PF dysfunction and Chronic Pelvic Pain Syndrome, Mental or Physical?

[Big Al AdministratorPEGym EditorMale Enhancement Coach Rep.PEGym Hero Find all posts View Profile Close Big Al]

It’s been a while, but what I’m getting is that you need to address the mental aspect enough (hard to tell when it’s enough) AND address the physical aspect enough.
Basically, once you have a certain amount of range of motion and strength in the glutes then the only thing left to fix would be mental I imagine?

Am I getting this right?

Is there a certain amount of hamstring flexibility for example, that you’d need to know that you’d good enough there?
Or maybe once you have a balanced pelvis, you know the rest is mental.

Addressing both aspects is important. The difficulty with dealing with the mental aspect is in learning objectivity. This is often easier said than done- and may require time as well as practice.

It's also easy to overthink the physical aspect. Instead of thinking that many different aspects need to be "just so", look at it from the perspective of a blank slate- where as long as there's no negative issues you should be at a functional level.

[Xams2387 Senior Member Find all posts View Profile Close Xams2387]

Addressing both aspects is important. The difficulty with dealing with the mental aspect is in learning objectivity. This is often easier said than done- and may require time as well as practice.

It's also easy to overthink the physical aspect. Instead of thinking that many different aspects need to be "just so", look at it from the perspective of a blank slate- where as long as there's no negative issues you should be at a functional level.

What would count as a negative issue though?

I’d think a tucked pelvis would.

Anything that’s causing someone to use the wrong muscles because of tightness or weakness seems to be a real issue here.

[Big Al AdministratorPEGym EditorMale Enhancement Coach Rep.PEGym Hero Find all posts View Profile Close Big Al]

What would count as a negative issue though?

I’d think a tucked pelvis would.

Anything that’s causing someone to use the wrong muscles because of tightness or weakness seems to be a real issue here.

A negative issue could be a legitimate physical injury. The common problem is in discerning what's a real injury or not. A palpable sensation of pain or strain would qualify.

[Xams2387 Senior Member Find all posts View Profile Close Xams2387]

A negative issue could be a legitimate physical injury. The common problem is in discerning what's a real injury or not. A palpable sensation of pain or strain would qualify.

I’d say a tilted pelvis is an issue. It causes you to use the wrong muscles. Including the pelvic floor taking a heavier brunt of the workforce. That would certainly cause cramping.

[Pegasus AdministratorPE Gym EditorPEGym Hero ☺ Admin of the Month Mar 2015 Find all posts View Profile Close Pegasus]

I’d say a tilted pelvis is an issue. It causes you to use the wrong muscles. Including the pelvic floor taking a heavier brunt of the workforce. That would certainly cause cramping.

The point is not everyone with pre e or hf or ed has any discernible physical issue . This is especially the case with hf and in fact some guys have cured it by geting over the anxiety . Others need a combined physical and mental approach looking at underlying cause including physical cause .
Even in the case of physical cause it is not always postural , overdoing kegel with no rk or stretch is a common cause of physical problems or a sudden esculation of edging or sex going from none to hours overnight or drug use etc.

[Xams2387 Senior Member Find all posts View Profile Close Xams2387]

The point is not everyone with pre e or hf or ed has any discernible physical issue . This is especially the case with hf and in fact some guys have cured it by geting over the anxiety . Others need a combined physical and mental approach looking at underlying cause including physical cause .
Even in the case of physical cause it is not always postural , overdoing kegel with no rk or stretch is a common cause of physical problems or a sudden esculation of edging or sex going from none to hours overnight or drug use etc.

Right. Anxiety needs to be addressed. And obviously so does relaxing the pelvic floor.

I’m not saying everyone with HF has a postural issue or tight muscles, I’m just saying that can be enough to cause and keep HF.

Obviously being wound up and kegeling can cause and keep it as well.

And then of course having both will cause and keep it too.

Basically if you have the physical tightness and/or posture issues and HF, you need to address it. I find it hard to believe just addressing the mental side of things when you have observable physical issues will fix HF.

It may be a little different with PreE and those other issues excluding HF. I’m not familiar with having those without having HF/Pelvic Tension so if that’s what you were saying postural changes wouldn’t help, then you’re possibly right, I wouldn’t know.

[Pegasus AdministratorPE Gym EditorPEGym Hero ☺ Admin of the Month Mar 2015 Find all posts View Profile Close Pegasus]

Hang on firstly I believe in combining mental and physical training even though I usually only help with the physical .

I do believe posture and muscle imbalance issues are common just not that they are always the underlying cause ,

If there are underlying issues they should be addressed however with hf particularly often the main issue is mental

[Xams2387 Senior Member Find all posts View Profile Close Xams2387]

Hang on firstly I believe in combining mental and physical training even though I usually only help with the physical .

I do believe posture and muscle imbalance issues are common just not that they are always the underlying cause ,

If there are underlying issues they should be addressed however with hf particularly often the main issue is mental

How do we know that though?
It seems about half the people who get better attribute it to mental causes and the other half attribute it to the physical causes.

Basically I think if you have physical issues you need to fix them while also fixing mental stress or maintaining your relaxed personality (preventing anxiety).

If you don’t have physical issues then it’ll just be the anxiety/mental stuff.

I’m pretty sure we’re on the same page.

It can only help to address both

[Pegasus AdministratorPE Gym EditorPEGym Hero ☺ Admin of the Month Mar 2015 Find all posts View Profile Close Pegasus]

Having hf without anxiety is rare so if you have hf it behoves you to look at anxiety .

In regard to pelvic floor in general there is a thread on working out the causes .

In the past if the member did not mention an underlying cause then the first line was pf balance ,only if that was hard to maintain did I actively look at underlying cause .

More recently I have been putting it out there that underlying causes are common so anxiety, postural issues , muscle imbalance eg weak posterior chain , apt ,ppt etc. A lot of the time my recommendation has been to see a physio . A physio is supposed to be able to diagnose postural and muscle issues and treat them . Over the net how am I to see and test for these issues and that is before I start talking quals. Remember recovery may not just be a matter of stretches it may involve a range of modalities including strengthening the posterior chain . The wrong training may not just be unproductive but counterproductive.

[Zeroo Junior Member Find all posts View Profile Close Zeroo]

My hard flaccid was induced 5 years ago by what I think was severe anxiety and excessive erections. Since getting hard flaccid, I have continued going to the gym regularly. I have stopped training legs and abs because I read on these forums that this will make symptoms worse. For the last few years I have trained chest, back, arms, shoulders but neglected abs and legs. I don't have severe anxiety or excessive erections anymore (it was just a one month episode) but I do think I have some type of chronic anxiety that I need to deal with. I am dealing with the anxiety part but I am unsure if I should start working my legs and abs in order to make up for some possible imbalances. Anyone have any advice? Thank you.

[HansTwilight Retired ModeratorPE Gym Editor Member of the Month Jan 2017PEGym Hero Find all posts View Profile Close HansTwilight]

My hard flaccid was induced 5 years ago by what I think was severe anxiety and excessive erections. Since getting hard flaccid, I have continued going to the gym regularly. I have stopped training legs and abs because I read on these forums that this will make symptoms worse. For the last few years I have trained chest, back, arms, shoulders but neglected abs and legs. I don't have severe anxiety or excessive erections anymore (it was just a one month episode) but I do think I have some type of chronic anxiety that I need to deal with. I am dealing with the anxiety part but I am unsure if I should start working my legs and abs in order to make up for some possible imbalances. Anyone have any advice? Thank you.

Do you suspect pelvic floor issues? I would not suggest neglecting legs day.

[Zeroo Junior Member Find all posts View Profile Close Zeroo]

Do you suspect pelvic floor issues? I would not suggest neglecting legs day.

Yes. I went to a pelvic floor physio and she told me I have tight pelvic floor muscles. I love training legs but was under the impression that it is a bad idea with this condition. I have been reading about hard flaccid on these forums and others for the past 4 years. As much information as I have read and benefitted from, I have also felt confused. I read that training the legs can aggravate the situation, much like training the abs and have consequently neglected these two muscle groups. I think that training my legs might help with muscle imbalances, if there are any (which I suspect there are).

[Xams2387 Senior Member Find all posts View Profile Close Xams2387]

Yes. I went to a pelvic floor physio and she told me I have tight pelvic floor muscles. I love training legs but was under the impression that it is a bad idea with this condition. I have been reading about hard flaccid on these forums and others for the past 4 years. As much information as I have read and benefitted from, I have also felt confused. I read that training the legs can aggravate the situation, much like training the abs and have consequently neglected these two muscle groups. I think that training my legs might help with muscle imbalances, if there are any (which I suspect there are).

I’d recommend seeing a physio who can help judge your posture and flexibility as well.

Then you can find out and atleast start working your legs in some way

[Xams2387 Senior Member Find all posts View Profile Close Xams2387]

My hard flaccid was induced 5 years ago by what I think was severe anxiety and excessive erections. Since getting hard flaccid, I have continued going to the gym regularly. I have stopped training legs and abs because I read on these forums that this will make symptoms worse. For the last few years I have trained chest, back, arms, shoulders but neglected abs and legs. I don't have severe anxiety or excessive erections anymore (it was just a one month episode) but I do think I have some type of chronic anxiety that I need to deal with. I am dealing with the anxiety part but I am unsure if I should start working my legs and abs in order to make up for some possible imbalances. Anyone have any advice? Thank you.

So many people have crappy posture and don’t have this issue.

So many people have anxiety and don’t have this issue.

So many people lift heavy, do PE, ride bicycles a lot etc and don’t have this condition.


I think you need to have some kind of anxiety in your life along with the bad posture and while either working out or doing PE to get this.

I could be wrong but it seems these are the main factors.

It’s like a perfect storm.

To undo it I just don’t think you can go wrong addressing them all.

-If you do PE, stop until you’re cured.
-If you ride a bicycle you may need to stop because it’s so quad dominant and you are forced to hunch over in a bad posture while doing it, thus reinforcing that bad posture and strengthening it.
-If you train legs/core you may need to work on your flexibility first or do lighter weights that use your full range of motion (while trying to improve upon it) in order to open things up and fix your pelvic tilt, whether it be an anterior or posterior tilt. You may need to strengthen your glutes and hamstrings. (A physio will help here).

[Bam23 Senior Member Find all posts View Profile Close Bam23]

Many people have it because they clench their pelvic muscles when they are stressed/anxious plus the clenching while sex/masturbation. It is an unnormal and unhealthy clenching.

Add the bad posture and voila. You have hard flaccid.