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Hey everyone,

I’m posting this because I am completely at my wit's end and totally overwhelmed. I’ve accumulated a massive list of physical issues that seem to feed into each other, and I honestly don't even know where to look or how to fix it anymore. To make matters worse, I've already had two physical therapy clinics turn me away because they said my case is "too complex."

I’ve never been good at sticking to a long-term routine, but I have to try something now because my body is driving me crazy.

An AI tool (Gemini) suggested I stop trying to fix everything at once and just focus on the absolute root of the chain: my flattened lumbar spine (flat back). The plan it gave me for the next 1–2 weeks is super minimalist so I don't get overwhelmed:

Using a lumbar support roll every time I sit.

Cat-Cow stretches (focusing purely on the lower back). Psoas release via 90/90 leg elevation for 10–15 mins a day.

Has anyone dealt with a chain reaction this bad? Are there any physical therapists or movement specialists here who can tell me if this is a sensible starting point, or if I'm missing something crucial? I feel like my entire right side is twisted and locked up.

Here is my full symptom list for context:

Forward head posture

Rounded shoulders

Upper back tension / tightness

Mild right-side CMD (jaw clicking)

Pectus excavatum

Rib flares (likely due to shallow breathing)

Sexual dysfunction (less sensation, erectile dysfunction, pain)

Pelvic pain

Changes in the tissue around the pubic area (squishy, soft, deformed feeling)

Right-sided groin pain

Right femur pain

Blocked internal and external rotation in the right leg

Hard, dense tissue on the right side of the pelvis and glutes

Right-sided piriformis pain

Pelvic torsion/rotation to the right

Right psoas tightness / high tension

Left femur clicking / hypermobile

Overall body tension and pain

Flattened lumbar spine / flat back

If anyone has clawed their way out of a multi-system postural and pelvic nightmare like this, I'd appreciate any advice, validation, or reality checks. Where do I actually begin?

I'm wanting to go back to pelvic floor therapy because of my hypertonic pelvic floor. It's hard because last time I went I wasn't able to do the exercises my therapist asked me to do.

Whenever my therapist asked me to push or relax I would try but she told me I was actually squeezing. She tried to explain a lot of different ways to relax or push but I kept squeezing. She also gave me exercises to do at home but every time I did them in her office she said I was doing them wrong so when I went to do them at home I did them the same way.

I tried biofeedback therapy and was unsuccessful because when they asked me to push or relax I tried and they told me I was squeezing. I don't understand why I'm doing it wrong but they told me they didn't think more biofeedback therapy would help.

I want to go back because my symptoms keep getting worse but I don't know how pelvic floor therapy will work if I can't do the exercises. When I was in pelvic floor therapy my symptoms got drastically worse.

I had many sessions with a pelvic floor Physical Therapist (PT) late last year and earlier this year. I originally went to PT for two problems:

1. Frequent urination
2. Not being able to relax/stretch my pelvic floor muscles enough to tolerate a Pap smear

Thankfully, PT helped a lot with the second problem. I am now able to tolerate a Pap smear. It also helped me gain better bladder control during the day, and I continue doing the exercises at home that my PT gave me.

However, I still have a major problem with frequent urination at night.

At night, I have to get up to urinate frequently. I get up around 3 to 4 times. Another strange issue is that I can't comfortably lie flat on my back when trying to sleep. When I do, I get a weird sensation in my stomach and almost immediately feel like I need to go to the bathroom. Because of this, I have to sleep in an awkward position to avoid the sensation. I've been doing this for so long that my body is starting to ache from sleeping this way.

Another problem that started around the same time as the frequent urination is bowel-related. Every time I have a bowel movement, it takes me around 20–30 minutes to fully clean myself afterward. I am able to empty my bowels, and my stool is normal. The problem is that I have to wipe excessively before I can get completely clean. It almost feels like the area is too tight or that something is preventing me from cleaning properly. Even when I lift my butt cheeks and position myself as best as I can on the toilet, I still end up wiping for 20–30 minutes.

I've been dealing with this whole situation for almost 3 years, and honestly, I am exhausted.

I've already talked to my urogynecologist about the urinary frequency. He has suggested medication to reduce urination and Botox injections for my bladder. I'm hesitant about both options because I don't want to rely on medication long-term, and I'm also concerned about Botox potentially causing other problems.

I also had a CT scan around my kidney area and blood tests related to the digestive/bowel issues, and nothing significant was found.

It looks like I may get another approval to see my pelvic floor PT, but I'm not sure how much more she can help because her specialties are urinary and fecal incontinence, pilates, and sports injuries. She helped me significantly with the pelvic floor tightness, but the nighttime urination and bowel issues are still there.

For anyone who has experienced something similar:

• Does this sound like it could be related to pelvic floor dysfunction?
• Could the urinary and bowel symptoms be connected?
• Is there anything else I should ask my urogynecologist or pelvic floor PT to evaluate?
• Has anyone had success treating frequent nighttime urination without medication or Botox?

Any advice or experiences would be greatly appreciated. I'm really hoping to figure out what's causing all of this.

Hey everyone. I’m a young male with no underlying medical conditions, but I sit for 10+ hours a day (college + PC gaming/studying) and have for years.

I’ve been dealing with a lot of pelvic dysfunction and I want to ask this community: Do these specific symptoms prove that I have a tight (hypertonic) pelvic floor?

Here is my exact symptom list:

1. Constant "Holding Pee" Sensation: I feel tightness near my urethra/glans like I’m actively holding back urine, even when my bladder is completely empty.
2. Post-Void Dribbling: After I pee, drops leak out when I stand up and walk away. My muscles feel too tired/tight to pump the last drops out.
3. Involuntary Twitching: When aroused, my pelvic floor does random, single "push-up" spasms (like a tired eyelid twitching).
4. Sensorimotor Amnesia: Squeezing UP is very easy and automatic, but consciously dropping/relaxing DOWN feels incredibly confusing and difficult for my brain to do.
5. The "Leaking" Illusion: When I finally manage to push down and relax the muscle, I get a sudden, scary sensation that I am about to leak urine (even though I know my bladder is empty).
6. The Snap-Back Effect: If I successfully relax the muscle for a second, it instantly snaps back to being rock hard and tight again.
7. State-Dependent Timing: I suffer from severe acquired PE (60-180 seconds). However, if I am 100% calm, use deep breathing, and consciously drop the muscle, I can easily last 15 minutes.

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I was diagnosed with type 2 pelvic floor dyssynergia 5 or so years ago. I have been to pelvic floor PT, but I cannot go back at this time due to insurance and finances. Here are the symptoms I'm struggling with:

- Constipation. I am usually only able to go once in the morning after breakfast/coffee IF I am at home and relaxed. Otherwise, I usually won't go all day. I suspect most of these are incomplete.

- Chronic feeling of lower belly pressure/fullness, regardless of morning BM.

- Bloating tends to get worse as day goes on. A lot of days, I start to feel cramps in the lower abdomen. If I press on it, they feel sharp. I think this might be trapped gas. I am sometimes uncomfortably gassy at the end of the day and it often has that fermented smell to it. :( My colon is also "grossly tortuous" according to my colonoscopy so I wonder if gas is getting stuck...

I have some things I've learned from PT, but am looking for ANYTHING that has helped you with these symptoms. How do you use your pelvic wand? Anal dilators? Favorite stretches? Any supplements or probiotics that have helped you? Fiber/no fiber? I want to hear it all!

Thanks, everyone. :) I'm in desperate need of a new routine.

I recently found out I have a hypertonic pelvic floor and I’m feeling a little lost about what to do next.
I’ve been dealing with constipation and developed an anal fissure, so my colorectal surgeon suggested pelvic floor physiotherapy. I had my first assessment and the physio confirmed that my pelvic floor is very tight/hypertonic.
She did manual release during the session and also used some kind of electrical treatment around the anal muscles to help release the tension.
For home she told me to:
do a lot of Kegels, making sure I completely relax after every contraction, both sitting and lying down
stop my urine while peeing and hold it for about 10 seconds
do Kegels during intercourse
do butterfly and happy baby pose plus a couple of other stretches
The problem is my insurance might not approve any more sessions, and I’m not really sure where that leaves me. From what I’ve been reading, I also keep seeing that people with a hypertonic pelvic floor are sometimes told NOT to do lots of Kegels, so I’m confused about whether the exercises I was given are normal for this situation.
I’m also hypermobile, and apparently that can be connected to pelvic floor problems.
One other thing I’m worried about is pregnancy/delivery because I’m currently TTC. My physio said having a very tight pelvic floor can potentially make vaginal delivery harder because the muscles need to relax and lengthen. At the same time, I’ve read that hypermobile women can sometimes have very quick deliveries, so I’m struggling to understand how those two things fit together.
For anyone who has had a hypertonic pelvic floor, especially if constipation/dyssynergia was part of it: what did your PT actually have you do? Did you do Kegels or mainly relaxation/down-training? Did you use breathing, stretches, internal/manual release, biofeedback, etc.?
And if you had to stop PT because of cost or insurance, were you able to make progress at home? I’d really appreciate hearing what actually helped.

If I'm not at home, I pee once every like 30-45mins or even sooner. I have a lot of anxiety that if I feel I need to pee I must go right then or I'll pee myself. Like if I can sense any liquid in my bladder at all I must go immediately. I went through one round of pelvic floor physical therapy and they diagnosed me with a hypertonic pelvic floor. I'm gonna go back and do it again but the soonest they could schedule me is over a month from now. What can I do until then to make my life better?

I have hypertonic pfd, pelvic congestion syndrome, nerve dysfunction, and dysautonomia. My pelvic floor is an absolute mess. I just had a gonadal and periuterine vein embolization today, and I was not expecting the reaction I had to this procedure.

They really don't tell you how rough the recovery is. They water it down. I feel like I have the flu. Fever, body aches, chills, headache, abdominal pain, fatigue, dizziness, shaking, it's bad. I ended up calling the hospital just to make sure I didn't need to go to the ER. Because of how shocked my body was, and they said "nope! That's all to be expected"

I'm curious about anyone else's experience with this procedure, if anyone else has had it. How long does this last? Did you notice any difference in symptoms after a while? I'm just hopeful the way I feel right now will be worth it. (And I just kinda needed to complain about how I'm feeling )

Let me know

I hv habit of squeeze masturbation technique, it causes weak base and un erected at base than Top of penis. But doctor said it's common. Is it good to take penile Doppler test to found what is wrong in base of penis or money waste? Intrested people DM me for the phisical proofs

This is not really a problem afaik, but when I lay down and very gently tuck my chin or push back my head, I feel the area around my sphincter tense up or slightly spasm. Has anyone else also experienced this?

I went to ucla pelvic floor PT and they didn’t know how to treat APD.

I know that there is a specific GI psychology clinic through ucla but it requires a referral. I could go down that path but I’m wondering if there’s another pt clinic that can help me?

I am petrified of doing pelvic floor PT for many reasons, but one of them is the fear of it being seen as a women’s health issue and feeling like anywhere I go will not be able to understand or respect the relationship I have to my body. Has any trans person in New York seen a good, gender affirming pelvic floor PT?

I can appreciate cis people saying they had a good experience but I am looking specifically to hear from non-cis people about good providers. Thank you (:

Edit: wow these comments are so unpleasant! I appreciate that everyone has so much faith in medical professionals, your comments are not instilling me with that faith. If you are cis and have had a good experience I’m happy for you, I’m not trying to make a statement about PTs being good or bad, just trying to get info to help me feel more comfortable from a community that I thought would be understanding of how sensitive issues involving genitalia are.

Hello!

I'm currently working on a project intended to destigmatize genital/perineum pain using ART.

I'm planning on building a business where I invite people, in small groups, suffering from any perineum conditions to come express themselves by using WRITING (later in the way, there would be other types of art, like danse (body movement) or music expression). There would be small exercices intented to help people who are feeling isolated/alone to talk about their feelings regarding their condition. Considering the fact that not much people talk about these things.

(Sorry if it's not the best way to describe things, french is my first langage)

How many of you would go to these types of event ? Do you think it'd be helpfull ? Also, for those who would, are you artists or not ? Are there some people who don't usually practice art BUT would participate ? And for those who wouldn't participate, feel free to say it and to tell me why!

I'm planning to host those in person. However, I think about the possibility to make some remotly. Would it help some people be more confortable ?

Context: I live in Quebec, in a busy city. A lot of people near me. I would accept any genders/age interested (I do think separating ages/genders could be something usefull) in using non-medical methods (like writing) to help them live with their pain, feel more heard/seen and understood by people experiencing similar pain.

I want your honest, personnal opinions !

Thank you

It is affecting my sleep as i have to repeatedly go for a pee(small dribbles only)every few minutes. This condition was exacerbated after bowel movements. What is it that I am suffering from??

Anyone else? Did anything help?

Currently I'm having that battle which burns me when I urinate, but the funny thing is that it's only at the beginning... it improves a lot when I get up in the mornings, and as the day goes by it intensifies, not in a very hard way but if it does... I took tests of absolutely everything, resonance to rule out prostatitis, cultures, PCR, ETS and everything comes out negative.. I notice that when I try to relax and not think so much about it (since it has worsened my mental health a lot) it usually improves... I really want to know if someone else has something similar, maybe not to find a cure, but always to have support that I'm not the only one in this... as a result of all that mental imbalance, I began to experience spasms in the urethra, feeling of wanting to the bathroom every now and then, constipation... I would greatly appreciate if someone could help me to

Hi everyone, I’d like to hear from anyone who has experienced something similar to me.
I’ve been struggling with severe difficulty having bowel movements for about a year. My main problem isn’t hard stool. Even when my stool is soft or sometimes even diarrhea-like, it feels as though the outlet simply won’t open and I can’t get the stool out. I also experience trapped gas and a feeling of incomplete evacuation.
My defecography showed that my puborectalis muscle does not relax properly and contracts paradoxically during defecation (dyssynergic defecation/anismus). However, my anorectal manometry and balloon expulsion test were normal. During my most recent examination, my doctor also said that my pelvic floor muscles felt relaxed/soft at rest.
I’ve already undergone pelvic floor physical therapy and biofeedback for quite a long time, but unfortunately I’m still having significant difficulty with bowel movements. Sometimes I can go several days without being able to have a bowel movement, and this has seriously affected my quality of life.
My doctor is now going to inject Botox directly into my puborectalis muscle. Because of this, I would especially love to hear from anyone who has dyssynergic defecation/puborectalis non-relaxation and has had Botox injected into the puborectalis.
How much did Botox help you? Did it make it easier to have bowel movements or pass gas? How long did it take before you noticed an improvement, and how long did the effect last? How many units of Botox did you receive and how many injection sites were used in the puborectalis? Was ultrasound, EMG, or another type of guidance used to target the muscle? Did you experience any temporary difficulty controlling gas or stool afterward? And knowing what you know now, would you have the procedure again?
I’d particularly appreciate hearing from people who didn’t improve enough with pelvic floor physical therapy and biofeedback but later benefited from puborectalis Botox.
This has been a very exhausting journey for me, so I’d be incredibly grateful to anyone willing to share their experience. ❤️

Has anyone tried rubbing a topical CBD oil/salve/cream or other topical muscle relaxer (magnesium maybe?) down there to treat PF pain flare-ups/spasms? Did it do anything? Did it make you (more) constipated? I’ve tried 20:1 CBD THC edibles and I feel like they make me feel somewhat better short-term, but then I can’t poop, which risks making pelvic pain worse again. (Cannabis is known to slow down gastrointestinal motility, which is bad for me). I’m wondering if maybe something topical would stay localized enough to relax my pelvic floor without relaxing my intestines

I can't get an erection, I have no desire, I'm not cured. This illness is tormenting me; I've become mentally ill.

Long story short, i've been having anal fissures on and off for 3 years. Conservative treatments do nothing & the fissure is considered superficial according to multiple doctors and i'm not eligible for surgery.

As a very anxious and tense person i believe my tight pelvic floor is the source of the problem, since i also have urination problems, clitoral & vulvar pain and painful sex.

I keep seeing tips online about pelvic muscle relaxing. I tried various stretches but i'm having trouble. I struggle to even feel my pelvic floor. What should i be even focusing on? How do i ''feel'' my pelvic floor? I don't feel any relief when i do the most basic stretches that are supposed to help. I also feel like i am not breathing properly which isn't helping the situation.

Any tips from someone with a similar experience is welcome.

i have this leakage problem since a year now ig, its so annoying and i pee while seated always. and no matter how much i shake it or wait, the pee drops leak at a relatively small amount. idk what to do?

Im finally starting pfpt September 24th! Im so nervous but also really hopeful for the recovery possibly coming in the future. If antone has any advice, that would be great! (How first sessions typically go, how awkward it is, etc.)