Mojo and the Painful Pelvis

Let me tell you about my soccer-playin’ husband’s pelvic-health history.

Husband: “In high school I started getting deep hip and low back pain. I went to the doctor, who gave me an X-ray, which led him to conclude that there was a tendon rubbing across the bone of the pelvis. Looking back with what I know now, it was probably the psoas tendon. I kept playing by finding a new way to move. Then, when I was nineteen, what were the symptoms that made me go in? I felt like I needed to go poop all the time, though I didn’t need to poop. Just a real heavy pressure all the time. I felt it was anus related, or colon-related, I didn’t think it was the prostate.”

Katy: “Did you even know what a prostate was?”

Husband: “Nope. So I went to the doctor and he stuck his finger in my butt and said that I had a prostate infection. He gave me some medicine and it went away.

Katy: “Anything else in your prostate history?”

Husband: “When I was a pre-teen, I noticed that sometimes if I peed right after ejaculating it would burn severely. I learned how to tense certain muscles to decrease the pain. I guess I just learned to tense those muscles all the time. Are you going to write that?”

Katy: “Of course I’m going to write that. Does it suck being married to me? With respect to the blog, I mean?”

Husband: “Yes. Actually now that I think of it, I also had persistent lower back pain and pelvic pain I chalked up to years of competitive soccer. I never used any other muscle in my pelvic area except my psoas. Until I met you.”

Katy: “That sounds suggestive.”

Husband: “I meant, until I met you and took your alignment course. It all made sense after that and my body didn’t hurt for the first time in decades.”

Here’s a letter from a different man in my in-box:

It came on when I was 21 out of no where. I’m 28 now.  I went through all the motions, all the docs seem to follow the same order. First it was the anti’s, Doxi, Cipro etc. Even stayed on Cipro for months. They tried bladder muscle relaxers.

Then all the tests, Pelvic MRI, Bladder CAT scan, Camera up the Urethra, Rectal Prostate Ultrasound. Blood/urine test, urine flow tests. I probably have been to 9 different urologists, a disease infectious doc, and a holistic center in NYC.

It all started in my senior year at college, I had unprotected sex and really two weeks after I felt a pain at the tip and then the bladder issues started and went on from there. Although I told every doctor this they could not connect the two and kept saying it was prostate inflammation or prostatitis.

I really have two issues and the first is hit or miss after ejaculating (not during). The pain can be burning, and I really have to wait at least 30min before urinating or it could result in the worst burning ever. It feels like I am peeing barbed-wire out. Things that seem to help during an attack is jumping in a hot shower and slowly working the urine out.

The 2nd is  every day I feel a slight burning in the bladder and the urethra is always tender. Additionally the bladder wont empty completely either. I have noticed a spasm in the anus area as well. I noticed too if I strain to go to the bathroom it can effect everything. One thing is that its been 7 years and they are not as severe as they use to be.

Meds tried:

  • Antibiotic specifically Cipro for 6 months. It did nothing.
  • Flomax. Did not help.
  • Flagry. It’s another anti. Did not work.
  • Shower after. Feels better but it does not solve the problem.

Tests I had:

  • Trans-rectal ultra sound of prostate before and after ejaculation. They did not find anything unusual.
  • Various urine flow tests. Nothing really there either.
  • CT scan of bladder.  Nothing found.
  • MRI of pelvis.  Nothing found.
  • MRI of lower back.  I do have a bulge in a disc but still going that route to see if that’s something.
  • Scope the inside of penis.  Didn’t find any stones or blockage.
  • Various does of Advil.  Nothing to note.
  • Ph of the stomach by swallowing a pill that measures how fast I digested.
  • Colonoscopy. Needed this for another reason but they didn’t see anything related to this problem.

Most recently I visited a different urologist where he did another scope and nothing was found (7 years later). He suggest Tranxane (anxiety med) for 6 weeks to relax the area. I’m not crazy about that.

***end letter

I get about 20 letters like this a month, all of them from men under the age of 35.

It doesn’t take a super-large literature review to find that the problem of young men and chronic pelvic pain/pain with ejaculation/pain with intercourse/erectile dysfunction — not associated with bacteria — is becoming more widespread. Research points repeatedly to pelvic floor hypertonicity (tension in the t’aint) and to chronic stress and/or anxiety. Of course, which came (HAHAHA) first, the anxiety or the burning pee? Who knows. This hypertonicity is why an anxiety medication is commonly prescribed for both men and women with pelvic floor issues.

What is also apparent is, pelvic floor issues don’t come on suddenly. Rather there are tiny things that seem unrelated, over time, that are all variables in the process of creating the perfect storm of a prostate issue. There are hypertonic muscles that develop in response to emotional stress and then there are hypertonic muscles that develop in response to movement patters — like a lifetime of soccer or cycling, for example.

Do you have a tendency for hypertonic muscles? Use this video to check your ability to relax the fronts of your thighs.

If your knee caps don’t move, then they’re locked in the “Up” position. What’s locking them “Up?” You are. I don’t know why you’re doing this. It could be from years of standing a certain way. It could be a reflexive action, due to the constant bombardment of stress. It could be motor-programs established for sports. Knowing why you’re tensing isn’t as important as knowing that your’re tensing. Once you’re aware of the tension you can learn to shut tension off, mindfully. Practice until relaxation comes naturally.

Turning off hypertonic on the fronts of your legs is easier than turning off your pelvic floor because you can see your quads. You can only see your pelvic floor “in your mind”.  Try applying the same “quad release” to the area between your penis and tail bone. The medical community calls this area the perineum, but I (and other classy people) call it the t’aint. Cuz it t’aint your penis and it t’aint your anus.

“You’re a debutante, Katy,” said nobody, ever.

Here are some articles that I’ve written on a hypertonic pelvic floor as well as Men’s health in general. I hope you find them them helpful.

A Too Tight Pelvic Floor   <—- This explains more about the mechanism of hypertonicity.

A Too Tight Pelvic Floor 2  <—- Here’s a list of risk factors, plus a note from my dad.

Low Hanging Fruit <—— Is your cremaster muscle working overtime to hike up the boys?

Eyes (and Meatus) Open <—- How is your orifice geometry? Check out your pee stream for prostate insight.

Men Have Pelves Too <—– It’s true!

I typically write for women because I am a woman. And it’s hard (HAHAHA) to write about penises when you don’t have one. Or rather, I believe a man would like to hear information about his penis from a man. But, I feel compelled to write this because it appears that there aren’t any men out there writing it down for you. Which isn’t really true. Read this to point to a couple resources written by men: for treatment (Dr. David Wise’s A Headache in the Pelvis) and to not feel like you’re going mad being referred from treatment to treatment (Teach Us to Sit Still by Tim Parks).

You can also read:

This blog post (click) written by one of our Whole Body students, detailing his experience with Male Pelvic Pain.

More on Dr. Wise’s point-of view on prostatitis here (click).

I’m presenting a (free!) online lecture on this topic called The Painful Pelvis, the Paleo Pelvis and Sex at Underground Wellness’ SexyBack Summit next week. I’ll be talking more about certain types of fitness-exercise (treadmill use, bicycles) and the pelvis, how to use your pee-stream (men) as a bio-indicator, and how to deal with pelvic pain in the bedroom. There are also a ton of other presentations on natural ways to get your mojo back. You can check out the line up and register by clicking (here).

CONTEST! Research shows that men don’t talk about PFD with others. To help spread the information, post this article saying something like “Don’t lose your Mojo to a Painful Pelvis!” to your Facebook or Twitter account tagging @AlignedandWell. Come back here to comment that you shared. I’ll draw a random number from the comments below Monday, May 20th. The winner will get a copy of my Below The Belt for Men DVD.

P.S. I just added a Men’s Health section and I’ll be adding writing more on this topic as well as others. Next up: HOW does chronic perineum tension irritate the prostate.

P.P.S. This post is dedicated to my husband who, never once was under the illusion he was marrying a debutante.

Are you still interested in learning more on this?

Are You Ready to Move?

Find products and instruction to get you started right now.

right pointing arrow visit the store left pointing arrow

25 thoughts on “Mojo and the Painful Pelvis

  1. I shared today! Actually, I share your blog posts quite frequently – usually by email. Today I shared on Facebook 🙂

  2. Katy, I have had PFD for about 5 years now due to hamstring and psoas issues. Stretching helps a lot to relieve pain. However, when I first had PFD symptoms, I got diagnosed with 9 UTIs in a year and half, all by a doctor who never bothered to culture my urine. Then I finally found a decent urologist who told me I had been misdiagnosed and a while after that I came across PFD.

    Anyway….as it turns out, now that I am getting my urine cultured, I am actually getting UTIs in addition to PFD. And, currently my doctor thinks I had a recurring one for 11 months that I didn’t know about during that time b/c I have pelvic pain frequently anyway. All that to say…is there some sort of biomechanist reason I am getting UTIs so frequently that my gynecologist or urologist wouldn’t consider?

    Also, while the stretching helps me manage the pain, I’m afraid due to stress (which I carry into my pelvic) and the way I stand (which is difficult to do in proper alignment since my muscles are still shortened), I’m still having issues. I really wish you were closer so I could figure out everything I’m doing wrong! I’m seriously considering flying out to you someday when I have the money. Anyway, thank you for all you do and for your response. You are amazing and always so helpful!

  3. Shared, shared and triple shared and emailed to all my Healthy Feet followers and every man I know and love and even a few I don’t love very much. Thanks for a great post! xx

  4. 🙂 :)….we’re smilin…and thanks for those other articles,esp.’low hanging fruit’….if you get insights to how we can talk to the cremasters to relax….that would be sweeet.

  5. Hi Katy,
    Shared twice.
    Thanks on behalf of the men who won’t talk. Perhaps they will read…
    (from a girl…)

  6. Hi Katy
    Thanks for writing this on men’s stuff. I guess you have a lot of male readers even tho it seems your comment posters are mostly women. I read all your posts but this post has made me comment this time. We’re out there… Maybe just a little shy! This post is important for us. Thanks for taking the time to write it.

    I read Tim Parks’ teach us to sit still” last year. Twice. What an amazing technique he has as a writer. He paints pictures with words; a true artist of language.

    Not just that, but he tells a true story that relates, it seems to me, to so many people and their ailments. I can’t count the number of people who said to me “but its about prostate problems”. Not true, its about chronic tension holding patterns, as you refer to in your post.


  7. It’s articles like this one that makes me want to start seeing men in my practice. Just doing the Self Care routine of the Maya abdominal Therapy ( would, at the least, take the place of the anxiety drugs for relaxing the pelvic floor. I HAVE had men in my workshops & they seem to get very fast relief from lack of circulation after just a few sessions of doing the Self care routine, and that is KEY in any healing process. Thank your hubby for us by being open to sharing 🙂

  8. I shared it on my FB and I share tons of your articles on the two blogs I edit (, Keep being awesome!

  9. My son has hypotonia. He’s 10 now for at least five years he’s had episodes where he screams at his penis because it hurts and he has to pee and can’t. Thank you Katy the docs have had no idea and mostly ignored it, except for a horrendously painful catherization under flouroscopy Now we have things we can teach him. FWIW he is an insane squatter. Despite being disposable diapered and late toilet trained he ALWAYS squats on the toilet to poop. I guess he figured out early some compensatory mechanisms.

  10. Have you heard about spontaneous ejaculation during exercise or anxiety/stress? Could that be due to tight psoas?

Comments are closed.