Specialized Male Pelvic Floor Evaluation for Pelvic Floor Conditions

At Schafer Physical Therapy, your care begins with a comprehensive, one on one evaluation performed by a board certified Doctor of Physical Therapy (DPT) with advanced training in male pelvic health. Our goal is to identify why your symptoms are happening, not just where the symptoms occur. Below is what you can expect during your first visit:

1. Detailed Medical History

Your evaluation starts with a thorough conversation. This information is critical as many pelvic floor conditions are influenced by factors beyond the pelvis alone. We discuss:

• Your symptoms and when they began
• What worsens or relieves them
• How symptoms affect daily life, exercise, bowel and bladder function, and sexual health
• Past injuries, surgeries, medical conditions, and medications

2. Comprehensive Physical Examination (External)

Pelvic floor conditions are rarely isolated. We evaluate the entire system that influences pelvic floor function:

Spine, Breathing, and Core

Assessment may include:

• Neck and jaw (for complex or long standing cases)
• Thoracic spine and rib cage mobility
• Lumbar spine mobility and strength
• Breathing patterns (diaphragmatic vs. upper chest)
• Abdominal wall tension and control

Hips and Groin

The hips and pelvic floor are deeply connected. We evaluate tenderness, length, strength, and coordination, as these muscles frequently contribute to pelvic floor symptoms as well. We assess:

• Hip adductors (groin)
• Hip flexors
• Gluteals and deep hip rotators
• Hamstrings

External Perineal Assessment (With Consent)

This provides valuable information about muscle tone, tenderness, and symmetry prior to any internal examination. When appropriate, the clinician may assess:

• The perineum
• External pelvic floor muscles
• Penis and testicles

3. Neurological Examination

Pelvic floor conditions often involves the nervous system, not just muscles. This helps determine whether nerve sensitivity or irritation is contributing to your symptoms. We may assess:

• Sensation in the perineum, penis, scrotum, and inner thighs
• Sacral nerve reflexes (such as the anal wink, when indicated)
• Neural tension involving the sciatic and pelvic nerves
• Muscle strength patterns (myotomes)

4. Internal Rectal Examination (When Indicated)

An internal rectal exam is never automatic and is only performed with your full understanding and consent. When appropriate, it provides unmatched clinical information. The process is explained step by step, performed slowly and respectfully, and stopped immediately if you are uncomfortable. There are no surprises and no pressure. The exam allows assessment of:

• Pelvic floor muscle tone (overactive vs. underactive)
• Trigger points and muscle tenderness
• Coordination and timing
• Ability to relax and contract
• Endurance and symmetry

5. Movement and Functional Assessment

We evaluate how your pelvic floor behaves during real world tasks. Breath holding, compensations, and excessive tension often appear here and provide critical insight into why symptoms persist. We will look at movements like:

• Squatting
• Lunging
• Hip hinging
• Single-leg balance
• Carrying heavy objects

6. Treatment Planning: Manual Therapy, Exercise, and Education

Your evaluation flows directly into a clear treatment plan.

Manual Therapy

Manual therapy helps restore mobility to the joints, circulation, and help re-instate proper equilibrium to the nervous system. Depending on findings, treatment may include:

• External myofascial release (abdomen, hips, groin)
• Internal pelvic floor release (when appropriate)
• Spinal mobilization or manipulation techniques
• Neural mobilization techniques

Exercise Prescription

Exercises are selected carefully and progressed appropriately. These may include:

• Diaphragmatic breathing
• Pelvic floor relaxation strategies
• Hip and trunk mobility and strength exercises
• Strength training with compound movements (squats, lunges, hinges)
• Functional retraining for daily activities

Not every man needs Kegels. In fact, many men with pelvic floor issues need the opposite. All exercises for prescribed on a case by case basis and are individual to you.

Education

Education is a cornerstone of recovery. We focus on:

• Understanding pain mechanisms
• Reducing fear and uncertainty
• Normalizing symptoms
• Building confidence in movement and exercise

One on One Care, Every Visit

All sessions are private, one on one for a full hour. You receive undivided attention, individualized care, and a clear home program designed to help you maintain results long-term. We don’t just treat symptoms, we help you understand your body so you can stay better for many years to come.

Schedule Your Visit

Are you ready to fix your pelvic floor issues? Please call 240-626-6454 or email philippe@philippeschafer.com to schedule a free 15 minute consultation or a 60 minute comprehensive evaluation in the clinic.