it can also bring short-term challenges such as pain, urinary leakage, and changes in sexual function.

Types of Prostate Surgery

  • Prostatectomy as a Surgical Procedure – Prostatectomy is a surgical procedure to remove the prostate gland, and there are several possible approaches, each with its own advantages and considerations.
  • Open Radical Prostatectomy – This traditional approach involves a single larger incision in the lower abdomen to access and remove the prostate. Open radical prostatectomy is often compared to minimally invasive techniques, with differences in recovery time, pain, and potential complications.
  • Radical Retropubic Prostatectomy – A type of open surgery performed through an incision in the lower abdomen, allowing direct access to the prostate. This surgical procedure is commonly used and enables the surgeon to remove nearby lymph nodes if necessary.
  • Laparoscopic Surgery – Laparoscopic surgery is a minimally invasive technique that uses small incisions, a laparoscope (a thin tube with a camera), and specialized instruments to perform procedures such as prostatectomy.
  • Laparoscopic Radical Prostatectomy – This minimally invasive approach uses laparoscopic surgery to remove the prostate. Laparoscopic radical prostatectomy is less invasive than open surgery and is often compared to robotic radical prostatectomy.
  • Robotic Radical Prostatectomy – A form of minimally invasive surgery where the surgeon uses robotic assistance to perform the procedure with enhanced precision. Robotic radical prostatectomy may offer benefits such as reduced blood loss, less pain, and faster recovery compared to traditional methods.
  • Laparoscopic/Robotic Prostatectomy – A minimally invasive approach with small abdominal incisions. Usually comes with less lower abdominal pain and a quicker recovery.
  • Radical Perineal Prostatectomy – Done through an incision between the scrotum and anus. Effective in some cases but can cause more localized discomfort.

What Pain Feels Like

Most men describe prostatectomy pain as:

  • A sore or pulling feeling in the lower abdomen
  • Discomfort when sitting, moving, or standing
  • Irritation or bladder spasms while the urinary catheter is in place or when it’s removed, often due to the presence of the catheter itself
  • Some trouble with bowel movements in the first week or two

After surgery, the urinary catheter acts as a urine drain, carrying urine from the bladder while the area heals.

Post-Operative Care

After prostate cancer surgery, such as a radical prostatectomy, following a thorough post-operative care plan is crucial for a safe and effective recovery. Your care team will provide specific instructions tailored to your needs, but there are some general guidelines that most patients should keep in mind.

First, take care of your surgical incisions by keeping the area clean and dry. Watch for signs of infection, such as redness, swelling, or unusual discharge, and let your doctor know if you notice anything concerning. Avoid soaking in baths or swimming pools until your healthcare provider says it’s safe.

Activity restrictions are common after surgery. While gentle movement, like short walks, helps prevent blood clots and supports healing, you should avoid heavy lifting, strenuous exercise, or sudden movements for several weeks. Listen to your body and gradually increase your activity level as you feel stronger.

Managing pain is another important part of post-operative care. Take pain medications as prescribed, and don’t hesitate to reach out to your care team if you experience severe pain or discomfort that isn’t improving. Staying ahead of pain can help you move more comfortably and recover faster.

Regular follow-up appointments are essential after prostate cancer treatment. Your doctor will monitor your progress, check your PSA blood test results, and watch for any signs of complications or remaining cancer cells. These visits are also a good time to discuss any concerns about urinary control, sexual function, or emotional well-being.

Finally, don’t underestimate the value of support—whether from family, friends, or professional counselors. Recovering from prostate cancer surgery is a journey, and having a strong support system can make a big difference in your overall well-being.

By following your post-operative care plan and staying in close contact with your healthcare team, you’ll give yourself the best chance for a smooth recovery and a return to normal life.

The First Few Weeks of Recovery

Recovery looks different for everyone, but common experiences in the first few weeks after surgery include:

  • Urinary leakage, especially when coughing or sneezing
  • Fatigue and a slower pace than usual
  • Mild abdominal swelling or tenderness
  • Some discomfort when going to the bathroom

During this time, a catheter is placed to help the bladder heal, and it is connected to a drainage system that includes a leg bag for daytime use and a night bag for overnight urine collection. The leg bag is worn discreetly under clothing and should be emptied regularly, while the night bag is larger and designed for use while sleeping. Proper care of both bags is important to prevent infection and ensure effective drainage.

The catheter is usually removed within 1–2 weeks. When the catheter is removed, you may feel a brief sensation, and it is common to experience some urine leakage or frequent urination as your bladder and pelvic muscles adjust. The process of having the catheter removed is straightforward, and your care team will provide instructions for post-removal care.

Frequent urination is also common in the initial weeks after surgery as the bladder’s capacity and control improve. Temporary weight gain may occur due to fluid shifts after surgery, but this usually resolves within about a week. Gentle activity—like short walks—is important to keep blood moving and prevent blood clots (DVT).

Catheter Removal and Urinary Leakage

When the catheter comes out, it’s common to have difficulty controlling urine flow. This happens because your pelvic floor muscles need time to regain strength. The sphincter muscles, especially the external sphincter, play a crucial role in maintaining urinary control, and strengthening these muscles is important for preventing leakage.

Urinary incontinence is a common complication after catheter removal, which can affect physical comfort, emotional well-being, and social activities. Your care team may suggest pelvic floor exercises (like Kegels), supportive underwear, or absorbent pads for peace of mind. Recovery is gradual, but with consistency, most men see big improvements over time.

How Physical Therapy Helps Prostatectomy Pain

One of the most powerful tools for recovery is pelvic floor physical therapy. After surgery, the muscles supporting your bladder and pelvic region—including those around the pubic bone, a key anatomical landmark—may be weak, leading to pain and leakage.

A pelvic floor therapist can guide you through targeted exercises that:

  • Strengthen bladder-control muscles
  • Reduce leakage when coughing or lifting
  • Easelower abdominal soreness
  • Support healthy bowel movements
  • Help restore sexual function by improving blood flow and nerve response (note: removal of the seminal vesicles during surgery can affect ejaculation and orgasm sensations)

Think of it as rehab for your pelvic region. Just like athletes train to recover after injury, you can retrain your body to heal more comfortably.

👉 For expert care, Pelvis NYC offers specialized pelvic health therapy for men, helping patients manage pain, regain bladder control, and return to normal life with confidence.

prostatectomy pain

Bowel Movements and Bathroom Issues

Having a regular bowel movement is an important part of recovery after surgery and can help prevent complications such as constipation or diarrhea. Constipation and discomfort with bowel movements are common after surgery, especially with pain medication. Staying hydrated, eating fiber-rich foods, and using stool softeners (if your doctor recommends them) can make things easier.

Potential Complications

Most recoveries go smoothly, but possible complications include:

  • Blood clots such as deep vein thrombosis (DVT) if mobility is limited; prevention includes early movement, compression stockings, and medication to reduce the increased risk of clots.
  • Urinary tract infection is a common concern while the urinary tract heals, especially with catheter use, and there is an increased risk of infection after surgery. If symptoms arise, a urine culture may be performed to diagnose the infection and guide treatment.
  • Lymph fluid buildup causing swelling, which can occur after removal of lymph nodes or a lymph node during surgery, sometimes leading to fluid pooling in the patient’s abdomen.

In severe cases, complications like infection or fluid buildup in the patient’s abdomen may require specialized intervention.

Follow your doctor’s instructions closely, take medications as prescribed, and contact your provider if you notice unusual pain, infection signs, or trouble with erections.

Sometimes, radiation may also be recommended after surgery to lower the risk of cancer returning. Radiation induced complications, such as cystitis or tissue changes, can also occur and may require specific management.

Returning to Sexual Activity

Intimacy is a major concern for many men after prostate surgery. Nerve damage during the procedure can affect erections, making them weaker at first. Recovery can take months, but many men improve with medications, devices, or therapies designed to support sexual function. However, certain medications may not be suitable for men with a history of heart disease, so patients should discuss these options with their doctor. Patience and open communication with your partner and doctor are key.

Long-Term Pain and Support

While most men feel significantly better after a few weeks, some experience ongoing prostatectomy pain from scar tissue or nerve irritation. If that happens, your doctor can recommend treatments to help. In severe cases, further treatment such as additional therapies or interventions may be necessary to manage persistent pain or complications.

Regular follow-up care is also essential. Expect PSA blood tests and routine check-ins to monitor recovery. If urinary leakage, erectile dysfunction, or emotional stress continue, support through physical therapy or counseling can make a big difference.

Final Thoughts on Prostatectomy Pain: Healing Takes Time

Recovering from prostate surgery is as much about patience as it is about physical healing. There will be ups and downs, but with time, most men regain control, reduce pain, and return to the activities that matter most.

👉 Here’s the bottom line:

  • Prostatectomy pain is normal but usually improves quickly.
  • The first few weeks are the toughest.
  • Physical therapy speeds recovery and helps with leakage and intimacy.
  • With the right care, most men return to normal life—including sexual activity.

Vaginal Muscle Spasms: Expert Guide from Dr. Samantha Vargas

Vaginal Muscle Spasms: Expert Guide from Dr. Samantha Vargas

Suppose you’ve been living with pelvic pain, bladder leaks, or discomfort during intimacy. In that case, you may be experiencing something that’s rarely talked about but far more common than you think — vaginal muscle spasms.

At Pelvis NYC, we help women overcome these symptoms in a supportive, judgment-free environment. Our pelvic pain specialists — including experienced physicians and pelvic floor physical therapists — diagnose and treat pelvic floor disorders with personalized, comprehensive care. Many women come to us believing these issues are just part of getting older, part of being a mom, or something they have to “tough out.” The truth is, vaginal muscle spasms are not a normal part of life — and you can treat them.

Our lead female pelvic floor physical therapist, Dr. Samantha Vargas, PT, DPT, is here to help you take back control of your pelvic health. As part of your evaluation, Dr. Vargas will perform a thorough physical exam to identify the underlying cause of your symptoms and guide your treatment plan. Our personalized approach is designed to relieve pain and restore your pelvic health.

Introduction to Pelvic Floor Muscles

The pelvic floor muscles are a group of muscles located at the base of your pelvis, forming a supportive hammock for your pelvic organs—including the bladder, uterus, vagina, and rectum. These muscles work in harmony with your abdominal and hip muscles to provide stability, support, and control for essential functions like urination, bowel movements, and sexual activity.

When your pelvic floor muscles are healthy, they contract and relax as needed, helping you maintain continence, support your pelvic organs, and enjoy pain-free movement. However, if these muscles become too tight, too weak, or lose their coordination, you may experience pelvic floor muscle spasms and other symptoms of pelvic floor muscle dysfunction. This can lead to muscle spasms, discomfort, and issues with bladder, bowel, or sexual health.

Understanding the vital role of your pelvic floor muscles is the first step in recognizing when something isn’t quite right. If you notice other symptoms such as pelvic pain, difficulty with bowel movements, or changes in bladder habits, it may be a sign of pelvic floor muscle dysfunction—and a reason to seek expert care.

What Are Vaginal Muscle Spasms?

Your pelvic floor is a network of muscles that support your bladder, uterus, and rectum. These muscles should work in balance — contracting when needed, relaxing when it’s time to release.

When the muscles around the vagina contract involuntarily, either constantly or intermittently, this is known as vaginal muscle spasms (a type of muscle spasm or involuntary contraction). These spasms can cause pelvic pain, bladder or bowel problems, and sexual discomfort.

Vaginal muscle spasms are a type of pelvic muscle spasm and are sometimes referred to as vaginal spasms.

Unlike a fleeting cramp, ongoing involuntary contractions or muscle contractions can lead to persistent symptoms and can worsen over time if left untreated.

Common Signs You Might Have Vaginal Muscle Spasms

Patients at Pelvis NYC often come in with one or more of the following symptoms:

  • A feeling of incomplete bowel movements
  • Urine or stool leakage
  • Lower back, pelvic, or genital pain
  • Pain or burning during urination
  • Trouble starting your urine stream
  • Painful intercourse or discomfort afterward

A gentle vaginal exam may be performed to assess the pelvic floor muscles and the vaginal opening for areas of tenderness or spasm.

During a pelvic floor assessment, these spasms often feel like tight, rope-like bands of muscle deep inside the pelvic area — much like knots you might find in your shoulders, but in a much more sensitive location. Diagnostic tests can help determine if symptoms are due to muscle spasms or if there is an infection present.

Chronic Pelvic Pain

Chronic pelvic pain is often one of the most frustrating symptoms associated with vaginal muscle spasms. This pain can feel dull, aching, or sharp, and it may radiate into the lower back, hips, or thighs. Ongoing pain is a hallmark of chronic pelvic pain, highlighting its persistent and disruptive nature.

For many women, chronic pelvic pain develops gradually and is dismissed as “normal” period pain, lingering postpartum discomfort, or simply part of aging. In reality, tight pelvic floor muscles can create ongoing irritation of nearby nerves and tissues, perpetuating the pain cycle.

Emotional pelvic pain and mental health factors can also contribute to or exacerbate chronic pelvic pain, making it important to address both physical and psychological aspects for effective treatment.

At Pelvis NYC, we focus on identifying whether pelvic floor tension is contributing to your chronic pelvic pain and creating a tailored plan to break that cycle.

Pelvic Floor Spasms

Pelvic floor spasms occur when any of the pelvic floor muscles contract involuntarily, often without your conscious awareness. Vaginal muscle spasms are one type of pelvic floor spasm, but they can also affect the muscles around the rectum and urethra. Pelvic floor spasms are one of several pelvic floor disorders that can affect women, including incontinence and prolapse, each with different causes and symptoms.

These spasms can make daily activities — like sitting, walking, or using the bathroom — uncomfortable or even painful. They can also be linked to bladder urgency, bowel issues, or sexual discomfort.

Our treatment approach focuses on restoring flexibility and coordination to these muscles through hands-on therapy, neuromuscular re-education, and personalized exercises. We use evidence-based methods to treat pelvic muscle spasms and restore function, ensuring each patient receives care tailored to their specific pelvic floor disorder.

Interstitial Cystitis and Pelvic Floor Tension

Interstitial cystitis (IC) — also called painful bladder syndrome — is a chronic bladder condition that can cause pelvic pain, frequent urination, and a constant feeling of needing to go.

What many women don’t realize is that pelvic floor spasms and vaginal muscle tension often co-exist with IC. Tight pelvic muscles can irritate the bladder and surrounding nerves, making symptoms worse. Symptoms of interstitial cystitis can mimic those of a urinary tract infection, but diagnostic tests often show no infection is present. Overactive bladder symptoms, such as urgency and urinary frequency, can also be linked to pelvic floor tension and spasms.

At Pelvis NYC, we work closely with IC patients to release pelvic floor tension, improve bladder habits, and reduce overall pelvic pain — creating a more complete approach to symptom management.

Why Do Vaginal Muscle Spasms Happen?

Identifying the underlying cause of vaginal muscle spasms is essential for effective treatment. The causes are often layered and can include:

  • Childbirth — especially long or traumatic deliveries
  • Pelvic surgeries — pelvic surgery can be a potential cause, as it may leave scar tissue or alter pelvic anatomy
  • Pelvic inflammatory disease — can contribute to pelvic pain and muscle spasms
  • Chronic straining from constipation or heavy lifting
  • Hormonal changes during menopause
  • Injury or falls — physical trauma, including injury or falls, even years after the event, as well as emotional or physical trauma, can trigger muscle spasms
  • High intensity exercise — can cause muscle tightness or trauma in the pelvic region
  • Frequent “just in case” bathroom trips
  • Genetics — naturally weaker connective tissue
  • Neurological conditions like Parkinson’s disease

Psychological trauma and nervous system dysfunction can also play a role in developing muscle spasms, as abnormal nerve signaling may perpetuate pain and involuntary contractions.

Reduced blood flow to the pelvic region and muscles surrounding the vagina can lead to increased lactic acid, contributing to pain and muscle tightness. Spasms can affect the pelvic muscle and vaginal muscles, impacting sexual intercourse, penetrative sex, and bowel movement. Chronic spasms may result in fecal incontinence, and muscle relaxants may be considered for severe cases.

Pelvic Health and Wellness

Pelvic health and wellness go far beyond just the absence of pain—they encompass your physical, emotional, and mental well-being. When pelvic floor muscles are functioning optimally, they support your daily activities, sexual health, and overall comfort. However, pelvic floor muscle spasms, sometimes felt as pelvic floor muscle twitches, can disrupt this balance and lead to a range of challenges.

Tight pelvic floor muscles or weak pelvic floor muscles can cause pelvic pain, make vaginal penetration uncomfortable, and interfere with normal bowel movements or bladder control. These symptoms of pelvic floor muscle dysfunction can impact your confidence, relationships, and quality of life.

Pelvic floor physical therapy is a proven, effective way to address these issues. Through a combination of manual therapy, stretching, relaxation exercises, and biofeedback, physical therapy helps restore normal muscle function and significantly reduce pelvic pain. Education about how to use and care for your pelvic floor muscles is also a key part of the process, empowering you to take control of your pelvic health.

By prioritizing pelvic health and wellness, you’re taking an important step toward relieving symptoms, improving function, and enhancing your overall well-being. Whether you’re experiencing pelvic floor muscle spasms, ongoing pelvic pain, or other symptoms of pelvic floor dysfunction, comprehensive physical therapy can help you regain comfort and confidence in your body.

Meet Dr. Samantha Vargas, PT, DPT — Female Pelvic Floor Specialist at Pelvis NYC

With a foundation in biomechanics and a passion for movement, Dr. Samantha Vargas began her career treating athletes — from NCAA Division I sports to professional baseball and rugby players. After earning her Doctorate in Physical Therapy and completing a prestigious sports residency at the University of Delaware, she became a board-certified sports clinical specialist.

Over time, Dr. Sam noticed a recurring theme: many of her female patients — whether athletes, active women, or new mothers — were quietly struggling with pelvic floor dysfunction, often dismissed or misunderstood by other providers.

Determined to change that, she pursued advanced pelvic floor rehabilitation training to help women address issues like pelvic pain, incontinence, sexual dysfunction, postpartum recovery, and prolapse. Today, Dr. Sam blends her sports medicine expertise with pelvic health care — using biomechanics, manual therapy, neuromuscular re-education, and customized exercise programs to meet each woman’s unique needs.

Her approach is compassionate, confidential, and stigma-free. Whether you want to return to sport, recover after childbirth, or simply live without pain, she’s committed to helping you restore function, alleviate discomfort, and reclaim confidence in your body.

Vaginal Muscle Spasms Treatment in NYC | Dr. Samantha Vargas

How We Treat Vaginal Muscle Spasms at Pelvis NYC

We personalize every woman’s care plan, which may include:

  • Pelvic floor physical therapy — hands-on release, stretching, and coordination training provided by physical therapists who specialize in pelvic health
  • Breathing and relaxation techniques — to reduce muscle tension
  • Postural and movement retraining — to support long-term relief
  • Lifestyle modifications — including healthy bladder and bowel habits
  • Physician collaboration — for medications like muscle relaxers if needed
  • Trigger point injections — for persistent pelvic muscle spasms and pain relief
  • Vaginal dilators — to gradually relax vaginal muscles and improve comfort during penetration
  • Vaginal estrogen — to improve tissue health and reduce symptoms of dryness or atrophy, especially in post-menopausal women

Your provider may perform a pelvic exam to guide treatment decisions and monitor your progress.

Our goal is to treat the root cause, not just mask symptoms — so you can get lasting results without unnecessary medication, injections, or surgery.

Take the First Step Toward Relief

Vaginal muscle spasms, chronic pelvic pain, pelvic floor spasms, and interstitial cystitis can feel overwhelming — but they are treatable. At Pelvis NYC, a female pelvic floor specialist provides care and understands the unique challenges women face.

You don’t have to live with pelvic pain or bladder and bowel issues. Relief is possible — and you deserve care that champions your needs.

📅 Schedule your consultation with Dr. Samantha Vargas, PT, DPT at Pelvis NYC today.

Treatment of Prostatitis: A Complete Guide for Long-Term Relief

Treatment of Prostatitis: A Complete Guide for Long-Term Relief

Prostatitis isn’t a topic most guys are comfortable discussing—but if you’ve been dealing with pelvic pain, painful urination, or discomfort during sex, it’s time to face it head-on. Recognizing prostatitis symptoms early is crucial for seeking appropriate treatment and improving outcomes. The treatment of prostatitis isn’t about popping pills and hoping for the best. It’s about understanding your body, getting the right diagnosis, and taking control of your health. And yes, physical therapy plays a bigger role than most men realize.

What Is Prostatitis?

Prostatitis means inflammation of the prostate gland. It can hit men in their 20s, 40s, or 60s. There are distinct forms, including acute and chronic prostatitis. Acute prostatitis presents suddenly with severe symptoms, while chronic prostatitis involves recurrent or persistent symptoms that may be more subtle or intermittent. Symptoms vary, but here’s what most guys report:

Different types of prostatitis call for different approaches, and understanding the best treatment of prostatitis depends on an accurate diagnosis.

Chronic Bacterial Prostatitis: The Stubborn Infection

This type is caused by lingering bacteria. You might feel like you have a UTI that never fully goes away. It creeps in slowly, and it keeps coming back. Recurrent infection and recurrent urinary tract infections are common in chronic bacterial prostatitis, often leading to persistent or episodic symptoms. Chronic infection can develop if the initial treatment is incomplete, making it difficult to fully eradicate the bacteria. Escherichia coli is the most common bacterial cause of chronic bacterial prostatitis. Treating chronic bacterial prostatitis is challenging and often requires prolonged antibiotic therapy to prevent recurrence.

What it feels like:

  • Dull ache in the pelvis or perineum
  • Recurrent UTIs
  • Feeling like you’re never fully emptying your bladder
  • Incomplete bladder emptying
  • Recurrent symptoms

Treatment plan:

  • Antibiotic therapy (long-term, 4-6 weeks or more): Appropriate antibiotic treatment is essential for bacterial prostatitis, targeting bacteria that penetrate prostatic tissue. The choice and duration of antibiotics should be based on pathogen sensitivity to ensure effective drug delivery into the prostatic tissue and reduce the risk of relapse.
  • Symptomatic treatment: This includes medications tailored to individual symptoms, such as nonsteroidal anti inflammatory drugs (NSAIDs) for pain relief, paracetamol, and alpha-adrenergic antagonists.
  • Anti-inflammatory meds
  • Prostate drainage or massage (yes, it’s a thing)
  • Pelvic floor physical therapy to help calm the aftershocks

If symptoms do not improve, monitor for complications such as prostatic abscess, which may require additional intervention.

Even after the infection is gone, many guys still deal with pain. That’s when physical therapy becomes a key component in the treatment of prostatitis.

Chronic Pelvic Pain Syndrome (CPPS): The Muscle-Tension Monster

This is the most common type of prostatitis. It is often referred to as chronic nonbacterial prostatitis or chronic abacterial prostatitis, terms that are frequently used interchangeably with chronic pelvic pain syndrome (CPPS). Prostatitis chronic pelvic pain is now recognized as a distinct syndrome, characterized by pelvic pain, urinary symptoms, and sometimes features similar to prostatitis. Interstitial cystitis is another condition with overlapping symptoms, making diagnosis challenging. Urinary symptoms may be related to issues at the bladder neck or due to bladder outlet obstruction, both of which should be considered during evaluation. Prostate inflammation and prostatic inflammation are possible contributors to the symptoms experienced in this condition. No bacteria. No infection. Just pain, tension, and frustration. It often gets misdiagnosed, and guys bounce from one doctor to another with no answers.

Symptoms include:

  • Aching in the pelvis, groin, or lower back
  • Pain during or after sex
  • Urinary issues without infection
  • Urinary obstruction (difficulty starting or maintaining urine flow, possibly due to bladder neck involvement)
  • Urinary retention (inability to fully empty the bladder, which can be a complication of prostatic swelling)
  • Feeling tight, stressed, or inflamed down there

The real issue?

Often, it’s your pelvic floor muscles going haywire. They’re tight, overworked, and stuck in a pattern of dysfunction. Dysfunction in the pelvic floor and surrounding prostatic tissue can also contribute to these symptoms.

What works:

  • Pelvic floor physical therapy – internal and external manual release
  • Breath training to reset your nervous system
  • Postural correction to get your body in sync
  • Trigger point therapy to release deep muscle knots
  • Symptomatic treatment of prostatitis with medications like paracetamol, NSAIDs, or alpha-adrenergic antagonists may help manage pain and urinary symptoms

Chronic Prostatitis: When It Won’t Go Away

If you’ve had pelvic pain or urinary symptoms for more than three months, welcome to the club nobody wants to join.

Many patients diagnosed with chronic prostatitis face significant challenges in clinical practice, as the condition often involves chronic infection and recurrent symptoms that can be difficult to manage. The National Institutes of Health classification system is commonly used to categorize prostatitis, reflecting the complexity and heterogeneity of patient profiles. Chronic prostatitis is also discussed within the broader context of digestive and kidney diseases, including kidney diseases, due to their impact on urological health and overall well-being.

Chronic prostatitis might be bacterial or non-bacterial. What matters most is that it’s ongoing, and it’s affecting your quality of life.

The fix?

You need a multifaceted approach:

  • Find out if there’s an infection
  • If infection is found, treatment of prostatitis with appropriate antibiotics is crucial, selecting antibiotics based on the causative agent
  • If not, shift focus to muscles, nerves, and lifestyle
  • Add in targeted physical therapy
  • Look at stress, diet, and mobility

Prostatitis treatments should be tailored to the underlying cause, using a symptom-focused strategy.

It’s not about being tough. It’s about being smart.

Diagnostic Tests: Know What You’re Dealing With

Prostatitis diagnosis begins with a thorough review of your medical history and a careful physical examination. Evaluating risk factors, such as previous urinary tract infections, recent procedures, or other underlying conditions, is essential for accurate assessment.

You can’t treat what you haven’t properly diagnosed. Testing may include:

  • Urinalysis and culture to check for urinary tract infection and urinary tract infections, as well as to analyze white blood cells.
  • Semen analysis for infection and inflammation.
  • PSA blood test (prostate specific antigen and serum prostate specific antigen) to help differentiate prostatitis from prostate cancer, though PSA can be mildly elevated in prostatitis.
  • Prostate fluid test including analysis of prostatic fluid, prostatic secretions, and prostate secretions for white blood cells and bacteria.
  • Imaging in complicated cases, or to assess for enlarged prostate or other abnormalities.

It is important to rule out benign prostatic hyperplasia, prostate cancer, and other conditions as part of the diagnostic process. Screening for sexually transmitted diseases may also be warranted.

And here’s something most urologists don’t talk about: pelvic floor dysfunction. It’s often the missing piece in the treatment of prostatitis, and it doesn’t show up on a lab report. That’s why a pelvic floor assessment by a trained physical therapist is gold.

Asymptomatic Prostatitis: No Symptoms, But Still There

Sometimes, prostatitis shows up in lab results when you’re not even feeling it. Prostate inflammation may be detected in asymptomatic cases through laboratory testing, such as during a fertility check or PSA test.

Should you worry?

  • Not always
  • But it’s worth monitoring
  • A pelvic floor check might still be smart

The Power of Physical Therapy in Treating Prostatitis

Here’s the deal: If you’ve ruled out infection and you’re still in pain, there’s a high chance your pelvic floor is the problem.

Physical therapy isn’t just for athletes. It’s for men like you who are tired of:

  • Waking up with pelvic tightness
  • Dreading urination or sex
  • Feeling like no one takes their pain seriously

At Pelvis NYC, we offer:

  • Internal and external manual therapy
  • Tailored exercise plans
  • Stress management techniques
  • Real talk, real solutions

We don’t just treat symptoms. We treat men who are ready to reclaim their health.

Treatment of Prostatitis: Effective Options and Management Strategies

Managing Psychological Symptoms: Mind Over Matter

Why your mental health matters

Let’s be real—dealing with chronic prostatitis, chronic bacterial prostatitis, or chronic pelvic pain syndrome (CPPS) isn’t just a physical battle. The constant pelvic pain, unpredictable symptoms, and frustration of not getting clear answers can take a serious toll on your mental health. Anxiety, stress, and even depression are common companions for men facing chronic prostatitis or nonbacterial prostatitis.

Ignoring these psychological symptoms doesn’t make them go away—in fact, it can make treating prostatitis even harder. When your mind is weighed down by worry or hopelessness, your body feels it too. That’s why addressing mental health is just as important as tackling the physical side of pelvic pain syndrome CPPS or bacterial prostatitis. By recognizing the emotional impact, you give yourself a better shot at real, lasting relief.

Strategies for coping and support

So, how do you take care of your mind while managing prostatitis? Start by building a toolkit of strategies that target both stress and symptom control:

  • Stress management techniques: Simple practices like meditation, deep breathing, or mindfulness can help calm your nervous system and reduce anxiety. Even a few minutes a day can make a difference.
  • Cognitive-behavioral therapy (CBT): Working with a therapist trained in CBT can help you break the cycle of negative thoughts and behaviors that often come with chronic prostatitis, acute bacterial prostatitis, or asymptomatic inflammatory prostatitis.
  • Support groups: Connecting with other men who understand what you’re going through can be a game-changer. Sharing experiences and advice helps you feel less alone and more empowered.
  • Pelvic floor physical therapy: While it’s great for physical symptoms, pelvic floor PT can also ease psychological symptoms by giving you more control over your body and reducing the stress that comes with chronic pain.

Remember, managing psychological symptoms is not a sign of weakness—it’s a smart, proactive step in treating prostatitis, whether you’re dealing with bacterial infections, chronic prostatitis, or any of the prostatitis syndromes. Work with your healthcare provider to create a plan that supports both your body and your mind. You deserve to feel better—inside and out.

Ready to Take Action?

You’ve read enough. Now it’s time to do something about it.

If you’re dealing with prostatitis—whether it’s your first flare-up or you’ve been living with it for years—you don’t have to keep suffering.

👉 Pelvis NYC has your back (and your pelvis). Book a consultation with our expert pelvic floor physical therapists who understand what you’re going through.

Take the first step. Get strong. Get answers. And get better.

Related Blog: Prostatectomy Pain: What You Should Know About Recovery

Complete Guide to Athletic Pubalgia

Complete Guide to Athletic Pubalgia

I’ve seen firsthand how frustrating chronic groin pain can be—whether you’re an elite athlete or just trying to get back to weekend pickup games. Athletic pubalgia (often called a “sports hernia”) is a clinical entity with evolving diagnostic criteria and is sometimes referred to as Gilmore’s groin. This condition affects many athletes across various sports and is really a spectrum of soft-tissue injuries around the pubic bone, not a true hernia at all. The affected area is typically the lower abdomen and groin region. It pops up in both men and women, can masquerade as other conditions (like prostatitis in men or postpartum pelvic pain in women), and thrives on core weakness and compensatory movement patterns.

The good news? With the right blend of manual therapy, movement retraining, pelvic-floor work, and progressive loading, most folks get back to what they love—pain-free.

What Is Athletic Pubalgia?

Athletic pubalgia is a chronic groin-pain syndrome caused by strains or tears of muscles and tendons at their pubic attachments—most often the obliques, rectus abdominis, and adductors, including the adductor longus. The pubic symphysis acts as a pivot point between abdominal and groin muscles at these attachments. The conjoint tendon also plays a significant role in the pathophysiology of this condition.

athletic pubalgia

It’s a “core muscle injury” that leads to pain with twisting, cutting, kicking, or even coughing. Athletic pubalgia is sometimes referred to as sportsman’s hernia and is considered a form of groin disruption. Inguinal pain is a common symptom and may be present alongside lower abdominal and groin pain. Pain may be reproduced during a sit up or resisted sit up, and hip extension can also exacerbate symptoms.

Core Muscle Injury — What That Really Means

It is a more accurate, all-encompassing term that explains the dysfunction at the heart of this condition:

  • It occurs where deep abdominal and groin muscles anchor to the pelvis—commonly the rectus abdominis and adductor tendons.
  • Over time, repetitive twisting, kicking, or sprinting stresses the core, creating small tears or imbalances that trigger chronic pain.
  • This injury often coexists with adductor strains or hip pathology, making accurate diagnosis essential.

Sports Hernia/ Athletic Pubalgia: Understanding the Terminology

  • Sports Hernia: The term popularized by media and patients to describe groin tissue injury without a true protruding hernia.
  • Athletic Pubalgia: The preferred medical term reflecting the location (pubis) and mechanism (athletic activity).

Both labels point to the same underlying pathology—and you’ll see both used by clinicians, researchers, and sports-med resources.

How Sports Hernias Occur

Repeated rotations, high-impact stops, and muscle imbalances overload the abdominals and adductors, and these injuries often require sudden changes in direction or forceful movements. As core weakness persists, stress funnels into the pubic attachments and sports hernias occur—silent yet painful injuries. Activities that increase intra-abdominal pressure, such as coughing, sneezing, or heavy lifting, can also trigger symptoms. Sports activity and sporting activity involving repetitive twisting and turning are common causes, especially in professional athletes who are particularly at risk due to the demands of their sport.

Causes and Risk Factors

Athletic pubalgia, commonly referred to as a sports hernia, develops when the soft tissues of the lower abdominal wall and groin area—especially the abdominal muscles and adductor muscles—are subjected to excessive strain. Unlike a true hernia, there’s no visible bulge, but the pain and dysfunction are very real. The root cause is often a weakening or tearing of the abdominal wall near the inguinal canal, where the conjoined tendon and pubic bone serve as critical anchor points for muscle attachments.

Sports hernias occur most frequently in athletes who participate in sports that demand explosive movements, rapid changes in direction, and powerful twisting motions—think soccer, football, ice hockey, and tennis. These activities place repeated stress on the lower abdominal muscles and adductor group, making them vulnerable to injury. Chronic groin pain and lower abdominal pain often develop gradually, but can also be triggered by a single, forceful movement.

Certain anatomical and biomechanical factors can increase the risk. Individuals with femoroacetabular impingement, labral tears, or a history of core muscle injury are more likely to experience groin pain and develop sports hernias. The structure of the inguinal canal, the strength of the conjoined tendon, and the balance between the abdominal wall and adductor muscles all play a role in susceptibility. Understanding these risk factors is key for both prevention and early intervention, helping athletes and active individuals avoid the cycle of chronic pain and repeated groin injury.

Who Is Affected by Athletic Pubalgia?

  • Male athletes: Often misdiagnosed as inguinal hernia or prostatitis because of overlapping pelvic-floor pain. A thorough review of medical history is essential for accurate diagnosis, especially since symptoms may overlap with other conditions.
  • Women: Particularly postpartum or high-level athletes with underlying pelvic instability; internal pelvic-floor work is frequently indicated.

Symptoms & Diagnosis

  • Pain: Dull, burning, or sharp ache in lower abdomen/groin that worsens with sprinting, twisting, sit-ups, or coughs. Patients are often experiencing pain that is chronic and worsens with activity.
  • No visible bulge: Unlike an inguinal hernia, there’s often no outward protrusion.
  • Diagnostic tools:
  • Physical examination: A thorough physical examination is crucial, including specific maneuvers to reproduce symptoms, such as resisted adduction and abdominal tests.
  • MRI: Gold standard for detecting soft-tissue tears or edema (68–98% sensitivity).
  • Ultrasound: Dynamic but operator-dependent.

Core Weakness & Pathomechanics

We often see a pattern of core instability, compensatory hip movement, and chronic pelvic loading driving symptoms. When the transverse abdominis, obliques, and pelvic floor aren’t firing synchronously, stress funnels into the pubic attachments—resulting in micro-tears and pain.

Conservative (Non-Surgical) Management

  1. Early rest & modalities (ice, NSAIDs) for 7–10 days as part of conservative therapy, which is the first-line approach for most cases.
  2. Phase I (Weeks 1–2): Gentle stretching, manual soft-tissue release, hip mobility.
  3. Phase II (Weeks 3–6): Core-stability drills (planks, dead bugs), isometric adductor holds, pelvic-floor retraining.
  4. Phase III (>6 weeks): Progressive loading, plyometrics, sport-specific drills—only if pain-free.

Outcomes: Up to 80–90% return-to-sport within 3–4 months when following structured rehab. Manual therapy added to exercise speeds return by ~4–5 weeks. While conservative treatment is often effective, some cases may require surgical intervention if symptoms persist.

When Surgery Is Needed

Indications include symptom persistence after 3 months of conservative care and confirmed pubic-wall deficiency on imaging.

  • Surgical procedures: Options include open repair, laparoscopic surgery (a minimally invasive surgical procedure), and pelvic floor repair techniques. Laparoscopic surgery is often compared to open surgery, with the minimally invasive approach potentially allowing for faster recovery and lower complication rates.
  • Open vs laparoscopic repair: Both yield >90% return-to-sport; laparoscopic may allow return in 3–5 weeks.
  • Adductor tenotomy: The adductor longus tendon is often targeted in this procedure, especially if persistent inner-thigh pain remains post-repair.
  • Conjoint tendon repair: During surgical repair, the conjoint tendon is evaluated and repaired if necessary, as abnormalities or tears can contribute to groin pain.
  • Surgical outcomes: Key measures include return to sport rates, symptom relief, complication rates, and overall patient satisfaction.
  • Surgical rehabilitation: A structured rehabilitation program is essential after surgery to restore function and performance, particularly for athletes.

Special Focus: Women & Postpartum

Postpartum pelvic-floor weakness and ligament laxity frequently complicate athletic pubalgia in women. Integrating internal pelvic-floor therapy with core and hip work is key—and outcomes are on par with male cohorts when this holistic approach is used.

athletic pubalgia

Dr. Gvili’s Integrated Rehab Model

sports hernia athletic pubalgia

First-line care focuses on restoring core-muscle injury through:

  • Manual therapy and soft tissue release
  • Core drills: planks, dead bugs, side‑planks
  • Pelvic‑floor retraining
  • Hip/adductor strengthening
  • Neuromuscular retraining and movement pattern correction
  • Sport-specific progressive loading

Studies show 65–90% of athletes improve within 4–8 weeks. ([turn0search9] [turn0search11])

Phase breakdown:

  • Weeks 1–2: Rest, ice, NSAIDs
  • Weeks 3–6: Core and pelvic strengthening
  • Post‑week 6: Return to sport progression, when pain-free

Outcomes: Conservative care yields up to 90% return-to-sport within 3–4 months; adding manual therapy can quicken recovery by 4–5 weeks.

Prevention and Future Directions

Preventing athletic pubalgia starts with a proactive approach to strengthening and protecting the core and groin area. Regular physical therapy that targets the abdominal muscles, adductor muscles, and hip flexors is essential for building resilience and reducing the risk of sports hernias. Incorporating dynamic stretching, foam rolling, and mobility work into your daily routine can help maintain flexibility and relieve muscle tension, which in turn helps prevent chronic groin pain.

Modifying sports activities to avoid excessive strain—such as limiting sudden changes in direction or high-impact twisting movements—can also lower the risk of injury, especially for those with a history of groin pain or previous core muscle injuries. Early intervention is crucial: advances in diagnostic tools like magnetic resonance imaging (MRI) now allow for more accurate and timely identification of sports hernias, enabling targeted treatment before pain becomes chronic.

Looking ahead, research is focused on refining both surgical and non-surgical treatment options. Minimally invasive surgical procedures and innovative rehabilitation protocols are being developed to improve outcomes and speed up recovery. Personalized rehabilitation plans, tailored to the individual’s specific injury, sport, and goals, are becoming the standard of care, helping athletes return to play safely and reducing the risk of re-injury. By staying informed and proactive, athletes and clinicians can work together to prevent groin pain and ensure long-term health in the groin area.

Key Takeaways

  • Athletic pubalgia isn’t a classic hernia—think soft-tissue injury around the pubis.
  • Core weakness + compensatory patterns underlie most cases.
  • Conservative rehab (manual therapy + core/pelvic-floor work) helps ~90% recover without surgery.
  • Surgical repair is highly successful (>90% RTP) when rehab fails.
  • Tailored pelvic-floor integration is essential for women and postpartum athletes.

Ready to tackle that stubborn groin pain? Dr. Adam Gvili at Pelvis NYC is here to collaborate—feel free to refer your toughest athletic pubalgia cases or reach out for a case discussion!

Can UroLift Cause Erectile Dysfunction? Your Guide to Better Understanding

Can UroLift Cause Erectile Dysfunction? Your Guide to Better Understanding

A Physical Therapist’s Take on BPH Treatment, Sexual Function & Recovery

Can UroLift Cause Erectile Dysfunction?

Let’s tackle this right out of the gate—can Urolift cause erectile dysfunction?- the short answer is no. The UroLift System is designed to relieve urinary symptoms caused by BPH (Benign Prostatic Hyperplasia) without affecting erectile function. Clinical studies show that UroLift does not cause new, sustained erectile dysfunction, setting it apart from other BPH treatments.

As a pelvic health PT, I work with men post-procedure and see firsthand that erectile dysfunction (ED) after UroLift is rare and typically unrelated to the procedure itself.

But does that mean it never affects your performance? Not exactly.

While the mechanical side of erections remains safe, some men report temporary issues due to:

  • Pelvic floor tension
  • Anxiety
  • Post-op inflammation
  • Pre-existing sexual health concerns

Most of this is manageable with pelvic rehab, relaxation techniques, and time. Importantly, UroLift is not associated with new sexual dysfunction, and the treatment effect on sexual function is minimal compared to other BPH therapies like TURP or laser, which have higher rates of sexual side effects.

What You Should Know About Erectile Dysfunction

ED is complex—it’s not just about the penis; it’s about nerves, blood flow, pelvic floor muscles, emotions, and overall health.

From my clinical perspective, men who experience ED post-UroLift often:

  • Already had mild ED
  • Are dealing with stress, performance anxiety, or prostate-related tension
  • Experience tight pelvic muscles that interfere with function

The good news? Physical therapy can help. We work on improving blood flow, relaxing the pelvic floor, and restoring confidence.

Understanding BPH Treatment and Sexual Health

BPH affects about 50% of men over age 50, and the number one symptom is disrupted urination—urgency, frequency, dribbling, or incomplete emptying.

Unfortunately, many treatments for BPH have a dark side: they can mess with your sex life.

Common BPH treatments and their sexual side effects:

TreatmentInvasive?Risk of ED?Risk of Retrograde Ejaculation?
TURPYesModerateHigh
Laser therapyYesModerateModerate
Medications (alpha-blockers, 5-ARIs)NoPossibleLow–Moderate
UroLiftNoVery LowVery Low ✅

Therapies such as TURP, laser, and even medication are associated with a higher risk of sexual side effects, including erectile and ejaculatory dysfunction, compared to UroLift®. UroLift® stands out as a minimally invasive alternative to traditional surgical options, with clinical data showing it does not cause new or lasting ejaculatory dysfunction.

Why Sexual Function Matters in BPH Treatment

It’s not just about urination—it’s about feeling like yourself again.

As a therapist, I’ve seen men recover their urinary confidence but still feel “off” because of unexpected sexual challenges. That’s why sexual function should always be part of the conversation around BPH treatment options.

UroLift shines here because it:

  • Preserves erectile function
  • Maintains ejaculation
  • Doesn’t involve hormones or cutting tissue
  • Allows for quicker recovery compared to invasive procedures
  • Helps patients avoid major surgery and is a safer alternative to most traditional surgical options

Exploring BPH Treatment Options (The Balanced View)

Before committing to a treatment, it’s wise to understand your options. It’s important to consider other BPH treatment options, such as medications, minimally invasive procedures, and traditional surgeries, to find what best fits your needs.

Medications
Medications are often the first line of therapy for BPH. BPH medications, such as alpha-blockers and 5-alpha-reductase inhibitors, can help relieve symptoms by relaxing the muscles of the prostate and bladder or by shrinking the prostate. However, some patients may experience side effects or may not achieve sufficient relief with medication alone.

Ultimately, the best approach is chosen after you and your doctor decide together based on your symptoms and preferences.

✅ Lifestyle + Watchful Waiting

Mild symptoms? Start here. Diet, hydration, bladder training, and pelvic floor therapy can help.

✅ Medications

Options like tamsulosin or finasteride, which are examples of BPH medications, are common but can cause dizziness, low libido, or ED in some men.

✅ Surgical Interventions

  • TURP: Effective but carries sexual side effects
  • Laser therapy: Less invasive than TURP but still risky
  • Prostatic urethral lift (UroLift): A minimally invasive treatment performed as an outpatient procedure, office-based, and sex-sparing

What Is the Prostatic Urethral Lift (UroLift System)?

The UroLift System deploys permanent implants made from standard surgical implantable materials to lift and hold prostate tissue away from the urethra. Think of it like opening curtains to let urine flow freely again.

Why Patients Love It:

Patients typically experience a quick recovery, minimal side effects, and preservation of sexual function after UroLift, making it a preferred choice for many.

  • No hospital stay
  • No cutting
  • No catheter (in most cases)
  • Sexual function stays intact
  • Quick return to work and life

For men who are sexually active and concerned about side effects, UroLift is often the first-line option I recommend in collaboration with their urologist.

Minimally Invasive with Solid Clinical Data

UroLift is FDA-approved and backed by some of the most robust clinical data in the BPH space. Clinical studies have demonstrated the effectiveness of UroLift as a minimally invasive treatment for treating BPH, providing evidence-based support for its safety and efficacy.

Key Stats from Clinical Trials:

  • 5-year data shows durable symptom relief
  • Patients report symptom relief after UroLift treatment
  • No new cases of ED reported in trials
  • High patient satisfaction
  • Improved urinary flow and quality of life

If you’re into data (and who isn’t when it’s your body), here’s what one of the leading studies showed:

“Erectile and ejaculatory function were preserved in 100% of sexually active men treated with UroLift.” — Journal of Sexual Medicine, 2019

How This Treatment Affects Daily Life

The goal of any BPH procedure shouldn’t just be symptom relief—it should be a return to normal life, including:

  • Better sleep (less nighttime peeing)
  • More confidence in social settings
  • Renewed sexual energy
  • Less anxiety about “accidents”

After UroLift, the most common side effects include urinary discomfort, pelvic pain, burning with urination, and blood in the urine. Most symptoms are mild to moderate and typically resolve within a few weeks. Symptoms related to the procedure are temporary, and most patients have their symptoms resolved within a short period.

Most of my patients report feeling lighter, more in control, and more themselves within weeks of UroLift.

And when they pair it with pelvic physical therapy? The results are even better.

What to Expect During UroLift Treatment

If you’re considering the UroLift System, you’ll be glad to know it’s a minimally invasive procedure designed with your comfort and convenience in mind. The entire treatment usually takes less than an hour, and it’s performed right in your urologist’s office or an ambulatory surgery center.

Here’s how it works: Using the UroLift delivery device, your doctor will deploy tiny, permanent implants that gently lift and hold the enlarged prostate tissue away from your urethra. This relieves the obstruction caused by benign prostatic hyperplasia (BPH) and allows urine to flow more freely—no cutting or removal of prostate tissue required.

The procedure can be done under local or general anesthesia, depending on your needs and your doctor’s recommendation. Most patients experience only minimal discomfort, and you’ll typically be able to go home the same day—often without the need for a catheter. Many patients experience symptom relief within just a few weeks after the procedure, and you can expect to get back to your normal routine quickly.

For men looking for a straightforward, effective way to address BPH symptoms and enlarged prostate tissue, UroLift offers a path to symptom relief with minimal downtime and a fast return to daily life.

Finding the Right Healthcare Provider for UroLift

Selecting the right healthcare provider is a crucial step in your journey to relief from BPH symptoms. The UroLift System consists of a specialized delivery device and permanent implants, and it’s important to choose a urologist who is experienced in performing this minimally invasive procedure.

Start by asking your primary care physician for a referral or searching online for urologists in your area who offer the UroLift System treatment. Look for providers who have a track record of success with the procedure and who can clearly explain how the UroLift System works to relieve obstruction caused by enlarged prostate tissue.

A knowledgeable provider will answer all your questions about benign prostatic hyperplasia, the UroLift System, and what to expect before, during, and after treatment. By partnering with an experienced urologist, you’ll be setting yourself up for the best possible outcome—achieving symptom relief and getting back to your life with confidence.

The Role and Importance of Physical Therapy in the Question: Can Urolift Cause Erectile Dysfunction?

As a pelvic health physical therapist, I’ve seen how targeted rehab can make a huge difference post-UroLift.
PT addresses pelvic floor tension, improves circulation, reduces anxiety, and promotes healthy muscle coordination. We also help men regain confidence and sexual function after BPH treatments. Personalized therapy programs can accelerate recovery, reduce post-operative discomfort, and improve outcomes for both urinary and sexual health.

can urolift cause erectile dysfunction

Rehab with Pelvic Floor Therapy After UroLift

Recovery doesn’t end once the UroLift procedure is over — rehab is where your body integrates the change. That’s why pelvic floor therapy is so valuable in the post-op phase.

I work with men to retrain muscles that may have been compensating for years of straining or dysfunction. After UroLift, some patients develop tightness, guarding, or overactive muscles as their body adjusts to the improved urinary flow. Addressing this early leads to better long-term outcomes.

What does rehab look like?

Typical post-UroLift pelvic floor rehab may include:

  • Pelvic floor relaxation and retraining exercises
  • Manual therapy for the lower back, hips, and perineum
  • Breathwork and core coordination drills
  • Education on bladder habits, voiding posture, and fluid timing

Many men are surprised by how much PT can enhance their confidence—not just physically, but sexually and emotionally too. Think of it as the final step in reclaiming your comfort, control, and quality of life after BPH treatment.

Final Thoughts on Can Urolift Cause Erectile Dysfunction

If you’re on the fence about UroLift, here’s my take:

If you want to fix your flow and keep your mojo, it’s one of the best options out there.

But don’t go it alone.

Discomfort varies greatly between individuals, but the procedure typically helps minimize discomfort for most patients.

Talk to your urologist. Talk to a pelvic therapist. Support your recovery, mentally and physically, and you’ll be back to peak performance in no time.Ready to take the next step? Visit Pelvis NYC to schedule a consultation with a specialist who understands your body and your goals.

Pelvic Wall Therapy: A Physical Therapist’s Complete Guide to Healing

A Physical Therapist’s Complete Guide to Healing

Pelvic wall therapy, more commonly referred to as pelvic floor physical therapy (PFPT), is gaining traction as a transformative approach to managing a wide range of pelvic health issues. Despite the growing attention, confusion still exists about what pelvic wall therapy entails, who it’s for, and why it’s a first-line treatment backed by research and medical professionals alike.

As a Doctor of Physical Therapy specializing in pelvic health, I’ve seen the profound impact that this form of therapy can have. This guide will walk you through everything you need to know about pelvic wall therapy.

What Is Pelvic Floor Therapy?

Pelvic floor therapy is a subset of physical therapy that focuses on treating conditions caused by dysfunction of the pelvic floor muscles. The pelvic floor consists of muscles and connective tissue that support the bladder, uterus (or prostate), rectum, and other pelvic organs. These muscles and connective tissue form a hammock-like structure that supports vital internal organs and is attached to the pubic bone and the pelvis, providing stability to the pelvic region.

In women, the pelvic floor also supports the vagina, along with other reproductive organs. Whether the muscles are too weak (hypotonic), too tight (hypertonic), or poorly coordinated, therapy can help retrain them. Dysfunction can involve muscle weakness or muscle spasms, leading to pelvic floor disorder and a range of pelvic floor disorders. These conditions can affect sexual function, and in men, may contribute to erectile dysfunction. This process improves function and alleviates common but often misunderstood.

pelvic wall therapy

Pelvic Floor Physical Therapy: How It Works

When people think of pelvic floor physical therapy, Kegels are often the first thing that comes to mind. While Kegels (pelvic floor contractions) can be beneficial for some patients, they are far from a one-size-fits-all solution, and in many cases, they’re not even appropriate, especially for those with pelvic floor overactivity or pain.

Pelvic floor physical therapy is a specialized therapy offering a range of treatment options tailored to each patient. This comprehensive, individualized approach goes far beyond simple exercises. An individualized plan is created based on a thorough assessment to relieve symptoms and reduce pain. The therapy addresses the full complexity of pelvic floor dysfunction by targeting muscular imbalances, nervous system regulation, postural alignment, and behavioral habits that contribute to symptoms. Treatment may include exercise to strengthen pelvic floor muscles, target specific muscles, and train for activities such as heavy lifting. Here’s what that approach often includes:

Internal and External Assessments

During the first appointment, therapists evaluate pelvic floor muscles through both external (abdomen, hips, back) and internal (vaginal or rectal) exams, and an internal exam may be performed as part of the assessment to check muscle tone, strength, and coordination. This helps identify tightness, weakness, prolapse, or scar tissue that may be contributing to symptoms.

Based on assessment findings and patient comfort, both internal and external therapy options are considered to create a comprehensive treatment plan.

Manual Therapy

Hands-on techniques—like myofascial release, trigger point therapy, and scar tissue mobilization—are used to relieve pain, improve circulation, and restore normal muscle function. These may be applied internally or externally. External therapy, including joint mobilization, may be used to address issues in the sacroiliac joint and other areas to improve mobility and support pelvic health.

pelvic wall therapy

Biofeedback

This technology uses special sensors attached to the body to monitor the activity of specific pelvic floor muscles. The results are displayed in real time on a computer screen, giving patients immediate feedback on how their pelvic floor muscles are functioning. This helps them learn how to properly contract and relax these muscles. It’s particularly effective for retraining coordination and improving control.

Neuromuscular Reeducation

Therapists help retrain how the pelvic floor works with the core, diaphragm, and posture. This often involves movement-based exercises that integrate breathing, lifting, and stability training for better overall control.

Tailored Pelvic Floor Exercises

Rather than one-size-fits-all Kegels, therapists prescribe tailored pelvic floor exercises that may include Kegel exercises and relaxation techniques, depending on whether the muscles are tight, weak, or poorly coordinated. These can include strengthening, relaxation, or endurance work depending on your goals.

Behavioral Coaching

Simple lifestyle changes—like improving posture, toilet habits, or breathing patterns—can have a major impact. Therapists guide patients on daily routines that reduce strain on the pelvic floor and support healing.

Collaborative Care

When needed, pelvic health therapists work alongside urologists, gynecologists, and other specialists to ensure comprehensive care, especially for complex conditions like interstitial cystitis or chronic pelvic pain.

Recognizing the Symptoms of Pelvic Floor Dysfunction

Many people live with pelvic floor dysfunction without even realizing it. Symptoms can vary based on whether the muscles are too tight or too weak. Common symptoms include:

  • Urinary incontinence (leakage during sneezing, laughing, or running)
  • Overactive bladder (frequent, urgent need to urinate)
  • Pelvic organ prolapse (a sensation of bulging or heaviness)
  • Chronic pelvic pain
  • Pain during intercourse or gynecological exams
  • Constipation or straining during bowel movements
  • Low back, hip, or tailbone pain with no clear orthopedic cause

If you’re experiencing one or more of these symptoms, pelvic wall therapy may help relieve symptoms and improve your quality of life.

Why Physical Therapy Is the First Line of Treatment

For those experiencing pelvic floor issues, physical therapy is often recommended before surgical or pharmaceutical interventions. Physical therapists play a crucial role in providing expert care, assessing each patient’s needs, and guiding them through a range of treatment options tailored to their condition. It’s a low-risk, high-reward strategy that’s supported by extensive research.

pelvic wall therapy

A 2024 review published in Frontiers in Global Women’s Health highlighted that pelvic floor physical therapy is significantly effective in treating pelvic floor dysfunction—including urinary incontinence, pelvic pain, and sexual dysfunction—without adverse side effects.

Unlike medications that mask symptoms, physical therapy addresses the root cause: the muscle imbalance or coordination dysfunction at the heart of the issue.

How We Treat Pelvic Floor Dysfunction in Clinical Practice

As a pelvic health physical therapist, I assess not only the pelvic muscles themselves, but also the surrounding structures that influence function. Each patient receives an individualized plan based on their specific pelvic floor disorder, taking into account their medical history, examination findings, and personal goals. Treatment plans typically include:

  • Manual therapy for trigger points and soft tissue tension
  • Postural correction and diaphragmatic breathing
  • Pelvic floor exercises that focus on both strength and relaxation, addressing muscle weakness as well as tightness
  • Scar tissue mobilization (postpartum or post-surgical)
  • Biofeedback and electrical stimulation as needed
  • Internal therapy for appropriate cases, when the patient is comfortable
  • Education on bladder and bowel behavior modification

Each treatment plan is customized. For example, some patients need to learn how to relax the pelvic muscles—not tighten them—especially those with chronic pain or interstitial cystitis.

Pelvic Floor Exercises: More Than Just Kegels

Pelvic floor exercises are foundational in therapy, but they must be done correctly and under the right circumstances. Not everyone should do Kegels. For individuals with overactive (tight) pelvic muscles, relaxation exercises and down-training are more appropriate.

Examples of common exercises include:

  • Slow and fast Kegels (for strengthening, when appropriate)
  • Deep core and gluteal activation
  • Bridge and squat progressions
  • Child’s pose breathing and pelvic drop stretches

Your therapist will evaluate your baseline and recommend exercises that meet your body’s specific needs.

Managing Chronic Pelvic Pain and Interstitial Cystitis with Therapy

Interstitial cystitis (IC), also known as painful bladder syndrome, is a chronic condition characterized by bladder pressure, pain, and frequent urination. While the exact cause is unknown, pelvic floor dysfunction is a common underlying factor, and IC is considered one of several pelvic floor disorders that can be addressed with therapy.

Research shows that physical therapy focusing on myofascial release and trigger point therapy can significantly reduce symptoms in people with IC. Internal therapy, such as internal vaginal or rectal release techniques, is often included in the treatment plan—alongside behavior changes and bladder retraining. The goal of therapy is to relieve symptoms and reduce pain, improving overall quality of life.

Patients with IC often respond best to a multidisciplinary approach involving PT, dietary changes, and pain psychology.

When Should You Start Pelvic Floor Therapy?

Early intervention is ideal. However, it’s never too late to seek help. You should consider seeing a pelvic health physical therapist if you:

  • Experience urinary or bowel leakage
  • Have pelvic pressure or notice a bulge
  • Feel pain with sex or during pelvic exams
  • Suffer from chronic pelvic or lower back pain
  • Are recovering from childbirth, abdominal surgery, or pelvic trauma

Postpartum recovery is especially critical. Studies show that initiating pelvic floor therapy within the first 6–12 weeks postpartum can prevent long-term issues such as prolapse, diastasis recti, and bladder dysfunction.

What Does a Pelvic Therapy Session Look Like?

A typical pelvic floor physical therapy session may include:

  • Review of symptoms and daily habits
  • Reassessment of posture, breathing, and muscle tone
  • Guided pelvic floor exercises or manual therapy, including internal and external therapy as appropriate
  • Education on self-care tools (perineal massage, dilators, postural changes)
  • Progress tracking and goal-setting

Therapy is typically done once per week for 6 to 10 weeks, depending on your condition and response to treatment.

Conclusion: Take the First Step Toward Pelvic Health

Pelvic wall therapy is a safe, effective, evidence-based path to healing pelvic floor dysfunction. Whether you’re a new mom, recovering from surgery, or managing chronic pain or interstitial cystitis, pelvic floor physical therapy offers real hope without relying on medications or surgery.

As a PT, I’ve seen how profoundly this therapy can change lives. Don’t wait for symptoms to worsen. With tailored guidance, pelvic floor rehabilitation can restore function, reduce pain, and help you reclaim control over your body.

pelvic wall therapy

Ready to take the first step? Visit Pelvis NYC to schedule an evaluation with a specialized pelvic health therapist and start your journey to recovery.

Varicocele: What Guys Should Know About This “Silent” Issue

Varicocele: What Guys Should Know About This “Silent” Issue

Most men don’t want to talk about their balls, especially if something feels weird or off down there. But if you’ve ever felt a strange heaviness, dull ache, or swelling in your scrotum, you might be dealing with something called a varicocele.

It’s more common than you’d think. About 1 in 7 men will get one, and for guys dealing with fertility issues, that number jumps to nearly 1 in 2.

So let’s break it down—what varicoceles are, why they matter, what you can do about them, and how physical therapy (yep, really) can be part of the solution.

The Male Reproductive System

Before we go deeper, let’s quickly break down how the male reproductive system works—and why something like a varicocele can quietly throw the whole thing off.

The main parts of the male reproductive system include the testicles, which are responsible for making sperm and testosterone; the epididymis, where sperm mature; and the vas deferens, which transports sperm during ejaculation. Supporting glands like the seminal vesicles and prostate add fluid that makes up semen, helping sperm survive their journey.

All of this needs to work in sync. But here’s the catch: sperm production is extremely sensitive, especially to heat, pressure, and blood flow. That’s why your testicles hang outside the body in the first place: to stay a few degrees cooler than your core temperature.

So when something like a varicocele causes enlarged veins and increased heat around the testicles, it can throw off that delicate balance. The result? Poor sperm health.

That’s where a semen analysis comes in.

If you’re trying to conceive and it’s taking longer than expected (usually six to twelve months), doctors often order this test to get a read on:

  • Sperm count – how many sperm are in your semen
  • Motility – how well your sperm swim
  • Morphology – how normal they look in size and shape
  • Volume and consistency of the semen itself

If any of those numbers are off, a varicocele is one of the first things a urologist will look for—because it’s such a common, correctable cause of male infertility.

So… What Is a Varicocele?

A varicocele is a varicose vein—but in your scrotum, not your legs. The veins that carry blood away from your testicles get enlarged and twisted, usually on the left side, thanks to how our plumbing is built.

You might feel:

  • A weird dragging sensation in your groin
  • A dull ache after standing or working out
  • Swelling or even a “bag of worms” feel (yeah, it’s as weird as it sounds)
  • Or maybe… nothing at all

And that’s what makes varicoceles so tricky. Some guys don’t notice anything until they and their partner start trying for a baby, and suddenly, a semen analysis throws up red flags.

Varicocele Symptoms: What to Watch For

Not all varicoceles cause noticeable pain or discomfort, which is why many men don’t even realize they have one until a fertility issue arises. But when symptoms do show up, they can include a dull, aching pain or a sense of heaviness in the scrotum. Some men notice a visible or palpable lump, often described as feeling like a “bag of worms” (strange but accurate), and swelling or asymmetry in the testicles, most commonly on the left side. Discomfort may become more noticeable after standing for long periods, lifting weights, or during physical activity.

In many cases, the first clue comes during a fertility workup, when a doctor orders a semen analysis and finds issues like low sperm count or abnormal motility. That’s often when the varicocele diagnosis comes into focus, turning what seemed like a minor issue into a much more pressing concern.

How Does Varicocele Affect Fertility?

Here’s where it gets serious. Varicoceles can mess with your male reproductive system in a few important ways:

  1. Raises testicle temperature → Sperm don’t develop properly in heat
  2. Reduces oxygen and blood flow → Leads to oxidative stress, damaging sperm DNA
  3. Impaired hormone regulation → May lower testosterone over time

📊 Studies show that varicoceles are present in 40% of men with abnormal semen parameters, and treating them can improve both sperm quality and pregnancy rates.

How Is a Varicocele Diagnosed?

Doctors typically diagnose a varicocele during a physical exam or scrotal ultrasound. You may be asked to stand and perform a Valsalva maneuver (basically bearing down) so they can check for vein enlargement.

It’s often graded from Grade 1 (small) to Grade 3 (large), and those grades help determine the need for medical treatment.

Varicocele Treatment Options: What Can You Do?

Not every varicocele needs to be treated. But if you’re in pain, your semen quality is poor, or you’re trying to conceive without luck, here’s what you can consider:

Watchful Waiting

If your varicocele is small and symptom-free, doctors may suggest monitoring it regularly, especially if you’re not trying to have kids right now.

Medical Treatment: Varicocele Surgery

If you’re dealing with pain or fertility problems, varicocele surgery (aka varicocelectomy) is often recommended. It involves tying off the enlarged veins to restore normal blood flow.

There are a few surgical techniques:

  • Microsurgical varicocelectomy – highest success, lowest risk
  • Laparoscopic surgery
  • Percutaneous embolization – a minimally invasive option using a catheter

According to the American Urological Association, surgery improves semen quality in 60–80% of men and boosts natural pregnancy rates in many couples.

How Can Physical Therapy Help Varicocele?

This is where things get interesting. Most men are never told that pelvic physical therapy can support recovery and manage symptoms, sometimes even before considering surgery.

1. Pain Management

Chronic testicular or pelvic pain isn’t always about the veins. Sometimes, it’s due to muscle tension, nerve entrapment, or poor posture.

A men’s health PT can release tension in the:

These techniques relieve pressure and improve blood flow.

2. Post-Surgical Recovery

After varicocele repair, PT helps you:

  • Regain core strength
  • Reduce scar tissue adhesions
  • Return to pain-free sex, sports, and workouts

🧠 Fact: About 30–50% of men with varicocele-related pain continue to feel discomfort even after surgery (AUA Guidelines, 2021). Physical therapy can address muscular and nerve-based causes that surgery doesn’t fix.

3. Pelvic Floor Rehabilitation

Pelvic floor dysfunction in men can mimic varicocele pain, worsen congestion, and impair urinary/sexual function.

Men’s health PTs use techniques like:

  • Biofeedback
  • Internal release (yes, men have pelvic floors too!)
  • Diaphragmatic breathing to improve circulation

4. Lifestyle Support

PTs can guide you in:

  • Movements that improve venous return
  • Anti-inflammatory routines (breathing, stretching)
  • Advice on compression, lifting techniques, and posture

What the Research Says

  • 2018 Review (Andrologia): Varicocele-related pain is often neuromuscular, not purely vascular. Conservative therapies like PT should be part of the care plan.
  • 2021 Study (Urology Journal): Men undergoing PT after varicocelectomy reported faster pain relief and improved daily function.
  • Pelvic PT Research (Hodges, 2020): The pelvic floor is central to venous and lymphatic return, a key factor in varicocele symptom management.

When Should You See a PT?

You should consider seeing a pelvic health PT if:

  • You’ve had surgery but still have discomfort
  • You’re dealing with testicular or groin pain that doesn’t seem to improve
  • You want to explore non-surgical options before going under the knife
  • You’ve noticed that posture, movement, or stress makes symptoms worse

There’s Help—You Just Have to Ask

A varicocele isn’t the end of the world—but it’s also not something to brush off. Whether it’s causing pain, fertility issues, or just messing with your peace of mind, you deserve answers and real solutions.

Between surgical treatment, lifestyle changes, and physical therapy, there are more options than you think. The key is getting the right diagnosis and building a team that helps you move forward—without shame, fear, or guesswork.

Ready to Take the Next Step?

If you’re dealing with testicular pain, fertility struggles, or just want answers about your body, you don’t have to navigate it alone. At Pelvis NYC, we specialize in male pelvic health, offering personalized, expert-led care that supports your recovery, improves blood flow, and helps you feel like yourself again.

Whether you’re preparing for varicocele treatment, recovering from surgery, or exploring non-invasive options, our team is here to help you move forward confidently and pain-free.👉 Book a private consultation today at Pelvis NYC and take control of your health, your fertility, and your future.

Varicocele- How PT can help?