Connect Physical Therapy: It's time to Own Your Body
  • Home
  • About
    • Michelle Dela Rosa, PT, DPT, PRPC
    • Karen A. Bruno, PT, DPT, PCES
    • Bryn Zolty, PT, DPT, PRPC, BCB-PMD, PCES
    • Katelyn (Kate) R. Sheehan, PT, DPT, ATC, PCES
    • Jennifer Watt, PT, DPT
    • Shraddha Wagh PT, DPT
    • Rosalind Cox-Larrieux, PT, MPT, PRPC
    • Giselle Oriendo, PT, CLT
    • Becca Ironside, PT, MSPT
    • Marzena Bard, PTA, CYT, PCES
    • Donna Zamost, PTA, PCES
  • Services
  • New Patients
  • Existing patients
    • Patient Cheat Sheet
    • Pelvic Floor Relaxation
    • Core Strengthening
    • Hip Strengthening
    • Pelvic Correctives
  • Videos
    • Female pelvic pain
    • Male pelvic health
    • Meditation
    • Back pain
    • Pregnancy & postpartum
    • Yoga
  • Ask us
  • Blog
  • Location

BLOG

Read about insights and research updates in
​orthopedic and pelvic physical therapy.

Q&A for men: third edition

9/23/2019

 
Picture

While drawing from her clinical experience, Becca Ironside, PT answers specific questions from men about their urinary, bowel, and sexual concerns.

​This is Connect PT's second edition of the Question and Answer series.

​Question from Kirk: I am an avid bike guy. I go outdoor trail riding on weekends, over 60 miles, if the weather is good. On my weekdays, I do spin classes to stay in shape. I have begun noticing a dull ache in my testicles that won’t go away, even if I skip a day of riding. I went to my urologist because of my testicular pain. After some tests and an ultrasound, she said there is nothing wrong with my scrotum, but that I should lay off the bike riding. It is my favorite way to blow off steam after a long week at the office. Is bike riding related to my testicular pain? If so, do I have to stop altogether?

Answer from Becca: Kirk, I understand how distressing it is to have undiagnosable pain in your pelvis. While working in a pelvic floor physical therapy clinic, we treat men like you all the time. Your testicular pain may be caused by tension in the small muscles of the saddle region of your body. The nerves and soft tissues of the groin are delicate and often get upset when they are compressed, as they would be during prolonged sitting on your bike seat. In your particular case, these bodily structures are also being jostled around quite a bit, especially during your trail rides on bumpy terrain. Spin classes also present a particular strain on the saddle area, as you are likely raising your butt off the seat for increased resistance and then slamming your body right back down to a sitting position a few moments later.

Bike riding is your passion, and I wouldn’t want to rid you of something you like, especially if it is helping you “blow off steam after a long week at the office”. There are a few modifications that may help ease the pressure off your testicles and decrease your pain. Firstly, buy a seat for your trail bike that is specially designed for people with pelvic pain. There are many from which to choose, and they will often have a hole cut out of the seat, so that your pelvic floor will not be in contact with any surface while you ride. Secondly, when outdoors, try to bike on level surfaces for now. The rugged land of the trails is like riding a Jeep in the jungle. What you want to do to rest your pelvic floor muscles and scrotum is to travel on level terrain (cement), which will feel like riding your grandfather’s Cadillac with superb suspension. I know, it won’t be the same, but bear with me. Your testicles need this rest right now. Thirdly, if you are going to do spin classes, buy your own bike seat designed for pelvic pain sufferers, install it before a class, and avoid the alternating standing/sitting repetitions that spin classes are famous for.

In time, your testicles will heal and you may get back to the point when you can resume trail riding. Also, if you have the time, find a pelvic floor physical therapist. The tight muscles of your pelvic floor can be stretched and any possible soft tissue restrictions within your scrotum can be addressed as well. By doing this, you will be sending your testicles on a much-needed vacation and they will thank you for it in the future.

Question from Lou: My partner and I are fairly certain that we are done having children. I am considering having a vasectomy but am worried that something might go wrong. Can you tell me about this surgery and what I might expect if I get it in the future?

Answer from Becca: I understand that this is a major decision, Lou, and you are not alone in the vast number of men who consider this procedure and are held back by trepidation about what the long-term implications might be. Let’s start with the anatomy or plumbing in how all this works. The sperm of a male is stored in tiny little coil, called the epididymis, that is located directly above each testicle. That sperm waits until it is needed, and then travels from the epididymis down a long tube called the vas deferens. The sperm then mixes with seminal fluid and is ejaculated through the penis. (This is a highly simplified explanation, but you get the idea). The procedure known as the vasectomy entails cutting both of the long tubes that serve as a conduit of the sperm to the ejaculatory fluid.

The surgery involves one or two small incisions in the scrotum. The vas deferens is cut and a small piece may be removed, leaving a gap between the two ends. The physician then sears the ends of the tube, and ties little knots on each end. This is then performed on the opposite vas deferens. Afterwards, there may be one to two small scars on the scrotum which heal rapidly. Then, voila! This surgery is a 99% effective form of birth control.

​The recovery time after a vasectomy is quite short. You will need a few days of rest and some ice on the groin. After undergoing this surgery, many men are satisfied that they 1) no longer have to use condoms if they have a single sex partner and 2) do not have to burden their female partner with the more tricky forms of birth control, which do not offer as high a protection against pregnancy.

​There is a small risk of side-effects for this surgery, including the formation of a granuloma (a small lump of scar tissue where the vas deferens has been cut), though this is often not pain-producing. The sensation and quality of ejaculation will usually remain completely unchanged. I hope that I have answered your questions, Lou, and best of luck in making your decision!

Question from Sergio: I am in my mid-thirties and have a very high-stress corporate job. On the days when I work 12 plus hours, my girlfriend often wants to have sex late at night. I find that I take longer to finish and that my ejaculation is more like a dribble than the forceful explosions that I usually have. Is something wrong? What should I do about this?

​Answer from Becca: Sergio, this is a great question and a common cause of concern for men. It all boils down to the lives that we live today. Many men have high-stress corporate jobs. Which means they are under tremendous pressure for long hours, they are often sitting, and their tension is traveling down to the muscles upon which they sit. This is the perfect description of mild pelvic floor tension. Just as some people carry their muscular tension in their shoulders or low backs, you are storing it in your pelvic floor, Sergio. And these days, with the way that we work and live in our society, your need for increased time to ejaculate and the decreased power of your ejaculation are both incredibly common.

While it wouldn’t hurt to see a urologist to rule out any other problems, these sexual issues are likely caused by tightness in your pelvic floor muscles. In order for arousal to take place, the muscles of the pelvic floor should lengthen and allow blood to pool within the testicles and penis. If these muscles are tight, they may not be allowing enough blood into these tissues and erections may be less rigid. This would cause a delay in ejaculation, resulting in increased time to finish the job. Furthermore, that decreased blood flow into the groin would result in less pressure generated to create the “forceful explosions” that you typically experience, Sergio. A weak dribble of seminal fluid at climax may often result.
​
In summary, there doesn’t seem to be anything wrong here, Sergio, except that you are living in the world today. My suggestion would be to practice some form of stress reduction at the end of these long workdays. It could be as simple as listening to some calming music during your commute home. You might want to do some simple stretches on the floor or spend time with your girlfriend without rushing into sex late in the evenings. Finally, you could reschedule sex for early mornings or weekends. This would assist your pelvic floor in being more primed and relaxed to achieve the quality of arousal and ejaculation that you deserve.
    Pelvic blog

    Categories

    All
    Case Study
    Coccydynia
    Constipation
    Diabetes
    Did You Know
    Equipment
    Events
    Hip And Abdominal Pain
    Incontinence
    Interstitial Cystitis
    Interviews
    Low Back Pain
    Meditation
    Men's Health
    Neck And Shoulder Pain
    Pelvic Pain
    Pregnancy
    Prolapse
    Prostate
    Pubic Pain
    Q&A
    Research
    Resources
    Smoking
    Urinary Frequency
    Vagus
    Visceral Manipulation
    Vitamin D
    Vulvodynia
    What's New
    Yoga

    Archives

    January 2023
    December 2022
    November 2022
    October 2022
    September 2022
    August 2022
    July 2022
    June 2022
    May 2022
    April 2022
    March 2022
    February 2022
    January 2022
    December 2021
    November 2021
    October 2021
    September 2021
    August 2021
    July 2021
    June 2021
    May 2021
    April 2021
    March 2021
    February 2021
    January 2021
    December 2020
    October 2020
    September 2020
    August 2020
    July 2020
    June 2020
    May 2020
    March 2020
    February 2020
    January 2020
    December 2019
    October 2019
    September 2019
    August 2019
    July 2019
    June 2019
    May 2019
    April 2019
    March 2019
    February 2019
    January 2019
    December 2018
    November 2018
    October 2018
    September 2018
    August 2018
    July 2018
    June 2018
    May 2018
    April 2018
    March 2018
    February 2018
    January 2018
    December 2017
    November 2017
    October 2017
    September 2017
    August 2017
    July 2017
    June 2017
    May 2017
    February 2017
    December 2016
    October 2016
    September 2016
    July 2016
    June 2016
    May 2016
    April 2016
    March 2016
    January 2016
    December 2015
    November 2015
    September 2015
    August 2015
    July 2015
    June 2015
    May 2015
    March 2015
    January 2015
    July 2014
    June 2014
    May 2014
    April 2014
    March 2014
    February 2014
    January 2014
    November 2013
    August 2013
    June 2013
    December 2012
    November 2012
    October 2012
    September 2012
    August 2012
    February 2012
    December 2011
    November 2011
    October 2011
    September 2011
    August 2011
    July 2011

©2009-2023 Connect Physical Therapy and Connect Physical Therapy East | It's Time to Own Your Body
facebook.com/connectphysicaltherapy | admin@connectpt.org
Whitehorse Professional Building | 1675 Whitehorse-Mercerville Rd, Ste 101 | Hamilton, NJ 08619 | P: 609-584-4770 | F: 609-584-4880
Candlewood Commons Office Park | 201 Candlewood Commons | Howell, NJ 07731 | P: 732-994-7755 | F: 732-994-7757
  • Home
  • About
    • Michelle Dela Rosa, PT, DPT, PRPC
    • Karen A. Bruno, PT, DPT, PCES
    • Bryn Zolty, PT, DPT, PRPC, BCB-PMD, PCES
    • Katelyn (Kate) R. Sheehan, PT, DPT, ATC, PCES
    • Jennifer Watt, PT, DPT
    • Shraddha Wagh PT, DPT
    • Rosalind Cox-Larrieux, PT, MPT, PRPC
    • Giselle Oriendo, PT, CLT
    • Becca Ironside, PT, MSPT
    • Marzena Bard, PTA, CYT, PCES
    • Donna Zamost, PTA, PCES
  • Services
  • New Patients
  • Existing patients
    • Patient Cheat Sheet
    • Pelvic Floor Relaxation
    • Core Strengthening
    • Hip Strengthening
    • Pelvic Correctives
  • Videos
    • Female pelvic pain
    • Male pelvic health
    • Meditation
    • Back pain
    • Pregnancy & postpartum
    • Yoga
  • Ask us
  • Blog
  • Location