Hard Flacid treatment

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

Every authority on this mirrors the view put for some time in Pegym that HF has very strong head issue links . This is brought up repeatedly through this thread .

To some extent I agree with Traz that working on the physical side in isolation usually does not produce a long term cure . The physical side has to be paired with work on the mental side .

[Dangler Senior Administrator☼ Wizard ☼ White Tiger Award 2015 Find all posts View Profile Close Dangler]

here is a cleaned up version of Pegasus's post:

By Mudkip98
So I created this subreddit because there is very little information online about hard flaccid, and pretty much nowhere for sufferers to gather and receive support. If you've found yourself here, then I'm sorry to hear that. You're probably very terrified that you'll never get better. Thankfully, this isn't the case, hard flaccid is curable, and it is completely possible for you to lead a life without it, and become a healthier person as a result.

What is hard flaccid?
Common symptoms include:

• Penis is hard and contracted while flaccid, with a rubbery like sensation instead of the usual spongy
• Trouble maintaining erection
• Loss of morning erections
• Loss of sensitivity in penis
• Penis remaining in semi-erect state
• Changes to penis shape
• Penis head doesn't fill properly during an erection
• Pain during erection
• Premature ejaculation
• Dull ache in the perineum area
• Swelling in the perineum area, notably during erections
• Spasms in the perineum area/anus
• Trouble urinating, or frequent need to urinate
• Constipation, trouble during bowel movements
• Prominent veins in the penis that were not there before
• Coldness of the penis head and scrotum
• Shrivelled scrotum even in warm temperatures

What cause hard flaccid?
Unfortunately hard flaccid is a condition that is greatly under-researched. Therefore little is known about why the condition occurs. However, it almost certain that it is due to a dysfunctional pelvic floor. This means you can take a sigh of relief because there is actually nothing wrong with your penis. Dysfunction in the pelvic floor can result in the blood supply to the penis and scrotum being affected, and as a result blood does not enter/ exit the penis properly resulting in symptoms such as hardness, change of shape, and erectile dysfunction. The nerves in the penis and pelvic floor are irritated resulting in a changes to the penis tissue. The dysfunction in the pelvic floor is due to it not being able to relax properly, and is in a constant state of spasm which can lead to swelling and hardness of the perineum anal tissue.

Why is the pelvic floor dysfunctional?
The hard flaccid community has been divided into three primary known causes:

• Trauma to the penis and pelvic region from unhealthy masturbation/sexual habits

1.This is more common among younger sufferers. A common example is when individuals masturbate for long periods of time (edge) while contracting the pelvic floor muscles. This results in a build up of tension in the PF, and causes it to lose the ability to relax properly and enters a state of contraction/ spasm.

2. Build up of tension in muscles/ fascia throughout the body
This is more common in older men, and is often accompanied by pains elsewhere in the body e.g. back, legs, neck, chest and most notably chronic pelvic pains (CPP). It is effectively like any other muscle issue where there is an imbalance in the body's muscle/ fascia resulting in tightness and tension in the pelvic floor causing dysfunction. It can be caused by bad posture habits, injuries or general years of muscle tightness

3. Stress or anxiety
HF is often a cause of stress / anxiety due to tension build up in the pelvic floor. As people experience stress, tension occurs in muscles throughout the body including the pelvic floor. HF may flare up only during stressful periods and may disappear during easier times, but for many it can become a constant thing.


What can you do about it?
1. The first step is to get to understand why you have hard flaccid. Learn as much as you can about the condition. There is limited information available online, but below are some great recourses:
https://drsusieg.com/podcast/hard-flaccid (podcast featuring Gerard Greene- expert in HF and male pelvic floor)
https://www.urologynews.uk.com/featu...accid-syndrome
https://www.harbornephysio.co.uk/bir...=detail&bId=47
https://hardflaccid.co/pages/what-is-hardflaccid
https://medium.com/@anonymous2016/i-...me-da4502b3a77
Books:
'A headache in the pelvis' by David Wise and Rodney Anderson. (This book was a breakthrough in understanding male pelvic pain)


Once you feel you have a better understanding of the condition, and perhaps have an idea as to why you may be suffering these are some good next steps to take:

• Book an appointment with a physio or pelvic floor physio

-This will help identify any root causes that may be affecting the issue, and will help create a recovery program to fix these issues
- If you happen to be in the UK, Gerard Greene at Harborne physiotherapy clinic in Birmingham is probably a world expert in the subject, and is very experienced in the issue where as many physios most likely won't have encountered it before

2. Book a doctor's appointment
- Don't expect too much from a doctor, they most likely won't have encountered the issue and may think you are being a hypochondriac, but it is important to be examined to rule out any other possible issues
- Get a referral for an abdomen and penile ultrasound scan. These may not show anything but it is good to rule out any other factors
- Get a referral to see a urologist. They may also may not have heard of the condition and may test you for other things, but again, it's far better to be safe than sorry

3. Relieving stress and anxiety
Stress is a common cause for HF, and often makes it worse. Unfortunately, HF will inevitably cause a lot of stress, making it worse. It is important not to panic, and to keep in mind that you can and WILL recover. If you are going through a difficult time in your life, as we all do, consider giving therapy a go.
Meditation is also a great way to relieve stress and put you in a better mindset. If you're new to the subject, then I highly suggest Headspace as a great place to begin your journey with meditation
https://www.headspace.com

4. Pelvic floor relaxation and reverse kegels
Pelvic floor relaxation is very important in the recovery from HF. Learning to relax the PF, and normalise the relaxed state instead of it being in a constant state of contraction is really important. Breath work is the most important tool in achieving this. Spend 5-10 minutes (twice a day) lying down and focussing on abdominal breathing. Feel your pelvic floor expand and relax as you do so. I recommend the video below as an example. Abdominal breathing throughout the day is not only great for the pelvic floor, but also helps release tension in your organs and is generally a much healthier way to breathe.
https://www.youtube.com/watch?v=s10veqXlADo
https://www.healthline.com/health/di...atic-breathing
Reverse kegelling is also very important. HF is often caused by the over contraction of the PF muscles. Reverse kegels are the opposite of this where you push out instead of contracting. Here's some more info:
https://www.risingmaster.com/reverse-kegels/

5. Pelvic floor yoga and stretching
Also really helpful in relaxing the pelvic floor and stretching the muscles and in doing so, releasing tension. Here's some great videos:
https://www.youtube.com/watch?v=ntP8eQY74Cw&t=1603s
https://www.youtube.com/watch?v=KQdN000kpqM

6. Therawand
The therawand is a physiotherapy massage tool that is designed to release pelvic floor tension through direct pressure to the muscles. It has been highly regarded as a necessity for HF recovery from those who have the condition as a result of stress or pelvic floor trauma.
https://www.harbornephysio.co.uk/bir...=detail&bId=47
This testimonial talks about the use of the wand and how it helped him.
https://www.thepelvicpainclinic.co.u...pps-therawand/
Some more info.
I would consult a pelvic floor expert before using one, and would definitely focus on pelvic floor relaxation and stretches for a wile prior to using one.

7. Nofap
For many people, porn addiction is a serious problem, and may be an indirect cause of HF. It can result in excessive masturbation for prolonged periods of time. Nofap is a great tool to recover from porn addiction and recondition the mind to reset to its natural state. The r/NoFap community of reddit is a great place to begin your life without porn, and receive support from fellow people with a determination for a healthy and positive life

8. Fascial stretching
For those who identified themselves as number 2 in the "why is the pelvic floor dysfunctional?' section, it is possible that fascia is the main cause of the blame for your CPP and HF. Standard pelvic floor yoga and relaxation exersises may not be enough, and you may require stretching that focusses on fascial release.
What is fascia you ask?
https://deeprecovery.com/understanding-fascia/
A great place to start with understanding fascia and its link to CPP and HF is Greg HF's youtube channel. He was a long time sufferer of hard flaccid, and has since made a full recovery using the DCT programme. I would definitely go through his vids, but bear in mind that his issues have come from fascial issues and so he can be dismissive about techniques that that tend to help HF caused more by penile trauma e.g. therawands and relaxation exercises.
Greg HF: https://www.youtube.com/channel/UCy2...EC9xQ/featured
The DCT programme is greatly recommended by long time fufferers of hard flaccid. And focusses on retraining the fascia and in turn fixing HF. I don't know much about it, but here's the website
https://freedomfrompelvicpain.com/hard-flaccid

9. Massages
This includes gentle massage t perineum area, as well as to scrotum and penis in order to release tension and normalise blood flow. Going for a professional massage will also release tension in tight areas that could be contributing to HF. I would leave the happy ending until after you've made a full recovery......

10. Diet, Exercise and sleep
a healthy diet, regular exercise and a good sleeping schedule are recommended for most health issues, but it is a very important part of recovering from HF. Not only are they very important in keeping your body strong and healthy, but put you in a much better headspace for a positive mindset and motivation to beat HF for good. Some exercise forms can induce HF e.g. running as it can induce the contraction of the pelvic floor, and can trigger the symptoms. However, it is recommended that you should not give up exercise, but instead adapt in order to not push your pelvic floor too much. Also alcohol is known to make the symptoms much worse as it is an inflammatory, and it is recommended that one should take a break from alcohol consumption until they have recovered all together.


I really hope this helps. Not to toot my own horn or anything but I wish there was a post like this available to me when the condition first started for me. It is basically everything I have learned during my time with Hard Flaccid. I can safely say that I am greatly on the way to being free of Hard Flaccid. The biggest factor is motivation and determination, and keeping in mind that this is a condition tat can be recovered from. Keep calm, stay focused and good luck friends!
- Mudkip98 (moderator)

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

Ta Dangler.

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

This is somewhat general but worth reading.
This from David Wise phd.
Quote
In my view the whole issue we are dealing with about treatment for pelvic pain is simply this–how to allow the body to heal itself? I think contemporary medicine tends to forget that it is almost always the case that ‘the body heals itself and the doctor collects the fee.’ In the National Library of Medicine today, I found there were 3743 research articles listed on prostatitis. An infinitesimal 7 articles even contained the word healing. My view about treatment for pelvic pain is that we want to optimize the circumstances for the body to heal itself, we want to get out of the way of the healing of the tissues, muscles and structures inside the pelvic floor. Healing is what we want. In my own case, when I began thinking this way, my condition began to resolve.
The Wise-Anderson Protocol is about healing. It is about creating a hospitable environment for the restoration of normal happy tissue inside the pelvic floor. The relaxation protocol allows the nervous system to quiet down so that the irritated tissues can heal and can stop being squeezed into an irritated state… a squeezing that in most people who have pelvic pain has become habitual and chronic. The relaxation protocol aims to change the habit of tightening the pelvic muscles under stress. The physiotherapy we do stretches and lengthens the pelvic tissue and deactivates trigger points to make room for a healthy life in the pelvic floor.
The idea of RSD as it is understood today, at least as I read it, implies a condition where healing is remote. I balk at theories that imply healing isn’t possible because of my personal experience and others who have gotten better with this problem. Healing is possible. The patients I have seen who have done the worst – especially those who have suffered from unwise medical interventions, have given the entire responsibility for curing their condition to someone or something outside them. They come to the doctor and say “fix me doc”. Any treatment for the kind of pelvic pain we treat needs to be the servant of the body’s healing mechanisms. This requires the intimate and whole hearted participation of the patient.
Physiotherapy alone, while an essential component, is usually inadequate to resolve symptoms because it alone cannot make this healing occur. I understand this experientially. It is tempting for someone to think that physiotherapy, this outside procedure, will fix them. In my experience this person will be disappointed as I was. I had over 50 physiotherapy treatments and at the end of them all, I was still symptomatic and in pain. It was only after I saw that my problem came from my chronic tension, anxiety and habitually squeezing my pelvis – and particularly when I began the relaxation protocol in earnest, often up to 2 hours a day for over two years and doing moment-to-moment pelvic relaxation throughout the day, that my symptoms began to resolve. The pelvic pain of those we help is not simply a mechanistic problem that can be fixed from the outside with a physical therapist’s finger. The habit of tightening the pelvic floor is usually decades old and has been practiced thousands of times. It is part of a coping repertoire. Tightening their pelvic floor under stress is the default mode and keeps the tissue of the pelvic floor irritated and shortened.