Men’s pelvic health physiotherapy is a broad and often under-discussed topic. From sexual function to urinary issues, muscle dysfunction to chronic pain, these problems can have a significant impact on quality of life.
At Wandsworth Physiotherapy, we specialise in a range of men’s health issues, focusing on pelvic floor health, sexual dysfunction, and general wellness. Understanding the interplay between these areas can help men regain control, improve confidence, and improve overall well-being.
Pelvic Floor Muscle Dysfunction
The pelvic floor is a group of muscles that support the bladder, bowel, and in men, the prostate and penis.
These muscles play a critical role in urinary and sexual function. Pelvic floor dysfunction occurs when these muscles are either underactive or overactive.
- Underactive muscles may lead to urinary leakage, erectile dysfunction (ED), and decreased control during sexual activity.
- Overactive muscles can cause pelvic pain, urinary urgency, and difficulties with ejaculation or erection.
Physiotherapists can assess pelvic floor muscle function through clinical assessment and imaging such as ultrasound scanning, which allows real-time visualisation of muscle contraction and relaxation. Tailored exercises, manual therapy, and lifestyle advice can significantly improve function and reduce symptoms.
Nerve Injury and Hypersensitivity
Men can also experience nerve-related issues affecting the pelvic region.
Trauma, surgery, or chronic compression of nerves can result in hypersensitivity, numbness, or pain in the pelvis, penis, or perineum.
Physiotherapy can support nerve recovery through gentle mobilisation, neuromuscular retraining, and pain management techniques. The earlier you can seek assessment and treatment the better, in order to help prevent chronic discomfort.
Men’s Pelvic Health Physiotherapy for Erectile Dysfunction (ED)
Erectile dysfunction affects a significant proportion of men, with 90% of cases having a vascular cause and about 10% related to psychological factors.
Common vascular causes include atherosclerosis, high blood pressure, and diabetes.
Physiotherapy can help by:
- Strengthening the pelvic floor – to enhance venous return and rigidity
- Improving overall circulation through exercise prescription
- Teaching relaxation – to reduce performance anxiety
For some men we use ultrasound assessment of penile blood flow to help identify any underlying vascular issues, which helps guid your treatment and lifestyle interventions.
Shockwave Therapy for ED
Shockwave therapy uses low-intensity sound waves to treat erectile dysfunction (ED) by promoting blood flow and new blood vessel growth, which can lead to stronger, more spontaneous erections. It is considered a non-invasive, drug-free option for men with mild to moderate ED, especially when vascular issues are the cause.
Men’s Pelvic Health Physiotherapy for Chronic Pelvic Pain and CPPS
Chronic Pelvic Pain Syndrome (CPPS) affects men of all ages. It may involve bladder pressure, perineal ache, or pain after ejaculation. Often there is no infection; instead, the pelvic floor muscles remain in a protective spasm and nerves become hypersensitive.
Management includes:
- Pelvic-floor release work
- Shock-wave therapy – to reduce muscle tension and improve micro-circulation
- Breathing and relaxation techniques – to down-regulate the nervous system
- Gradual return to physical activity
Combined with exercise therapy, stress and sleep management, and lifestyle modification, physiotherapy plays an important role in managing CPPS.
Men’s Pelvic Health Physiotherapy for Hard Flaccid Syndrome
Hard flaccid syndrome is a complex condition where the penis remains semi-rigid even in a flaccid state, often accompanied by pain, erectile difficulties, and pelvic discomfort. The syndrome is believed to involve muscle overactivity, nerve irritation, and vascular changes.
Hard-flaccid syndrome is characterised by a semi-rigid penis at rest, loss of sensation, and pelvic tightness. It can also be accompanied by pain and erectile difficulties. It is thought to involve over-activity of pelvic muscles, nerve irritation, and altered blood flow.
Treatment focuses on restoring normal muscle tone and sensitivity through:
- Pelvic-floor relaxation and biofeedback
- Manual therapy to surrounding soft tissues
- Breathing and posture correction
- Gradual re-exposure to sexual activity and exercise
Early education and reassurance are incredibly important with this syndrome – this condition is distressing but usually reversible with the right care.
Men’s Pelvic Health Physiotherapy for Peyronie’s Disease
Peyronie’s disease involves abnormal plaque formation in the penis, leading to curvature, pain, and sometimes erectile difficulties. It often begins with a painful phase lasting 12–18 months, followed by stable plaque formation.
Ultrasound scanning of the penis allows physiotherapists and clinicians to visualise plaques and plan treatment. For selected cases, focused shockwave therapy can reduce plaque stiffness and improve penile elasticity.
Red Flags in Men’s Health
It is important to recognise symptoms that require prompt medical evaluation. While physiotherapy can help with many pelvic and sexual health issues, certain signs indicate the need for further investigation:
- Persistent pelvic, testicular, or penile pain
- Urinary incontinence or stress urinary incontinence (SUI)
- Urinary urgency or frequency
- History of post-radical prostate surgery
- Suspicion of cancer, particularly prostate cancer
- Recurrent urinary tract infections (UTIs)
During your initial assessment, your physiotherapist will ask you a number of questions, that might not seem relevant to your symptoms. This is to ensure that we look at the whole picture and if there are any red flags that are identified, we can refer you to the right healthcare provider to ensure safe, rapid and effective management.
Link Between Men’s Pelvic Health and General Wellness
Many issues in men’s pelvic health and sexual function are closely linked to broader aspects of health. Addressing these underlying factors can improve both pelvic and overall wellbeing.
- Weight management: Excess body weight can increase pressure on the pelvic floor, reduce vascular health, and contribute to erectile dysfunction.
- Smoking: Nicotine affects blood flow, impacting vascular health and erectile function.
- Alcohol consumption: Excessive alcohol can impair hormonal balance and sexual performance.
- Diabetes: Poorly controlled blood sugar affects nerve function, circulation, and wound healing, contributing to pelvic pain and ED.
- Testosterone and age-related decline: Low testosterone can affect libido, energy, and muscle function. Blood tests can assess hormone levels, and in selected cases, testosterone replacement therapy (TRT) may be considered.
- Nutrition: A balanced diet supports vascular health, hormone balance, and overall energy levels. Nutritional therapy can complement physiotherapy for men’s health issues.
By taking a holistic approach, physiotherapists can address both the localised symptoms of pelvic dysfunction and the systemic factors that influence men’s health.
Men’s Health Physiotherapy Treatments at Wandsworth Physiotherapy
Physiotherapy treatment for men’s health is diverse and we make sure that it is tailored to each individual’s needs.
These are some of the evidence-based treatment options that we offer at Wandsworth Physiotherapy:
- Ultrasound assessment of pelvic-floor and penile structures – Visualising muscles, nerves, and penile plaques to guide therapy.
- Biofeedback-guided pelvic floor training to learn precise control of pelvic muscles – Strengthening or relaxing pelvic muscles and correcting abnormal muscle firing patterns to restore muscle balance and coordination.
- Manual therapy and soft-tissue release to ease tension of the pelvic region, and improve blood flow
- Focused shock-wave therapy – Non-invasive treatment for CPPS, Peyronie’s disease, and selected cases of ED.
- Lifestyle coaching – Guidance on exercise, diet, weight management weight management, alcohol moderation, and smoking cessation.
- Education and reassurance to reduce fear and empower self-management
- Exercise and Rehabilitation: Personal training, yoga, Pilates.
Most men notice measurable improvement within a few sessions when exercises are performed consistently and lifestyle factors are addressed alongside treatment.
At Wandsworth Physiotherapy, we work closely with urologists, GPs, and other healthcare professionals to provide integrated care.
The Importance of Awareness
Despite the prevalence of these issues, men often delay seeking help due to embarrassment or lack of awareness. It’s important to understand that pelvic floor dysfunction, ED, CPPS, and Peyronie’s disease are common and treatable. Physiotherapy offers practical strategies to manage symptoms, restore function, and improve quality of life.
When to Seek Help
Like with many health problems, the earlier that you seek assessment and treatment for men’s pelvic health physiotherapy, the better. Men can be notoriously bad at this! But it really can make a big difference in management and outcomes.
While some issues may resolve with home exercises or lifestyle changes, persistent pain, urinary changes, or sexual dysfunction should be assessed by a professional.
Our Physiotherapists specialising in men’s health can:
- Conduct a thorough assessment, including pelvic floor and nerve function
- Use ultrasound imaging to visualise structures
- Develop personalised treatment plans
- Advise on lifestyle, nutrition, and general health factors
Red flag symptoms, such as testicular lumps, severe pelvic pain, or persistent urinary issues many require a prompt referral to a urologist or GP.
Men’s pelvic health physiotherapy complements medical treatment but is not a replacement for urgent investigation.
Conclusion
Men’s health encompasses more than just sexual function or prostate issues. Pelvic floor dysfunction, chronic pelvic pain, nerve injury, and conditions such as Peyronie’s disease or hard flaccid syndrome can significantly impact quality of life.
Men’s pelvic health physiotherapy offers effective, non-invasive strategies to restore muscle function, improve circulation, relieve pain, and enhance overall wellness.
Equally important is addressing general health factors like weight, smoking, alcohol, diabetes, and low testosterone, which are often closely linked to pelvic and sexual health.
If you experience pelvic pain, urinary changes, or sexual dysfunction, don’t wait – early assessment and treatment can make a significant difference.
At Wandsworth Physiotherapy, we provide a specialist men’s health services, offering a holistic approach that combines expert assessment with evidence-based physiotherapy to help you get back to feeling your best.
Our specialist team of men’s health physio’s and osteopaths are available for discrete consultations at Wandsworth Town, Clapham Junction and Battersea Nine Elms.