Pelvic Floor Therapy for Men in San Diego
Men have pelvic floors too. And when something isn't working right, it's treatable.
Maybe you've been dealing with pelvic pain that no one can explain. Maybe you're leaking when you cough, jog, or lift something heavy. Maybe you have a tailbone ache that shows up every time you sit down. Maybe you've been to a urologist, a GP, and a physical therapist, and the pain is still there.
One thing that comes up often in my practice: the pelvic floor refers pain to the hip and the lower back. When someone has been in regular PT for back or hip issues and it's not getting better, that's often a clue the pelvic floor is involved. An internal pelvic floor exam can find things that external-only assessment misses.
I'm Dr. Ashlee Gendron. I treat pelvic floor conditions in men and women at my clinic in Rancho Bernardo. The mechanics of the pelvic floor are the same regardless of anatomy. I walk through the same assessment sequence with every client, tailored to what you came in for.
Conditions I Treat in Men
Male Pelvic Pain
Pain in the perineum, groin, testicles, penis, or lower abdomen that doesn't come from a clear injury or infection. Sometimes called chronic prostatitis or chronic pelvic pain syndrome (CPPS), even when there's no prostate infection. For a lot of men, the real driver is a tight, overactive pelvic floor. Common clues: constipation and pain with sitting.
Urinary Urgency, Frequency, and Leaking
Running to the bathroom more than you should need to. Feeling like you can't fully empty. Dribbling after you think you're done. Leaking when you cough, sneeze, or exercise. Worth knowing: leaking with a cough or sneeze usually gets labeled as weakness, but it's often a tight pelvic floor that can't coordinate a quick contraction. Different problem, different fix.
Erectile Dysfunction
When pelvic floor muscles aren't functioning well, it can contribute to erectile dysfunction through the muscular and circulatory mechanisms involved. Pelvic floor therapy addresses those mechanisms directly through targeted exercises, manual therapy, and coordination work.
Post-Prostatectomy and Post-HoLEP Recovery
After prostate surgery, including laser prostatectomy (HoLEP), the pelvic floor muscles need retraining. Leaking, urgency, and bladder control difficulty are common after these procedures, and pelvic floor therapy is a key part of recovery.
Bowel and Constipation Issues
Straining, incomplete emptying, or pain with bowel movements. The pelvic floor controls the opening and closing of the bowel. When those muscles are too tight or uncoordinated, it affects everything downstream.
Tailbone Pain (Coccydynia)
Pain at the tailbone, especially when sitting or standing up from a chair. The pelvic floor attaches to the tailbone. Tension in those muscles pulls on it.
Post-Surgical Pelvic Pain
Pain that lingers after hernia surgery, prostate surgery, or abdominal surgery. Scar tissue and muscle guarding stick around long after the incision heals.
Back, Hip, and Pelvic Girdle Pain
Sometimes "back pain" or "hip pain" is actually referring from the pelvic floor. If you've been treated elsewhere and it hasn't resolved, this is worth checking.
Pain with Sitting or Cycling
Cyclists and desk workers both. Chronic sitting and saddle pressure can trigger pelvic floor tension that doesn't resolve with rest.
Assessment, In Order
I don't skip to the pelvic floor. I get there when the rest of the system has been ruled out. The sequence matters.
Posture and Breathing
I start here, every time. How you carry yourself and how you breathe tell me a lot about what your pelvic floor is doing before I touch anything.
Clear the Back and Hips
Range of motion testing, past injury intake, and special manual tests to see whether movement provokes your symptoms. If the back or hip is the source, we treat it as that. If they're clear, we move on.
Internal Exam, as Needed
If the assessment points to pelvic floor involvement, an internal rectal exam is the most direct way to assess the muscles. What that looks like: one finger rectal insertion, to your tolerance level. It should not be painful. I'm checking for muscle tension, tender points, and weakness. Whether we do an internal exam depends on what you're dealing with and what you're comfortable with. Every patient is different.
Manual Therapy
Hands-on work to release tight pelvic floor muscles, treat trigger points, mobilize scar tissue, and calm an overactive nervous system. For many men with pelvic pain, the muscles are too tight, not too weak. Releasing tension comes first.
Coordination and Breath Training
Pelvic floor muscles can be weak and tight at the same time. When that's the case, the real issue is coordination. The muscles aren't working with the breath. That's what I teach you how to correct, because it's what kegels alone will never fix.
Home Program
Every session you leave with specific things to work on. Stretches, breathing exercises, self-release techniques, or movement changes. Simple, specific, and actually useful between visits.
Return to What You Love
Running, cycling, lifting, sitting through a workday without pain. The goal is getting you back to your life, not just managing a symptom.
Why My Approach Is Different
Minute Sessions
Pelvic floor conditions take time to unpack. You get my full attention, no rotating between patients.
Assessment in Order
Posture, breathing, back, hips, pelvic floor. I don't skip to the pelvic floor. I get there when the rest of the system has been ruled out.
Coordination, Not Just Strength
Kegels don't fix coordination problems. If the muscles are tight, more squeezing makes it worse. I assess first, then decide.
You Don't Have to Live with It
Men's pelvic floor conditions are often dismissed, misdiagnosed, or treated with antibiotics for infections that aren't there. A lot of men go years without a real answer.
The pelvic floor is a group of muscles. Like any other muscle group, it can get tight, weak, uncoordinated, or painful. It responds to assessment and targeted treatment. Pelvic floor therapy looks at what imaging and blood work can't see: how your muscles are actually functioning, where the tension is, and what's driving the pain or dysfunction. For a lot of men, this is the missing piece.
Transparent Pricing
In-Clinic
Rancho Bernardo, Wed and Fri
Initial Evaluation
90 minutes
$150
Follow-Up Session
60 minutes
$125
Men's pelvic floor therapy sessions are in-clinic at my Rancho Bernardo location. No immediate referral needed to get started. Superbills provided for PPO insurance reimbursement.
Men's Pelvic Floor Therapy FAQ
Yes. My practice isn't limited to women. The pelvic floor is a muscle group, and it responds to assessment and treatment regardless of anatomy.
The muscles and the mechanics are the same. Your pelvic floor connects your pubic bone to your tailbone and forms a sling that supports your bladder, bowel, and core. The conditions look a little different in men and the assessment is tailored to your anatomy, but the framework is the same: check posture and breathing, clear the back and hips, then assess the pelvic floor directly if needed.
No, you do not need an immediate referral in California. You can start with me without going through another doctor first. If you'd like me to coordinate with your urologist, GP, or specialist, I can do that too.
One finger rectal insertion, to your tolerance level. It should not be painful. I'm checking for muscle tension, tender points, and weakness. Whether we do one depends on what you're dealing with. Some clients don't need it. Some do.
90 minutes, one-on-one. We go through your full history. I evaluate your posture and breathing first, then clear the back and hips, then assess the pelvic floor if the rest of the system points there. You leave with a clear picture of what's going on and specific things to start working on.
Ready to Get Answers?
If you've been dealing with pelvic pain, leaking, or anything else that no one has been able to explain, start with a free 15-minute phone call. Tell me what's going on, and I'll tell you if pelvic floor therapy can help. No pressure, no commitment.