[{"@context":"https:\/\/schema.org\/","@type":"Article","@id":"https:\/\/share-dev.upmc.com\/2025\/06\/pelvic-floor-therapy-men\/#Article","mainEntityOfPage":"https:\/\/share-dev.upmc.com\/2025\/06\/pelvic-floor-therapy-men\/","headline":"When Men Need Pelvic Floor Physical Therapy","name":"When Men Need Pelvic Floor Physical Therapy","description":"<p>Chronic prostatitis, or chronic pelvic pain syndrome, is often misdiagnosed as an infection, but is highly treatable with pelvic floor physical therapy.<\/p>","datePublished":"2025-06-24","dateModified":"2025-08-27","author":{"@type":"Organization","@id":"https:\/\/www.upmc.com\/services\/rehab","name":"UPMC Rehabilitation Institute","url":"https:\/\/www.upmc.com\/services\/rehab","sameAs":"https:\/\/share-dev.upmc.com\/upmc-rehabilitation-institute\/","parentOrganization":"UPMC"},"publisher":{"@type":"Organization","name":"UPMC HealthBeat","logo":{"@type":"ImageObject","@id":"https:\/\/share-dev.upmc.com\/wp-content\/uploads\/2019\/04\/UPMC-HealthBeat-Logo.png","url":"https:\/\/share-dev.upmc.com\/wp-content\/uploads\/2019\/04\/UPMC-HealthBeat-Logo.png","width":600,"height":60}},"image":{"@type":"ImageObject","@id":"https:\/\/share-dev.upmc.com\/wp-content\/uploads\/2025\/06\/GettyImages-1325746132-e1750444035678.jpg","url":"https:\/\/share-dev.upmc.com\/wp-content\/uploads\/2025\/06\/GettyImages-1325746132-e1750444035678.jpg","height":866,"width":2000},"url":"https:\/\/share-dev.upmc.com\/2025\/06\/pelvic-floor-therapy-men\/","about":["Health Topics A-Z","Rehabilitation"],"wordCount":1114,"articleBody":"About 25% of the people Shari Berthold, PT, DPT, sees as a pelvic floor physical therapist are men.Some see her for help gaining urinary control after prostate removal for prostate cancer. She teaches them muscle retraining, including Kegel exercises.But there\u2019s another group of men who also need pelvic floor physical therapy. And often, they don&#8217;t know it.\u201cMen with chronic pelvic pain syndrome are an underserved group,\u201d says Shari, a UPMC Rehabilitation Institute physical therapist in Williamsport, Pa. Many of these men have chronic prostatitis, and \u201coften, they\u2019ve been given antibiotics, which aren\u2019t effective.\u201dThis is because most of the time, their prostatitis isn\u2019t from an infection \u2014 it\u2019s related to a pelvic floor muscle problem.Unlike after prostate removal, the issue isn\u2019t that their pelvic floor is weak. Instead, it\u2019s far too tight, which causes a whole host of symptoms. In addition to pain, tight pelvic floor muscles can lead to urinary frequency, weak urine stream, and sexual dysfunction.\u201cProstatitis can happen to one out of every two guys his lifetime,\u201d Shari says. \u201cIt\u2019s a very common problem, but men are embarrassed to talk about it sometimes.\u201dShari wants to change that because men\u2019s pelvic floor dysfunction is a highly treatable condition.What Is Prostatitis?Prostatitis is an inflammation of your prostate gland. The symptoms men notice most include:Pain when peeing or ejaculating.Groin or genital pain.Abdominal or low back pain.Trouble peeing (peeing too much, having a weak stream, or difficulty starting the stream).Types of prostatitisThere are four types of prostatitis.Acute bacterial prostatitis \u2014 This rare type tends to happen in men in their 20s and 30s. Antibiotics are the best treatment for it.Chronic bacterial prostatitis \u2014 Also rare, this tends to affect men 30 and older. Antibiotics can treat it, too.Chronic prostatitis \u2014 The most common type, also called chronic pelvic pain syndrome. Instead of an infection causing pain, the muscles around the prostate do. Chronic pelvic pain syndrome can affect men of all ages, and antibiotics won\u2019t help.Non-symptomatic inflammatory prostatitis \u2014 This type usually doesn\u2019t have symptoms, and a doctor might find it while testing for something else.If a man had an infection in the past, their primary care doctor might assume it\u2019s another infection. Hence, they might prescribe antibiotics again without running a urine test. When the symptoms don\u2019t go away, the doctor may refer them to a urologist.At UPMC, the urology team works closely with the pelvic floor physical therapy team. \u201cThat\u2019s often when we get involved with muscle training,\u201d Shari says.What Are Male Pelvic Floor Exercises for Prostatitis?\u201cPelvic floor muscle training is about learning fine motor control of the pelvic muscles,\u201d Shari says.A healthy muscle contracts, relaxes, and lengthens. You need to do all three of these things with your pelvic muscles. Too often, men keep those muscles constantly contracted.Tight muscles can spasm and cause pain and inflammation. All that tension can irritate the bladder, which can irritate everything nearby. \u201cEverything is neighbors with everything else down there,\u201d she says.This can cause pain in any of the nearby organs, as well as urinary and bowel movement problems. It\u2019s a cycle because the pain makes you contract your muscles. Constantly contracting only worsens the pain and inflammation.It helps when she shows the muscles involved via ultrasound. The men she treats can see on the screen how a muscle responds to coughing, lifting, or taking deep breaths.Her goal is to help them learn how they can control these muscles through a host of muscle identification and relaxation exercises. \u201cOften, men are bracing their entire core,\u201d she says.What Causes Chronic Pelvic Pain Syndrome in Men?Sometimes, the problem stems from the way men lift heavy weights. It\u2019s an overuse of their glutes, made worse by tight hamstrings, abs, and hip rotators.Other times, it\u2019s a chronic stress response to whatever is going on in their life, and Shari plays detective. \u201cI try to find out if they have anxiety,\u201d she says. \u201cHow their sleep is, their work life, their home life, their overall stress.\u201dShe takes a bio-psycho-social approach, trying to understand the whole picture. Sometimes, this is as simple as doing too many squats and not enough stretching, leading to overly tight muscles. But other times, it&#8217;s also a combination of personal, work, family, or financial stress \u2014 when you\u2019re stressed, you clench, tighten, and tense.From a physiological standpoint, she can teach breathing, relaxation, and stretching techniques within a few sessions. \u201cMost guys feel better within about 12 weeks,\u201d she says.Shari may also refer people to counseling\/behavioral therapy to help keep the problem from recurring.What About Kegel Exercises for Men?Kegel exercises involve squeezing the muscles you use to hold in urine or stop a bowel movement. You hold the contraction for five to 10 seconds and then repeat 10 to 20 times, several times a day.Male Kegel exercises are very helpful for men who\u2019ve had a prostatectomy to treat prostate cancer. Berthold teaches these types of exercises to men post-surgery.But Kegels are the last thing a man with prostatitis should do. Pelvic floor exercises for men focus on relaxing, stretching, and letting the tension go.How Do I Know if I Have an Enlarged Prostate or Pelvic Floor Dysfunction?With age, your prostate can become enlarged. It starts putting pressure on your urethra and weakens your stream. That\u2019s not a pelvic floor dysfunction issue.However, without treatment, the enlarged prostate can cause other problems. Your bladder has to contract harder and harder to get urine through. The bladder wall gets thicker and tighter.Medically, your doctor can prescribe medicine to relax the prostate and open the tube. But a pelvic floor PT can also offer behavioral strategies, although an enlarged prostate isn&#8217;t a primary reason to see a specialist like Shari.\u201cWith enlarged prostate, you want to treat medically first,\u201d she says. \u201cIf that doesn\u2019t help, a PT can teach other strategies.\u201dAs for how to tell the difference? An enlarged prostate is consistent and progressive, she says. \u201cBut if the problem comes and goes, it means the muscles are sometimes relaxing and sometimes not. And that is a pelvic floor issue.\u201dDon\u2019t Put Up With Chronic Pelvic Pain Syndrome\u201cJust talk to your doctor and get a proper diagnosis,\u201d Shari says. \u201cTreatment really isn\u2019t that complicated or expensive. It doesn\u2019t require surgery, and often, it doesn\u2019t even require medicine.\u201dLearn about pelvic floor physical therapy or find a UPMC Rehabilitation Institute location near you.Sources"},{"@context":"https:\/\/schema.org\/","@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"name":"2025","item":"https:\/\/share-dev.upmc.com\/2025\/#breadcrumbitem"},{"@type":"ListItem","position":2,"name":"06","item":"https:\/\/share-dev.upmc.com\/2025\/\/06\/#breadcrumbitem"},{"@type":"ListItem","position":3,"name":"When Men Need Pelvic Floor Physical Therapy","item":"https:\/\/share-dev.upmc.com\/2025\/06\/pelvic-floor-therapy-men\/#breadcrumbitem"}]}]