Author: Dr. Adam Gvili, PT, DPT

Are Guys Embarrassed When They Can’t Get It Up? What You Need to Know

The question – Are Guys Embarrassed When They Can’t Get It Up?- is something I can answer easily. As a men’s physical therapist, I’ve worked with countless men who walk into my clinic feeling anxious, frustrated, or even ashamed because they can’t “perform.” And I always remind them of one simple truth: you’re not broken — you’re human.

One of the most common, yet least discussed, concerns among men is erectile dysfunction (ED) — and yes, many guys do feel embarrassed when they can’t get it up. If you’re a guy struggling with this, know that you’re not alone in feeling vulnerable. But the good news is, there are very real, physical ways to restore function and confidence. Let’s talk about why it happens, why it’s nothing to be ashamed of, and what you can do about it.

Are Guys Embarrassed When They Can’t Get It Up?

“Are Guys Embarrassed When They Can’t Get It Up?” Yes, many men feel embarrassed when they can’t get an erection — and that’s completely understandable. In these situations, a man often feels anxious, ashamed, or worried about how his partner will react. Society often ties masculinity to sexual performance, but from a clinical perspective, this issue is rarely about masculinity at all.

In fact, when stress and embarrassment take over, your body shifts into a fight-or-flight response, which restricts blood flow to the pelvic area — the exact opposite of what you need to get or maintain an erection. It’s important to remember that it is expected that not every man will be able to get an erection every time, and occasional trouble with erections is a normal part of life.

So if this has happened to you, remember: this moment does not define your worth—it’s not a failure, it’s physiology. And it’s treatable. Many men experience trouble with erections at some point.

Erectile Dysfunction: A Physical Perspective

Erectile dysfunction affects millions of men globally, and as a physical therapist specializing in men’s health, I see firsthand how movement, posture, and circulation influence sexual performance.

Common physical causes include:

Weak pelvic floor muscles
Poor blood circulation
Nerve compression from the spine or pelvis
Limited mobility or posture imbalances
Side effects of medication or stress

There are various treatments available for erectile dysfunction, including both physical therapy and medical options such as medications.

Pelvic floor physical therapy can retrain muscles that support erections, improve blood flow, and restore control. Many patients may also benefit from medications as part of their treatment plan. Many of my patients notice not only stronger erections but also improved confidence and body awareness — all without relying solely on medication.

Sexual Health and the Whole-Body Connection

Your sexual health is a mirror of your overall health. The heart, nerves, spine, and even breathing patterns influence sexual function.

In therapy sessions, we often work on:

Breathing techniques to relax and improve blood flow
Pelvic floor strengthening for better control and endurance
Postural alignment and mobility to reduce nerve pressure
Stress management for hormonal balance and confidence

When your body moves better, you feel better — and perform better.

Sexual function is a natural part of overall health and well-being.

The Spinal Cord’s Role in Sexual Function

The spinal cord acts like the communication highway between your brain and your body. The nerves responsible for erection — mainly the pudendal and pelvic nerves — originate from the lower spine (S2–S4). Which nerves are affected is a matter of individual assessment, as each person’s injury or condition can impact nerve function differently. Some people with spinal cord injuries may still experience reflex erections, depending on the level and completeness of their injury.

Issues like lower back pain, disc compression, or even prolonged sitting can interrupt those signals. Through manual therapy, movement training, and nerve mobilization, physical therapy helps restore that vital connection, often leading to noticeable improvements in sexual function for the person.

Understanding Physical Changes Over Time

As we age or go through life changes — injuries, stress, inactivity — the body adapts, sometimes in ways that limit circulation and muscle function. In the past, people may have believed that aging always leads to loss of sexual vitality, but new approaches show otherwise. With the right care, your body can absolutely regain its physical strength and responsiveness.

A tailored movement and pelvic health program can reignite energy, restore performance, and bring back confidence at any age.

Maintaining Healthy Relationships

Maintaining healthy relationships is one of the most important things you can do when facing erectile dysfunction or other sexual health challenges. The truth is, most men will experience erectile problems at some point in their lives, and it’s perfectly normal—definitely not a big deal or a reflection of your worth, attractiveness, or the strength of your relationship.

However, the anxiety and stress that often come with ED can sometimes create a self-fulfilling prophecy: the more you worry about your ability to get an erection, the more likely it is to happen again. This cycle is common, but it can be broken.

The most effective way to support both your sexual health and your relationship is open, honest communication. Being comfortable talking with your partner about your feelings, worries, and desires can help reduce stress and build trust. Focusing on emotional and physical connection—rather than just the act of sex—can bring new pleasure and intimacy. Exploring heightened sensitivity in other areas of the body, or trying new things like sex toys, can help you and your partner discover different ways to enjoy each other.

It’s also important to be aware of factors that can contribute to erectile dysfunction. Prescription drugs, recreational drugs, and alcohol can all impact your ability to get or maintain an erection. If you’re concerned, don’t hesitate to seek professional medical advice. A doctor can help you understand the underlying causes and recommend the best treatment options for you. Systematic reviews and meta-analyses show that a combination of medication (like Cialis or Levitra), lifestyle changes, and sometimes devices like a vacuum erection device can be very effective.

For couples where one partner has a spinal cord injury, it’s important to be aware of autonomic dysreflexia—a sudden increase in blood pressure that can occur during sex. With the right precautions and guidance from your healthcare provider, you can still enjoy a safe and satisfying sex life.

Finally, remember that sexual health is about more than just erections. It’s about connection, pleasure, and feeling good in your body and your relationship. By focusing on communication, seeking treatment when needed, and supporting each other, you and your partner can navigate any challenges that come your way—and come out stronger together.

How to Get an Erection More Naturally

Here are therapist-approved ways to support your body’s ability to get and maintain an erection naturally:

Breathe and relax. Deep breathing promotes blood flow and relaxation.
Do pelvic floor exercises. Strengthen the muscles that support erections.
Stay active. Regular movement boosts circulation and energy.
Stretch your hips and spine. Keep nerves free from compression.
Communicate openly. Talking to your partner or therapist can ease anxiety and improve connection.
Prioritize good sleep. Quality sleep is essential for healthy erectile function and overall sexual performance.

These small, consistent steps can create big changes over time — both physically and emotionally. Remember, maintaining focus on being present and attentive to your body and experiences can also help support intimacy and connection.

Take the Next Step — With Pelvis NYC

If you’re struggling with ED, pelvic pain, or changes in sexual function, you don’t have to navigate it alone. At Pelvis NYC, our men’s health specialists understand that these challenges are deeply personal — and we treat them with compassion, expertise, and total confidentiality.

Our team uses advanced pelvic floor physical therapy and evidence-based movement training to help you reconnect with your body and rebuild confidence — one step at a time.

💪 Take control of your sexual health today. Visit Pelvis NYC to schedule a private consultation and start your journey toward better function, confidence, and connection.

Because you deserve to feel strong, capable, and fully yourself again.

Disclaimer: The information provided in this article is for general informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

How to Get Longers Erection Naturally | Pelvis NYC

Because confidence in the bedroom starts with confidence in your body.

Living in New York can be exhilarating—but also exhausting. The stress, late nights, and non-stop pace can take a toll on everything, including your sex life. Mental health plays a significant role in erectile function, and addressing mental health concerns is important for improving sexual performance. If you’ve been struggling with shorter erections, erection problems, or just want to maintain an erection for longer, you’re not alone.

This guide breaks down what really affects your ability to get a longer erection, how lifestyle changes can help, and why men across NYC are turning to pelvic floor physical therapy at Pelvis NYC for a lasting solution.

Understanding What a “Longer Erections” Really Means

When most men search for “how to get longer erections,” what they’re really looking for is control—the ability to get and keep an erection when they want it. It’s not about lasting for hours (that could actually be a medical issue called priapism), but about having the stamina, confidence, and comfort to enjoy intimacy without worry. For most men, an erection lasts anywhere from a few minutes to longer, and the duration can vary based on individual factors like health, lifestyle, and psychological state.

A healthy erection depends on:

Good blood flow to the penis
Strong pelvic floor muscles
Balanced hormones
A calm, confident mind

Emotional health and performance anxiety can also play a significant role in sexual performance. Addressing emotional well-being and managing performance anxiety are important for maintaining healthy erections and overall sexual satisfaction.

So if your erections feel weaker or fade too quickly, it’s often your body’s way of asking for better care—not punishment.

The Truth About Erectile Dysfunction (ED)

Erectile Dysfunction—or ED—isn’t just “an older man’s issue.” Stress, poor sleep, alcohol, smoking, and even sitting too much can cause it.
In New York, where long work hours and high stress are the norm, ED rates are higher than most men realize.

Common causes include:

Reduced circulation from high blood pressure or cholesterol
Nerve issues from diabetes or back injuries
Hormonal imbalance (low testosterone)
Mental fatigue, stress, and anxiety
Pelvic-floor muscle tension or weakness
Sleep disorders

The last one—pelvic-floor dysfunction—is something most men never consider, yet it directly affects how well you can maintain an erection.

Both physical factors (like blood flow and nerve health) and risk factors (such as high blood pressure and cholesterol) can contribute to ED symptoms.

Achieving and Maintaining an Erection

Getting and keeping an erection isn’t just about desire—it’s a finely tuned process involving your brain, nerves, and circulatory systems all working together. When everything’s in sync, blood flow fills the erectile tissue, leading to a firm, lasting erection. But if you’re dealing with high blood pressure, damaged blood vessels, or other health conditions, that process can get interrupted, making erectile dysfunction (ED) more likely.

The good news? You have more control than you think. A healthy diet packed with whole foods, regular exercise, and managing your blood pressure can all help improve blood flow and support erectile function. Maintaining a healthy weight, cutting back on alcohol consumption, and quitting smoking are also powerful ways to protect your blood vessels and boost your sexual health. Even small changes—like taking the stairs or swapping out processed snacks—can make a real difference in your ability to achieve and maintain an erection.

If you’re noticing changes in your erections, don’t ignore them. Addressing these factors early can help you improve erectile function and enjoy a more satisfying sex life.

How a Healthy Diet Can Help You Maintain and Prolong Erections

What you eat in the city that never sleeps matters more than you think.

Add: fruits, veggies, nuts, fish, and whole grains (they support blood flow).
Avoid: processed foods, too much salt, and sugary drinks—they damage circulation.
Bonus: dark chocolate and watermelon (in moderation) are natural vasodilators, helping improve blood flow to the penis.

Managing blood sugar through a healthy diet is crucial for supporting erectile health and maintaining overall sexual function.

If you’re serious about a prolonged erection, start with your plate.

Healthy Weight = Better Blood Flow

In NYC, grabbing quick meals and skipping workouts can add pounds fast. But extra weight increases estrogen, reduces testosterone, and damages blood vessels—all enemies of strong erections. Losing weight not only helps balance hormones but also reduces the risk of cardiovascular disease, which is closely linked to erectile problems.

Losing even 10–15 pounds can dramatically improve your ability to maintain an erection.

Lifestyle Changes That Boost Performance

Simple, sustainable habits can help you achieve longer, firmer erections:

Regular exercise – increases blood flow and testosterone, supporting better sexual performance
Quit smoking – improves vascular health within weeks
Limit alcohol consumption – too much alcohol weakens erections and can negatively affect sexual performance
Manage stress – meditation, therapy, and deep breathing help regulate cortisol; reducing elevated cortisol levels can improve sexual performance and erectile health
Prioritize sleep – your testosterone levels rise when you rest, which benefits sexual performance

These changes don’t just help your sex life—they improve your overall health.

Healthy Habits for Sexual Health

Your daily habits have a huge impact on your sexual health and your ability to avoid erectile dysfunction. Start with your plate: a healthy diet rich in fruits, vegetables, whole grains, and lean proteins helps keep your blood vessels clear and your blood flow strong. Regular exercise—especially aerobic exercise like brisk walking, cycling, or swimming—gets your heart pumping and supports healthy circulation throughout your body.

Managing chronic stress is just as important. Techniques like meditation, deep breathing, or yoga can help lower stress hormones that might otherwise affect your erections. Prioritizing good sleep, maintaining a healthy weight, and keeping alcohol consumption in check all contribute to better sexual health. It’s also wise to steer clear of illegal drugs and limit nicotine use, as both can damage blood vessels and increase your risk of ED.

By making these healthy habits part of your routine, you’re not just improving your sex life—you’re investing in your overall well-being.

How Alcohol Consumption Affects Erections

A drink or two may help you relax, but heavy drinking numbs the nerves and blood vessels that make an erection possible.
Chronic alcohol use is one of the top causes of erection problems among younger New York men.
If your goal is a longer erection, try swapping a few cocktails for sparkling water—you’ll notice the difference in more ways than one.

Quit Smoking for Stronger, Longer Erections

Smoking restricts blood flow and damages arteries—including those that feed your penis. Smoking cigarettes also reduces nitric oxide production, a chemical essential for opening blood vessels and supporting erections.
The good news? Within three months of quitting, circulation improves, sensitivity increases, and erections often last longer.
If you needed another reason to ditch the cigarettes, this is it.

Underlying Health Conditions to Watch

Certain conditions can make achieving or maintaining an erection more difficult:

Diabetes
High blood pressure
High cholesterol
Heart disease
Hormonal imbalance
Sickle cell disease

These conditions can contribute to sexual dysfunction, so it’s important to manage them with the help of a healthcare provider.

If you have any of these, working with your doctor—and a pelvic health therapist—can improve not only your health but your sexual stamina too.

Regular Exercise and Pelvic Strength

Hitting the gym or taking a run through Central Park isn’t just about abs—it’s about blood flow and muscle control.

Cardio keeps your heart healthy; strength training boosts testosterone; and pelvic-floor exercises improve the actual muscle control that keeps your erection firm and lasting.

Regular exercise and pelvic-floor training can help treat erectile dysfunction and improve comfort during sexual intercourse.

How Pelvic Floor Physical Therapy Helps You Get a Longer Erections

Here’s something most men in New York don’t realize: pelvic-floor dysfunction is often the hidden reason behind weaker erections, early ejaculation, or loss of control. Pelvic floor dysfunction can also contribute to premature ejaculation and affect erections in various ways.

Pelvic floor physical therapy focuses on the muscles that support your penis, bladder, and pelvic organs. When those muscles are too tight, weak, or uncoordinated, erections suffer.

At Pelvis NYC, licensed pelvic health specialists help men:

Strengthen and retrain pelvic-floor muscles
Improve circulation to the pelvic area
Release tension that restricts blood flow
Correct posture and breathing that impact pelvic alignment

These evidence-based techniques can help you achieve longer, firmer erections naturally, without pills or side effects.

How to Get Longer Erections that Last

If you’re looking for ways to get an erection that lasts, you’re not alone—and there are proven strategies that can help. The key is increasing blood flow to the penis, which supports both the strength and duration of your erection. Regular exercise, a balanced healthy diet, and effective stress management are foundational steps for improving erectile function.

It’s also important to avoid habits that can undermine your efforts, like excessive alcohol consumption and smoking. Managing chronic stress through relaxation techniques or counseling can further support your sexual health. For some men, prescription medication—such as oral medications or ED pills—can be a helpful tool in treating ED and achieving an erection that lasts. Always consult a healthcare provider before starting any new medication to ensure it’s safe and right for you.

Don’t overlook the power of Kegel exercises, either. By strengthening your pelvic muscles, you can improve erectile function and gain better control during sexual activity. With the right combination of lifestyle changes and, if needed, medical support, you can enjoy stronger, longer-lasting erections and a more satisfying sex life.

What to Expect at Pelvis NYC

If you visit Pelvis NYC for pelvic-floor therapy, your treatment plan may include:

A full evaluation of your pelvic-floor strength and tension
Guided muscle-activation and relaxation exercises
Biofeedback therapy for better muscle control
Manual therapy to release tight tissues
Education on posture, breathing, and stress management

This kind of therapy isn’t invasive or awkward—it’s professional, targeted, and proven effective.

Overcoming Erection Problems Is Possible

You don’t need to accept weak erections as your “new normal.” Whether you’re 25 or 65, your body can improve with the right care.
By combining lifestyle improvements with pelvic-floor therapy, many men see a significant increase in erection strength, duration, and confidence within just a few weeks.

Your Next Step: Book a Consultation at Pelvis NYC

If you’re ready to take back control of your sexual health, Pelvis NYC is here to help.
Their expert physical therapists specialize in men’s pelvic health and erectile dysfunction treatment in New York City, offering compassionate, science-based care in a comfortable environment.

👉 Schedule your confidential consultation today at Pelvis NYC and discover how targeted pelvic-floor therapy can help you achieve a longer erection—naturally, safely, and confidently.

Muscle Pull and Strain: How to Heal and Prevent Future Injuries | Pelvis NYC

We’ve all been there — that sharp, sudden “ouch!” moment when a muscle tightens or twinges mid-movement. Muscle pull and strain are examples of sudden injuries that often cause sudden pain, typically occurring during or immediately after an activity.

Whether it’s from a workout, lifting something heavy, or simply reaching the wrong way, a muscle pull and strain can happen to anyone. These are among the most common injuries people experience in daily life and physical activity. As a physical therapist, I see this every day — people frustrated, sore, and just wanting to move without pain again.

The good news? Most muscle strains heal remarkably well with the right care, patience, and effective movement strategy. Let’s talk about what’s really going on when you “pull a muscle,” how to tell the difference between mild and severe strains, and how physical therapy can get you back to doing what you love — safely.

What Is a Muscle Strain?

A muscle strain happens when muscle fibers stretch beyond their limits or tear. A strained muscle is an injury involving the stretching or tearing of muscle fibers, which make up the muscle tissue. This can occur suddenly during activity (an acute muscle strain) or develop gradually from repetitive stress (a chronic muscle strain).

You might hear people use terms like “pulled muscle” or “muscle tear” — they’re all describing the same thing: damaged muscle fibers within the affected muscle. In a muscle injury, the affected muscle’s tissue is damaged, and the severity can range from mild to severe depending on the extent of the injury. These injuries need time and care to recover.

Understanding Muscle Anatomy and Function

To truly understand why muscle strains occur, it helps to know a bit about how your muscles are built and how they work. Muscles are made up of bundles of muscle fibers, each surrounded by a protective layer of connective tissue. Inside these fibers are even smaller units called myofibrils, which are responsible for muscle contraction and movement.

When you engage in physical activity—whether it’s lifting, running, or even repetitive movements at work—your muscles contract and stretch to move your joints. However, if a muscle is pushed beyond its normal range, such as during a sudden movement or when you do too much physical activity without proper preparation, those muscle fibers can become overstretched or even tear. This is what we call a pulled muscle or muscle strain.

Chronic muscle strains often develop over time from repetitive movements, poor flexibility, or consistently overloading your muscles without enough rest. Understanding this anatomy and function is key to appreciating why taking care of your muscles—and not overdoing it—is so important for long-term health and injury prevention.

Understanding the Different Types of Muscle Strains

Not all muscle strains are the same — some are minor annoyances, while others can completely sideline you. Healthcare professionals classify a muscle pull and strain into three grades depending on how much damage has occurred. Understanding which one you’re dealing with helps set realistic expectations for recovery and guides your treatment plan.

Grade 1: Mild Muscle Strain

A mild strain involves a small number of overstretched or torn muscle fibers. You might feel a little tightness or soreness, especially when you stretch or move, but strength and function usually remain normal. With rest, gentle movement, and proper care, these typically heal quickly.

Grade 2: Moderate Muscle Strain

A moderate muscle strain means more fibers are damaged — sometimes even a partial tear. The area may swell or bruise, and you’ll likely notice pain or weakness when you try to use the muscle. Activities like lifting, running, or even walking might feel limited for a while. This level of strain benefits greatly from guided physical therapy to restore strength and flexibility safely.

Grade 3: Severe Muscle Strain

A severe muscle strain (or complete muscle rupture) occurs when the muscle or tendon fully tears. The pain can be sharp and immediate, often accompanied by swelling, bruising, or even a visible gap in the muscle. This injury requires prompt medical evaluation and, in some cases, surgical repair. But don’t lose hope — with a well-structured rehab program, full recovery is absolutely possible.

Whether your muscle strain is mild, moderate, or severe, early care makes a huge difference. The sooner you understand your injury and begin appropriate treatment, the faster you’ll get back to moving comfortably and confidently.

Muscle Pull vs. Strain: Is There a Difference?

In most cases, a pulled muscle and a muscle strain mean the same thing — a stretch or tear in the muscle. While muscle pulls and strains refer specifically to injuries of the muscle fibers, strains and sprains are both common injuries but affect different tissues: strains involve muscles or tendons, while sprains affect ligaments.

Ligament sprains, such as ankle sprains, are also frequent and are often confused with muscle strains. Ankle sprains are among the most common types of joint injuries, highlighting the importance of distinguishing between strains sprains and ligament sprains for proper treatment and recovery.

What matters most is the extent of the injury and how you care for it afterward.

How Muscle Strains Are Diagnosed

When you visit a healthcare provider (or a physical therapist), we’ll start with a medical history — how and when the injury happened, what movements make it worse, and what your daily activities look like.

Then, during a physical exam, which is the primary tool for diagnosing muscle injuries, we’ll assess swelling, tenderness, muscle strength, and range of motion. A muscle strain is diagnosed based on your history and findings from the physical exam; imaging is used if further clarification is needed. In some cases, imaging tests like magnetic resonance imaging (MRI) or ultrasound can help confirm the severity of the strain and rule out other injuries such as sprains and strains combined, especially when the diagnosis is uncertain or if surgical intervention is being considered.

Other symptoms, such as numbness, muscle weakness, or systemic signs, may indicate a more severe or related condition and should be discussed with your provider.

Common Risk Factors for Muscle Strains

While anyone can experience a muscle pull, certain factors increase your risk:

Not warming up properly before activity
Muscle fatigue or overuse
Poor posture or movement mechanics
Dehydration and lack of flexibility
Sudden changes in exercise intensity or duration

Knowing your risk factors can help you prevent muscle strains in the future — which is something physical therapy focuses on just as much as recovery.

Acute vs. Chronic Muscle Strains

Acute muscle strain: Happens suddenly, often during sports or lifting. Pain is immediate and sharp. Acute strains, also called acute muscle strains, often result from sudden injuries during physical activities or contact sports, such as football.
Chronic muscle strain: Develops slowly from repetitive motion, poor movement patterns, or overtraining. The pain is often dull but persistent.

Both types can benefit from professional care — especially if they start interfering with your movement or comfort.

How Physical Therapy Helps With a Muscle Pull and Strain

This is where I get excited — because physical therapy is one of the most effective ways to recover from muscle strains and prevent them from happening again.

A physical therapist can help you:

Relieve pain and swelling through targeted manual therapy and gentle stretching, and help manage muscle spasms and severe pain that may occur after a muscle strain
Restore flexibility and strength safely, without risking re-injury
Address underlying causes, such as muscle imbalances or poor movement patterns
Educate you on prevention, so you don’t find yourself in this position again
Provide appropriate treatment and proper treatment plans tailored to the severity of your injury, ensuring optimal healing and reducing the risk of complications

Physical therapy can also help minimize the impact of scar tissue that forms during the healing process, supporting better muscle regeneration and reducing the risk of future injury. More severe injuries may require a longer rehabilitation process and specialized care to ensure a safe and full recovery.

Every strain has its own story — and so does your recovery. The key is building resilience and moving with confidence again, not just rushing to get back to your routine.

Preventing Muscle Strains: Small Steps, Big Impact

A few daily habits can make a huge difference in keeping your muscles healthy and flexible:

Always warm up before activity
Stay hydrated and maintain good nutrition
Stretch regularly, especially if you sit for long periods
Listen to your body — if something feels off, rest before it becomes an injury

Returning to Activity After a Muscle Strain

Once you’ve experienced a muscle strain, it’s natural to want to get back to your favorite activities as soon as possible. However, giving your injured muscle the right amount of time to heal is crucial for a full recovery and to avoid more severe strains down the road.

The timeline for returning to physical activity depends on the severity of your muscle strain. Mild strains may heal within a few weeks, while moderate strains can take several weeks to a few months. Severe strains, especially those involving a partial or complete tear, may require several months of careful rehabilitation.

Ready to Move Without Pain After Muscle Pull and Strain?

If you’re dealing with a pulled muscle or a muscle strain that just won’t go away, know that help is closer than you think. At Pelvis NYC, our physical therapy team designs customized recovery plans that don’t just treat the injury — they teach your body how to move better, feel stronger, and stay injury-free.

Don’t let a muscle strain slow you down. Reach out to Pelvis NYC today and start your journey back to confident, pain-free movement.

My Lower Back Hurts: Causes, Treatments, and Proven Relief Strategies

Have you ever woken up, tried to get out of bed, and thought, “My lower back hurts — again”? You’re not alone. Back pain affects people of all ages and lifestyles, from office workers sitting too long to athletes pushing their limits. While it’s common, it’s not something you have to live with.

Understanding what’s causing your pain — and how to relieve it — can make all the difference. In this guide, we’ll explore the causes of lower back pain, how to identify acute low back pain, what tests like the straight leg test reveal, and proven treatment strategies to help you move freely again.

Understanding Why “My Lower Back Hurts”

If you’ve ever caught yourself saying, “My lower back hurts,” you’re not alone. Low back pain is one of the most common medical complaints worldwide and a leading cause of missed work. It is especially prevalent among adults, who represent a significant proportion of those seeking care for this condition. Whether it started suddenly after a workout or built up over time from poor posture, understanding what’s causing it is the first step toward healing.

When pain occurs, it may be due to muscle strain, ligament sprain, disc irritation, or nerve compression. Acute back pain can occur suddenly or develop gradually, often as a result of musculoskeletal causes. Other times, it’s related to lifestyle factors like prolonged sitting, stress, or improper lifting. Knowing the difference helps guide effective treatment — especially when managing acute low back pain versus chronic discomfort.

Acute Low Back Pain vs. Chronic Pain

Acute low back pain typically lasts from a few days up to six weeks and often results from overuse or sudden strain. It’s uncomfortable but usually short-lived. Most patients with acute low back pain improve with conservative treatment. Chronic low back pain, however, lingers for months and may involve deeper structural or neurological issues.

Recognizing this distinction helps your provider determine the right approach — whether it’s simple rest, guided exercises, or targeted physical therapy at a clinic like Pelvis NYC, where specialists focus on restoring function and preventing recurrence. Prolonged bed rest is not recommended for acute low back pain; instead, continued activity is encouraged. Muscle relaxants may be considered as a pharmacological treatment option, alongside NSAIDs and acetaminophen, although they are not superior to NSAIDs for pain relief.

Family practice providers often manage both acute and chronic low back pain.

The Role of the Straight Leg Test and Straight Leg Raising

During a physical evaluation, your provider may perform a straight leg test (also known as straight leg raising) to assess whether nerve irritation is contributing to your pain.

Here’s how it works: while you are in the supine position (lying on your back), the clinician gently lifts one leg, performing hip flexion while keeping your knee straight. If this maneuver reproduces your pain—especially if it radiates down your leg—this is considered a positive test or positive straight leg test, indicating nerve root involvement and possible radicular symptoms. A positive straight leg test is often sensitive for detecting nerve root irritation and may suggest a herniated disc.

This test helps distinguish simple muscular causes from more serious neurological findings that might require advanced care.

Additionally, your provider may perform a femoral stretch test. If this maneuver causes pain in the anterior thigh, it suggests involvement of the L2-4 nerve roots.

Why a Neurological Assessment Is Important

If your back pain is severe, persistent, or radiates into your legs, your clinician might recommend a neurological examination. This examination is performed on patients to assess reflexes, muscle strength, coordination, and sensory response, focusing on the evaluation of nerve roots for signs of irritation or compression.

During the examination, the patient’s sensory and motor function are tested, including assessment of the lateral aspect of the thigh and foot, as well as movements of the feet and foot such as plantarflexion and toe lifting. These tests help identify deficits related to specific nerve roots, such as L4, L5, and S1.

The spinal cord, housed within the spinal canal, is a critical structure protected by the vertebral column. Its relationship to the nerve roots and their exits is essential in understanding neurological findings in patients with low back pain.

Certain findings during the examination may raise concern for more serious underlying issues, such as spinal cord compression or cauda equina syndrome, and may prompt further diagnostic evaluation.

Recognizing “Red Flags” in Low Back Pain

Identifying red flags is a crucial part of the initial evaluation of low back pain.

Although most cases of low back pain are not serious, there are certain red flags you should never ignore:

Loss of bladder or bowel control
Numbness in the groin or inner thighs
Unexplained weight loss or fever
Severe pain following trauma or accident
History of cancer or infection

If you experience any of these symptoms along with “my lower back hurts,” seek immediate medical attention. Early intervention is key to preventing long-term damage.

Diagnostic Tests: What to Expect and When They’re Needed

When you’re dealing with acute low back pain, it’s natural to wonder if you need further testing. In most cases, diagnostic tests aren’t necessary right away—especially if your symptoms are mild and there are no red flags. However, if your pain is severe, persistent, or accompanied by symptoms like leg weakness, numbness, or changes in bladder or bowel control, your provider may recommend additional tests to get to the root of the problem.

Common diagnostic tools include X-rays, CT scans, and MRIs, which can help identify issues such as herniated discs, spinal stenosis, or compression fractures that may be causing nerve root irritation. Electromyography (EMG) can also be used to assess nerve function and pinpoint the source of nerve root irritation or sciatica. The straight leg raise test remains a valuable, in-office assessment for detecting nerve root involvement—if lifting your leg causes pain that radiates down the leg, it may indicate irritation of the sciatic nerve.

Remember, these tests are typically reserved for cases where conservative treatment hasn’t improved your symptoms or when more serious causes of back pain are suspected. Always discuss the need for diagnostic tests with your healthcare provider to ensure you receive the most appropriate care for your specific situation.

“My Lower Back Hurts:” How Physical Therapy Can Help

Physical therapy plays a central role in treating and preventing low back pain. At Pelvis NYC, our therapists specialize in pelvic and spinal rehabilitation — focusing on restoring movement, reducing pain, and strengthening core stability, with particular attention to the lumbar spine and pelvis.

Your treatment plan might include:

Manual therapy to release tight muscles, including the paraspinal muscles, and improve mobility
Targeted exercises to stabilize your spine and pelvis
Postural education to reduce daily strain
Neuromuscular re-education to retrain movement patterns

For those dealing with acute low back pain, gentle mobility work and progressive strengthening can make a significant difference in recovery speed and long-term outcomes.

Proven Relief Strategies You Can Start Today

You don’t have to live with constant discomfort. Here are some strategies you can start right now to manage your pain and prevent flare-ups:

Stay Active – Gentle walking, swimming, or stretching can relieve stiffness. Including gentle lateral flexion and forward flexion exercises may help improve spinal mobility and reduce discomfort.
Maintain Good Posture – Keep your spine aligned, especially when sitting for long hours.
Use Heat and Ice – Alternate between warm compresses and cold packs to manage inflammation.
Strengthen Your Core – Strong abdominal and pelvic muscles reduce pressure on the lower back.
Seek Professional Care – If your pain persists or worsens, schedule a consultation for a neurological assessment and customized physical therapy plan.

If conservative strategies do not provide relief, surgical treatment or surgery may be considered as a last resort.

Lifestyle Modifications for a Healthier Back

Taking care of your spine goes beyond just treating pain—it’s about building habits that keep your back strong and resilient. Regular exercise, including physical therapy routines, helps strengthen the muscles that support your spine and improves flexibility, making you less prone to acute low back pain. Maintaining a healthy weight is also crucial, as carrying extra pounds can put additional stress on your back.

Simple changes like practicing good posture, using proper lifting techniques, and taking frequent breaks to stretch during long periods of sitting can make a big difference. Managing stress through relaxation techniques such as meditation or deep breathing can also help, since tension often settles in the back muscles. If you smoke, consider quitting—smoking can reduce blood flow to the spine and slow healing.

By weaving these lifestyle modifications into your daily routine, you’ll not only reduce your risk of low back pain but also support the long-term health of your spine and muscles.

Preventing Future Episodes of Low Back Pain

Once you’ve experienced acute low back pain, preventing it from coming back becomes a top priority. The key is to stay proactive with your spine health. Continue with physical therapy exercises that focus on strengthening and stretching the muscles supporting your back—these routines help maintain flexibility and reduce the risk of muscle spasm or nerve root irritation.

Make it a habit to take regular breaks from sitting or repetitive activities, allowing your muscles to relax and reset. Be mindful of your movements: avoid heavy lifting, sudden twisting, or bending that could strain your back. Ergonomic adjustments at work and home, such as supportive chairs and proper desk setup, can also help protect your spine.

By committing to these preventive strategies, you’ll lower your chances of recurrent episodes of acute low back pain and keep your back—and your life—moving forward.

Coping with Back Pain: Emotional and Practical Tips

Living with back pain can be tough, not just physically but emotionally as well. It’s important to recognize the impact chronic back pain can have on your mood and daily life. Don’t hesitate to reach out to family, friends, or a mental health professional for support—you don’t have to face it alone.

On the practical side, there are several ways to manage pain and make daily activities easier. Applying heat or cold packs can help soothe sore muscles and reduce inflammation. Taking regular breaks to rest and gently stretch your back can prevent stiffness. For some, transcutaneous electrical nerve stimulation (TENS) offers relief by using mild electrical currents to interrupt pain signals. Nonsteroidal anti-inflammatory drugs (NSAIDs) can also help manage pain and swelling, but always use them as directed by your doctor.

If needed, assistive devices like canes or walkers can take pressure off your spine and make movement safer. Most importantly, work closely with your healthcare provider to develop a treatment plan tailored to your needs—addressing both the physical and emotional aspects of back pain for the best possible quality of life.

Take the Next Step Toward Healing

If you’ve been saying, “My lower back hurts,” for days or weeks, it’s time to act. The longer you wait, the harder it can be to regain comfort and mobility.

👉 Reach out to Pelvis NYC today for a comprehensive evaluation and a personalized treatment plan. Our expert therapists will help you identify the root cause, treat your pain effectively, and get you back to moving with confidence and ease.

Achilles Rupture: How to Recognize, Treat, and Prevent Tendon Injuries

If you’ve ever felt a sudden “snap” or “pop” in the back of your leg followed by sharp pain, you may have experienced an Achilles rupture. This injury can feel dramatic—almost like someone kicked you from behind—but it’s actually the Achilles tendon, the strong band of tissue that connects your calf muscles to your heel bone, giving way.

Achilles ruptures often occur due to sudden forced plantar flexion, especially during sports or vigorous activities, when the foot is rapidly pushed downward with great force.

Let’s walk through what an Achilles rupture really is, how it’s diagnosed, and what treatment and recovery can look like.

Understanding Achilles Tendons and Injuries

The Achilles tendon is the largest tendon in your body, connecting the powerful calf muscles to the heel bone. This strong, fibrous band is essential for ankle plantar flexion—the movement that lets you push off the ground when you walk, run, or jump. Because the Achilles tendon absorbs so much force during these activities, it’s especially vulnerable to injuries and ruptures. Achilles tendon injuries, including Achilles tendon ruptures, are common in sports that require sudden bursts of speed, quick changes in direction, or repetitive jumping. Understanding how the Achilles tendon works and why it’s so important can help you recognize the signs of tendon rupture and take steps to protect this vital part of your ankle and lower leg.

Types of Achilles Tendon Injuries

Achilles tendon injuries can vary widely in severity, from mild strains to complete ruptures. One common issue is Achilles tendinopathy, a condition caused by overuse or degeneration of the tendon over time. Partial tears occur when only some of the tendon fibers are damaged, leading to pain and weakness but not a total loss of function. In contrast, a complete rupture—often called a torn Achilles tendon—means the tendon has snapped entirely, usually resulting in a sudden inability to push off the foot.

Acute Achilles tendon rupture is a traumatic injury that happens suddenly, often during intense physical activity, and requires prompt medical attention. Chronic injuries, on the other hand, develop gradually due to repetitive stress or age-related changes in the tendon. Identifying whether you have a partial tear, complete rupture, or chronic Achilles tendon injury is crucial for choosing the right treatment, whether that’s nonsurgical treatment, surgical repair, or a combination of approaches to restore tendon health and function.

What Is an Achilles Tendon Rupture?

An Achilles tendon rupture occurs when the tendon is ruptured, meaning it has been completely torn. The severity can range from a small Achilles tendon tear that makes walking painful to a full rupture that may prevent you from pushing off your foot altogether.

How Do Achilles Ruptures Happen?

Achilles ruptures are often linked to sports that involve quick stops, starts, or jumps, like basketball, tennis, or soccer. But they can also happen during everyday activities—running up the stairs, missing a step, or even slipping on the sidewalk.

Some common risk factors include:

Tight calf muscles or poor flexibility
Skipping warm-ups before exercise
Taking certain medications that weaken tendons
Patient age (most common in adults 30–50)
Use of fluoroquinolone antibiotics

Certain medications and systemic diseases can weaken the tissue around the Achilles tendon, increasing the risk of rupture.

Understanding these risks can help you prevent an Achilles tendon rupture before it occurs.

Diagnosis: Medical History, Physical Examination, and Imaging Tests

Doctors start with a physical exam and by gathering your medical history—what you felt, when it happened, and any previous ankle or calf issues.

A physical examination often includes the Thompson test, where your calf is squeezed to check if your foot moves. The test is performed with the patient in the prone position, lying face down with the knee flexed. If the foot doesn’t move, it suggests a rupture.

For clarity, imaging tests such as ultrasound or magnetic resonance imaging (MRI) may be ordered. These confirm whether it’s a partial or complete Achilles tear and help guide the treatment plan. Imaging can also help rule out other injuries, such as fractures, that may occur alongside an Achilles rupture.

Achilles Tendon Rupture Treatment Options

Treatment for a ruptured Achilles tendon depends on the severity of the rupture, your activity level, and your goals. Options generally include:

Nonoperative treatment is a conservative approach and an alternative to surgery.
Operative management, also referred to as surgical intervention, involves repairing the tendon through surgery.

Surgical intervention may offer a reduced risk of re-rupture for some patients compared to nonoperative treatment.

Nonsurgical Treatment

Conservative methods typically involve immobilization with a walking boot or functional bracing, which are alternatives to casting or splinting, to allow the tendon to heal naturally while protecting the injured leg.
Protocols may include non-weight-bearing initially, followed by gradual weight bearing and early weight bearing as tolerated, to speed recovery and improve ankle function.
Gradual stretching and strengthening
Physical therapy to restore function

This approach is often recommended for partial tears or patients who are less physically active. Conservative methods focus on minimizing strain on the injured leg and promoting safe, progressive rehabilitation.

Achilles Tendon Repair (Surgical Treatment)

Surgery reconnects the torn tendon.
There is a risk of nerve injury, especially with minimally invasive or percutaneous techniques.
Wound complications, such as infection or delayed healing, can occur after surgery.
Adequate blood supply is important for optimal tendon healing and recovery.
Typically followed by a period of immobilization.
Rehabilitation with physical therapy afterward.
Sports medicine specialists often manage surgical intervention and rehabilitation, particularly for athletes aiming to return to high-level activity.

This option is often chosen by younger or more athletic patients who want to return to high-level activity.

The Role of Physical Therapy in Recovery

No matter which treatment path you take, physical therapy is essential. Recovery from an Achilles rupture or Achilles tendon tears involves a process known as functional rehabilitation, which is aimed at restoring function, strength, balance, and mobility so you can return to your daily life and favorite activities.

A physical therapist can help you:

Rebuild calf and ankle strength
Improve flexibility and range of motion
Correct imbalances that could lead to future injuries
Progress safely from walking to running or sports

Studies have shown a significant difference in outcomes for patients who undergo structured functional rehabilitation protocols compared to those who do not, with better recovery and lower re-injury rates.

Without therapy, recovery can be slower, and the risk of re-injury is higher. With it, you’re giving your body the tools to heal and thrive.

Prevention and Reducing Your Risk

While it’s impossible to eliminate the risk of Achilles tendon rupture entirely, there are several effective ways to reduce your chances of injury. Regularly stretching and strengthening your calf muscles can help support the Achilles tendon. It can improve flexibility in your foot and ankle. Gradually increasing the intensity and duration of your physical activities, rather than making sudden changes, can also protect the tendon from overload. Wearing supportive footwear that fits well and is appropriate for your sport or activity is another key preventive step. Pay attention to any early signs of Achilles tendon pain or discomfort, and don’t ignore a persistent ache. An early intervention can prevent more serious injuries.

It’s also important to avoid steroid injections and certain antibiotics, such as fluoroquinolones, which have been linked to an increased risk of tendon rupture. If you do experience an Achilles tendon injury, seeking proper treatment—including physical therapy exercises and, when needed, minimally invasive surgery—can help the tendon heal properly and lower the risk of re-rupture. By taking these precautions, you can keep your Achilles tendon strong and reduce the likelihood of long-term problems.

Ready to Begin Your Recovery?

An Achilles rupture may feel like a major setback, but it doesn’t have to be the end of your active lifestyle. With the right treatment and guidance, you can come back stronger.

At Pelvis NYC, we specialize in personalized physical therapy programs. It will support your recovery journey—from early healing to full return to movement.

Don’t let an Achilles rupture keep you sidelined. Contact Pelvis NYC today and take the first step toward your recovery.

Why Your Ankle Pain Persists (and What You Can Do About It)

We don’t think much about our ankles—until they hurt. Suddenly, that small but mighty joint can make something as simple as walking to the subway feel like a marathon. Ankle pain can cause difficulty walking, especially on uneven surfaces or stairs, making daily activities much harder.

Whether it’s a sharp pain after rolling your ankle on the sidewalk or a nagging ache that won’t go away, ankle pain is more than an inconvenience. It’s a signal from your body asking for attention. Noticing pain early is crucial, as it can be a sign of an injury that requires prompt care.

Ankle Injury vs. Ankle Sprain: What’s the Difference?

You’ve probably heard someone say, “Oh, it’s just a sprain.” But anyone who’s had one knows there’s nothing “just” about it. An ankle sprain happens when you overstretch or tear the ligaments that stabilize your ankle—usually from a twist, a misstep, or sports. These ligaments connect the ankle bones, and tears can lead to swelling and bruising. It’s actually one of the most common ankle injuries out there.

The tricky part? Even a minor sprain can come back to haunt you if it doesn’t heal properly. Left unchecked, it can turn into chronic ankle pain—that dull, persistent ache that flares up when you least expect it. Untreated injuries can also result in long-term ankle pain that persists for weeks or longer.

Common Causes of Ankle Pain

Not every case of ankle pain comes from a dramatic fall or sports injury. Sometimes it sneaks up on you. A few common culprits include:

Flat feet: When your arches collapse inward, your ankles often pay the price. Excess body weight can contribute to ankle pain by increasing strain on the arches and joints.
Overuse: Daily runs or long shifts on your feet can create stress and microtears. Overuse can also lead to foot pain and discomfort in the surrounding areas.
Arthritis: This can stiffen the joint, making each step feel heavier than the last. Arthritis can cause joint pain, especially when the cartilage between two bones wears down. Specific types of arthritis, such as rheumatoid arthritis and reactive arthritis, can affect the ankle joint, with rheumatoid arthritis involving the immune system attacking the joints.
Old injuries: That sprain you ignored in college? It might still be messing with your gait today. Conditions like gout can cause intense pain in the big toe, and issues with the heel bone can also contribute to ankle pain.

The bottom line? Foot and ankle pain is rarely “random.” There’s almost always an underlying reason—your job, your shoes, your anatomy, or simply life catching up with you.

Why Chronic Ankle Pain Is More Than Just Annoying

This type of pain doesn’t just slow you down physically. It changes how you move. You might start favoring one side, limping, or avoiding certain activities altogether. Over time, this can create ripple effects—hip pain, back pain, even posture issues. What starts as a little ankle twinge can impact your whole body.

Diagnosing Ankle Pain: Getting to the Root of the Problem

When you start to feel pain in your ankle, getting an accurate diagnosis is the first step toward lasting relief. A healthcare professional will take a close look at your medical history and perform a hands-on examination of your foot and ankle to pinpoint the source of your discomfort. Sometimes, they’ll recommend imaging tests—like X-rays or MRIs—to check for issues such as a broken ankle, arthritis, or other hidden problems that could be causing your pain.

In certain cases, you might be referred to a specialist, such as an orthopaedic surgeon or a foot and ankle surgeon, for a more in-depth evaluation. This is especially important if your pain is persistent or if you’ve had previous injuries that never fully healed. The Arthritis Foundation suggests that if your ankle pain doesn’t improve or gets worse over time, it’s wise to seek medical attention. With an accurate diagnosis, your healthcare professional can create a personalized treatment plan to relieve ankle pain and help you get back on your feet.

Ankle Pain Treatment Options: From Quick Fixes to Lasting Relief

Medical experts, including the Cleveland Clinic, often recommend a blend of short-term and long-term strategies for ankle pain relief:

RICE (rest, ice, compression, elevation) for acute injuries. Use an ice pack to reduce swelling and pain, and wrap the injured area with a compression bandage, ensuring it is applied properly to avoid cutting off circulation.
Supportive footwear or braces to keep things stable
Medication for pain and inflammation when needed. Anti-inflammatory medications are commonly used to reduce swelling and ease pain as part of conservative treatment.
Surgery, but only when conservative treatments don’t cut it

These are common treatments for ankle pain. Soft insoles can also help provide comfort and support.

But here’s where many people find real transformation: physical therapy.

How Physical Therapy Changes the Game

Think of physical therapy as training for your ankle—not just to heal, but to come back stronger than before. A skilled therapist will:

Strengthen the muscles around your ankle so they can support you better
Work on balance and stability so you’re less likely to roll or sprain it again, helping you safely return to physical activities and sports
Address biomechanical issues, like flat feet, that put extra stress on your ankle
Use hands-on techniques to restore mobility and flexibility

Unlike quick fixes, PT gets to the root cause. It’s not just about reducing pain today—it’s about building resilience so your ankle can carry you confidently into tomorrow.

When to Seek Medical Attention

Not all ankle pain requires a trip to the doctor, but there are times when you shouldn’t wait. Suppose you experience severe pain, swelling, or notice that your ankle is red or warm to the touch. In that case, it’s time to seek immediate medical attention—especially if you suspect a sprained ankle or a broken ankle after an injury. Chronic ankle pain that lingers or interferes with your daily activities is another sign you should see a healthcare professional.

According to the Cleveland Clinic, if your pain lasts more than a few days or is constant, don’t try to tough it out. A healthcare professional can assess your ankle injury, determine the underlying cause, and develop a treatment plan to relieve pain and promote healing. Remember, early intervention can prevent minor injuries from turning into long-term problems.

Ankle Pain Surgery: What to Know If You Need More Than Conservative Care

While most ankle injuries can be managed with rest, physical therapy, and other conservative treatments, sometimes surgery is the best option for lasting relief. Ankle pain surgery may be recommended for conditions like severe arthritis, tendonitis, or stress fractures that haven’t responded to other treatments. Your healthcare provider will walk you through the risks and benefits, helping you decide if surgery is right for your specific situation.

If you do need surgery, you’re not alone—many people find that it’s the turning point in their recovery. After the procedure, physical therapy plays a crucial role in restoring strength, flexibility, and function to your ankle, reducing the risk of future injuries. Open communication with your healthcare provider ensures you have a clear treatment plan and the support you need every step of the way.

Lifestyle Changes for Ankle Pain Management

Small changes in your daily routine can make a big difference in managing ankle pain and preventing future injuries. Foot and ankle surgeons often recommend wearing supportive shoes that fit well and offer good arch support—this helps reduce ankle pain and keeps your feet and ankles stable. Swapping out high-impact activities for lower-impact options, like swimming or cycling, can also help protect your joints.

Maintaining a healthy diet and a healthy weight reduces pressure on your ankles and supports overall healing. Regular physical activity, such as walking, encourages blood flow and keeps your joints flexible. The foot and ankle experts also suggest making time for gentle stretching and strengthening exercises to keep your ankles strong. By taking these steps, you can reduce your risk of injuries and keep pain at bay.

How to Prevent It: Steps to Keep You Moving

Prevention is key when it comes to keeping your ankles pain-free and ready for anything. Start by choosing shoes with a soft sole and a low heel to minimize stress on your ankle joints. Gradually increase your physical activity to avoid overuse injuries, and make sure to include exercises that strengthen the muscles around your ankles—think toe raises, heel raises, and balance drills.

Using arch supports or orthotics can help reduce pain and provide extra stability, especially if you have flat feet or a history of foot problems. Regular check-ins with a healthcare professional can catch small issues before they become big problems, and they can recommend effective ankle pain treatment options tailored to your needs. By taking these proactive steps, you’ll reduce your risk of severe ankle pain, chronic ankle pain, and keep your feet and ankles healthy in the long run.

Ready to Step Out of Pain?

Your ankles work hard for you every day. It’s time to return the favor. If ankle pain—whether from an injury, flat feet, or something else—is holding you back, physical therapy could be the turning point.

At Pelvis NYC, we specialize in helping people move beyond foot and ankle pain with personalized, one-on-one treatment plans. We don’t just treat the injury—we help you reclaim your stride, your strength, and your freedom to move.

Don’t let ankle pain define your day. Take your first step toward relief with Pelvis NYC today. Book through this link.

You might be interested in reading: Achilles Rupture: How to Recognize, Treat, and Prevent Tendon Injuries

Pain in the Back of Shoulder Explained

Shoulder pain is one of the most common complaints I hear as a physical therapist. But few things are as frustrating as persistent pain in the back of the shoulder. This type of pain can interfere with reaching, lifting, sleeping, and even simple daily tasks like putting on a shirt. Sometimes the pain is a dull, constant ache. Other times, it radiates, pinches, or worsens with certain movements. No matter how it shows up, one thing is clear: it can affect your quality of life.

It’s important to pay attention to when pain starts. Especially if it worsens or is accompanied by other symptoms, as this can help determine when to seek further evaluation.

In this blog, I’ll walk you through the most common causes of pain in the back of shoulder, highlight related conditions, and provide actionable physical therapy and self-care strategies. My goal is to help you better understand your pain and empower you with knowledge to take control of your recovery.

Introduction

Shoulder pain is a widespread issue that affects millions of people every year, often disrupting daily life and limiting activity. Because the shoulder joint is one of the most mobile and complex joints in the body, it’s especially vulnerable to injury and strain. Common causes of shoulder pain include rotator cuff tears, shoulder blade pain, and referred pain from other areas of the body. Whether the pain is sharp, dull, or radiates down the arm, it can stem from a variety of sources—ranging from overuse and poor posture to acute injuries or underlying medical conditions.

Recognizing the root cause is crucial for effective treatment and long-term relief. If you experience severe pain, numbness, or tingling in your shoulder or arm, it’s important to seek medical attention promptly, as these symptoms may indicate a more serious problem. In this guide, we’ll explore the most common causes of shoulder pain and provide strategies to help you manage and overcome discomfort.

Understanding Shoulder Anatomy

The shoulder joint, or glenohumeral joint, is a remarkable ball-and-socket joint formed by three bones: the upper arm bone (humerus), the shoulder blade (scapula), and the collarbone (clavicle). This unique structure allows for a wide range of motion, making it possible to reach, lift, and rotate your arm in almost any direction. Surrounding the joint are layers of soft tissues—muscles, tendons, and ligaments—that provide stability and support. The rotator cuff, a group of four muscles and their tendons, is especially important for keeping the upper arm bone securely in the shoulder socket and enabling smooth, controlled movement.

However, the very flexibility that makes the shoulder so functional also makes it prone to problems. Overuse injuries, poor posture, and wear-and-tear arthritis can place excessive strain on the surrounding muscles and soft tissues, leading to pain and limited mobility. Conditions like frozen shoulder, bulging or ruptured discs in the neck, and even heart attacks can also cause pain that radiates to the shoulder area. Understanding how the three bones, the rotator cuff, and the supporting structures work together is key to identifying the source of your pain and developing an effective treatment plan. By appreciating the complexity of the shoulder joint, you’ll be better equipped to protect it, maintain good posture, and restore a healthy range of motion.

Pain in the Back of the Shoulder

It is often linked to musculoskeletal issues like muscle strain, rotator cuff irritation, frozen shoulder, or acute injury. It can also arise from spinal problems or even internal conditions that “refer” pain to the area. The sensation may be sharp, dull, burning, or radiating—and knowing the difference helps narrow down the cause.

Localized pain in the back of the shoulder may indicate specific shoulder problems that require targeted evaluation, especially if the pain worsens over time or interferes with daily activities.

Shoulder Blade Discomfort

Pain in the back of the shoulder is often felt around or under the shoulder blade (scapula). This is because the shoulder blade serves as a foundation for many muscles that stabilize and move the shoulder joint. Inflammation of the bursa, a fluid-filled sac that cushions the joint, can also cause pain and restrict shoulder motion in this area. When the joint is stiff or dysfunctional, the scapular muscles overcompensate, leading to tightness and soreness.

Relieve Shoulder Blade Pain

As a PT, I often prescribe gentle, posture-friendly exercises to relieve shoulder blade pain:

Shoulder blade squeezes: Sit tall, pull your shoulder blades back and down, hold for 5 seconds, and relax.
Wall angels: With your back against a wall, slowly raise and lower your arms like making a snow angel.
Child’s pose stretch: Kneel on the floor, reach arms forward, and let the upper back open up.
Heat or warm shower: Loosens tight muscles and makes stretching more effective.

These simple movements, done consistently, can help reduce strain and restore balance in the upper back.

Referred Pain

Not all shoulder pain originates in the shoulder. This phenomenon is called referred pain, which refers to pain felt in the shoulder that actually originates from another structure or area. For example, issues in the neck, spine, or even internal organs can radiate into the back of the shoulder. Distinguishing called referred pain from local shoulder dysfunction is critical in developing the right treatment plan.

Frozen Shoulder

Frozen shoulder (adhesive capsulitis) is one of the most restrictive conditions I see. It occurs when the capsule around the shoulder joint thickens and tightens, causing stiffness and limited range of motion. Patients often describe difficulty lifting the arm overhead, fastening a bra, or reaching into a back pocket.

Stages of frozen shoulder:

Freezing: Painful and gradually stiffening (6 weeks–9 months).
Frozen: Less pain, but severe restriction (4–6 months).
Thawing: Motion slowly returns (6 months–2 years).

Physical therapy focuses on gentle mobility exercises, joint mobilizations, and progressive stretching to shorten recovery time and reduce pain in the back of shoulder.

Poor Posture

Posture plays a huge role in shoulder health. Hours of sitting slouched, leaning forward at a desk, or scrolling on a phone contribute to poor posture, which strains the muscles around the back of the shoulder. Over time, this creates imbalances and chronic pain.

PT tip: Strengthening the upper back and core, while stretching the chest, can dramatically improve posture and relieve shoulder blade pain. Make it a habit to practice good posture as part of your daily routine to prevent back and shoulder pain. Small habits—like keeping screens at eye level and using a supportive chair—go a long way.

When Shoulder Pain Could Be a Heart Attack

While most pain in the back of the shoulder is musculoskeletal, sometimes it can be a warning sign of something more serious. Heart attacks can cause pain that radiates into the left shoulder, jaw, or arm. If you notice sudden shoulder pain along with chest pressure, shortness of breath, nausea, or dizziness, seek prompt medical attention immediately. It’s always better to be cautious.

Cervical Herniated Disc

The neck (cervical spine) can be a hidden culprit for back-of-shoulder pain. A cervical herniated disc is a type of bulging or ruptured disc, where the cushioning discs between the vertebrae bulge or rupture, pressing on nearby nerves. This can cause radiating pain that spreads from the neck into the shoulder blade, arm, or even fingers. Symptoms often include tingling, numbness, or weakness.

Physical therapy treatments may include posture training, traction, nerve glides, and gentle strengthening exercises to reduce pressure and improve stability.

Causes of Shoulder Pain

Pain in the back of shoulder can come from many sources. Common causes include:

Frozen shoulder
Rotator cuff strain or tear
Rotator cuff tendon injury
Cervical herniated disc
Compression fracture
Dislocated rib
Shoulder dislocations
Poor posture
Referred pain from internal organs (like the heart)

Because the shoulder is a complex joint, pinpointing the exact shoulder condition often requires a detailed evaluation from a PT or physician.

Compression Fracture

A compression fracture in the spine—often due to osteoporosis—can cause back and shoulder pain. When a vertebra collapses, it alters spinal alignment and strains nearby muscles, sometimes felt as pain in the back of the shoulder. Medical imaging and consultation are necessary here, as treatment may involve bracing or medical management in addition to physical therapy.

Dislocated Rib

A dislocated rib can mimic shoulder blade pain. When a rib slips out of alignment, it can affect the rib cage and surrounding muscles, irritating nerves and creating sharp pain with deep breaths, lifting, or twisting. Manual therapy, breathing exercises, and gentle mobilization are common PT strategies to restore rib alignment and reduce pain.

The Role of Physical Therapy

As a PT, I view physical therapy as the cornerstone of recovery for shoulder pain, especially when dealing with pain in the back of the shoulder. Physical therapy is a key component of pain management for shoulder issues, providing specialized interventions to reduce pain and improve quality of life. While rest or medication may provide temporary relief, PT targets the underlying causes—whether that’s stiff joints, weak muscles, poor posture, or nerve irritation. The goal is not only to reduce pain but also to restore strength, range of motion, and confidence in your daily movements.

Depending on the cause, treatment may include:

Gentle stretching: Movements such as pendulum swings, towel stretches, wall climbs, and cross-body reaches help restore mobility gradually. We start slowly, working within your comfort zone, and progressively expand your range as the shoulder adapts.
Strengthening: Building strength in the rotator cuff, scapular stabilizers, and postural muscles provides the foundation for healthy shoulder mechanics. This often includes resistance band exercises, light weights, and bodyweight drills that retrain your shoulder to function smoothly and safely.
Postural training: Poor posture is one of the most common contributors to pain in the back of shoulder. As PTs, we focus on postural awareness, ergonomic corrections, and exercises to open the chest and strengthen the upper back. This improves alignment and reduces unnecessary strain on your shoulders.
Manual therapy: Hands-on techniques like joint mobilization, soft tissue release, myofascial release, and gentle stretching can help relieve stiffness, improve circulation, and restore normal joint mechanics. Many patients notice immediate relief and improved mobility after these sessions.
Modalities: Depending on your needs, we may use heat, ultrasound, cold therapy, or electrical stimulation. These tools don’t fix the root cause but create the right environment for healing by calming inflammation and easing discomfort.

What makes PT unique is personalization. No two patients experience pain in the back of the shoulder in the same way.

Prompt Medical Attention

There are situations where shoulder pain requires urgent care:

Sudden severe pain after an accident (possible fracture or dislocation)
Numbness, tingling, or weakness spreading into the arm or hand
Shoulder pain with chest pain, dizziness, or difficulty breathing (possible heart attack)

Never ignore these red flags, and seek treatment from a healthcare professional immediately if you experience any of them.

Herniated Disc vs. Frozen Shoulder

It’s easy to confuse herniated disc pain with frozen shoulder. Here’s a quick breakdown:

Frozen shoulder: Dull ache, stiffness, loss of range in all directions.
Herniated disc: Sharp, shooting pain, sometimes described as stabbing pain due to nerve involvement, often worsens with neck movement, sometimes with numbness.

A PT assessment can determine the root cause and guide you toward the right care.

Final Thoughts

Pain in the back of shoulder can be overwhelming, but it’s treatable with the right combination of self-care, physical therapy, and lifestyle changes. Whether your pain stems from frozen shoulder, posture, a disc issue, or even something more serious, understanding the source is the first step toward relief.

With time, patience, and consistent effort, most people regain mobility and return to pain-free living. Don’t ignore your symptoms—get evaluated, start treatment, and take control of your recovery.

Take the Next Step with Pelvis NYC

If you’re dealing with persistent pain in the back of the shoulder, don’t wait. At Pelvis NYC, our expert physical therapists provide personalized, hands-on care to address the root cause of your pain. From posture training to targeted exercises, we’ll help you move better and feel better.

👉 Book your appointment with Pelvis NYC today and start your journey to recovery.

How to Relieve Frozen Shoulder Pain | Self-Care & Physical Therapy in NYC

Suppose you’re struggling with frozen shoulder (also called adhesive capsulitis). In that case, you know how frustrating it can be when simple tasks like reaching overhead, putting on a jacket, or sleeping comfortably become nearly impossible. As a physical therapist, I often hear patients ask: “Is there anything I can do at home for frozen shoulder self-care?”

The shoulder is a ball-and-socket joint, where the upper arm bone (humerus) fits into the shoulder socket (glenoid cavity). This structure allows for a wide range of motion, but also makes the shoulder susceptible to conditions like frozen shoulder.

The good news: Yes. With the right combination of frozen shoulder treatment, shoulder exercises, and self-care strategies, you can gradually restore movement, reduce stiffness, and find pain relief.

This guide covers everything you need to know about frozen shoulder self-care—from recognizing symptoms to managing risk factors and integrating PT-based solutions.

What is Frozen Shoulder (Adhesive Capsulitis)?

Frozen shoulder happens when the capsule surrounding your shoulder joint thickens and tightens, limiting motion. This condition occurs when the shoulder capsule becomes inflamed and adhesions form, leading to restricted motion. The exact cause of frozen shoulder remains unknown, though certain risk factors increase susceptibility. This leads to pain, stiffness, and difficulty moving your arm.

It typically develops slowly and goes through three stages:

Freezing stage – Increasing shoulder pain and limited motion.
Frozen stage – Frozen shoulder occurs as the capsule thickens and synovial fluid decreases, resulting in pain and stiffness. Pain may lessen, but stiffness peaks.
Thawing stage – Mobility gradually returns.

Pain and stiffness are hallmark symptoms, and restricted motion and loss of the shoulder’s range are key features. Reduced synovial fluid in the joint contributes to shoulder stiffness and limited shoulder movement.

You might be interested in reading Pain in the Back of Shoulder Explained!

Frozen Shoulder Symptoms

Common symptoms of frozen shoulder include:

Persistent shoulder pain, especially at night
Pain that can radiate from the shoulder to the upper arm
Stiffness that makes everyday tasks hard
Limited range of motion in all directions
Difficulty lifting, reaching, or rotating the arm

Frozen shoulder affects about 2-5% of the general population, most commonly adults between 40 and 60 years old.

If you notice these signs, especially combined with risk factors, you may be starting to develop frozen shoulder.

Risk Factors for Frozen Shoulder

Not everyone gets adhesive capsulitis, but some people are more at risk. Key risk factors include:

Age (most common between 40–60 years old)
Diabetes or thyroid conditions
Shoulder immobilization (from injury, fracture, or surgery)
Previous rotator cuff injury
Sedentary lifestyle or lack of mobility

Frozen Shoulder Treatment: The Role of Physical Therapy

While frozen shoulder can sometimes resolve on its own, physical therapy treatment helps speed recovery and prevent long-term stiffness. The primary goals of treatment are to restore motion and reduce pain. As a PT, I typically use:

Manual therapy to mobilize the joint capsule, helping regain motion and improve shoulder movement
Shoulder exercises for flexibility and strengthening, which also help regain motion and improve shoulder movement
Heat or ice therapy for pain relief
Education on posture, movement, and self-care at home

Simple treatments like heat, ice, and gentle stretching are often effective for most patients. Symptoms may slowly improve over time, and full recovery can take several months to years, depending on the individual.

Combining in-clinic treatment with a structured self-care routine offers the best results.

Shoulder Treatment Options Beyond Physical Therapy

While physical therapy is often the cornerstone of frozen shoulder treatment, there are additional options available for those who need further relief or whose symptoms persist. One commonly used intervention is a steroid injection into the shoulder joint. This can help decrease pain and inflammation, making it easier to participate in a range of motion exercises and daily activities. Steroid injections are especially helpful during the early, painful stages of adhesive capsulitis.

For some patients, if physical therapy and injections do not provide enough improvement, a procedure called manipulation under anesthesia may be considered. During this treatment, a healthcare provider gently moves the affected shoulder through its full range of motion while the patient is under anesthesia, helping to break up tight portions of the shoulder capsule and improve mobility.

In rare cases where severe stiffness and pain remain despite other treatments, arthroscopic surgery may be recommended. This minimally invasive procedure involves making small incisions in the shoulder and using a camera to guide the release of the tight shoulder capsule and removal of any scar tissue that may be restricting movement. Surgery is typically reserved for those with persistent frozen shoulder symptoms that do not respond to less invasive treatments.

It’s important to discuss all available shoulder treatment options with your healthcare provider. Together, you can determine the best approach to decrease pain, restore range of motion, and help you return to your normal activities.

Frozen Shoulder Self-Care: What You Can Do at Home

Here’s how you can actively participate in your recovery:

Some people find that with consistent self-care, such as gentle stretching and following recommended exercises, pain and mobility may begin to improve within six weeks, although full recovery can take longer.

Additionally, some individuals consider dietary supplements to support joint health, but it is important to consult your healthcare provider before starting any new supplement.

1. Gentle Shoulder Exercises

Safe, consistent motion prevents worsening stiffness. Try these PT-approved frozen shoulder exercises:

Pendulum swings – Let your arm hang and make small circles.
Towel stretch – Hold a towel behind your back and gently pull upward.
Wall walks – Use your fingers to climb a wall, gradually lifting your arm higher.

Once your range of motion improves, adding strengthening exercises can help support your shoulder and prevent future problems.

2. Heat Before Stretching

Apply heat for 10–15 minutes before exercises to relax tight tissues and ease pain. Taking a warm shower before stretching can also help relax the shoulder muscles and prepare them for exercise.

3. Ice After Activity

If your shoulder feels sore, use ice to calm irritation.

4. Maintain Good Posture

Avoid slouching or guarding your arm too much—gentle movement throughout the day supports recovery.

The Rotator Cuff and Frozen Shoulder

Although adhesive capsulitis mainly affects the joint capsule, your rotator cuff muscles often weaken from lack of use. Rotator cuff tears are another common shoulder problem, and sometimes imaging tests like MRI are needed to distinguish between a rotator cuff tear and frozen shoulder. Strengthening these muscles is a key part of long-term shoulder treatment and preventing re-injury.

Pain Relief Tips for Frozen Shoulder

In addition to self-care exercises and therapy, patients often find relief with:

Over-the-counter anti-inflammatory medication (if cleared by your doctor)
Gentle stretching routines
Prioritizing sleep positions that reduce pressure on the affected shoulder

If pain persists or the diagnosis is unclear, a healthcare provider may recommend a physical exam and imaging tests, such as X-rays or MRI, to rule out other causes of shoulder pain. A thorough physical examination is important to assess shoulder mobility and identify the underlying problem.

Preventing Future Episodes of Frozen Shoulder

Once you’ve recovered from frozen shoulder, taking steps to prevent it from returning is essential for long-term shoulder health. Regular shoulder exercises that maintain flexibility and strength in the shoulder joint are key to preserving your range of motion and reducing the risk of developing frozen shoulder again. Working with a physical therapist can help you learn the right exercises and stretches tailored to your needs.

Managing underlying risk factors is also crucial. Conditions like diabetes, thyroid disease, and heart disease can increase your chances of developing adhesive capsulitis, so keeping these medical problems under control with the help of your healthcare provider is important. Maintaining a healthy weight, eating a balanced diet, and avoiding smoking all contribute to better joint health.

If you’ve had a recent shoulder injury or surgery, early movement and gentle rehabilitation exercises can help prevent the shoulder capsule from tightening. Don’t wait for stiffness to set in—consult a physical therapist soon after any shoulder issue to get personalized guidance on safe, effective exercises.

By staying proactive with your shoulder care, you can help ensure your shoulders remain healthy, mobile, and pain-free for years to come.

Final Thoughts on Frozen Shoulder Self-Care

Recovering from frozen shoulder takes patience—but with the right plan, you don’t have to live in pain. A mix of physical therapy treatment and frozen shoulder self-care strategies can help restore movement, reduce stiffness, and give you back your daily function.

If you’re struggling with shoulder pain or think you may have adhesive capsulitis, consider visiting a physical therapist. Together, we can create a plan for pain relief, mobility, and long-term shoulder health.

Take the Next Step with Pelvis NYC

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FAQs

1. Can frozen shoulder heal on its own?
Yes, but recovery can take months to years. Physical therapy treatment and self-care exercises can significantly speed up healing.

2. What is the fastest way to relieve frozen shoulder pain?
Gentle shoulder exercises, heat before stretching, and ice afterward can provide immediate pain relief.

3. Is frozen shoulder the same as a rotator cuff injury?
No. Frozen shoulder involves the joint capsule tightening, while rotator cuff injuries affect the shoulder muscles and tendons. However, the two can overlap.

4. When should I see a physical therapist for frozen shoulder?
If shoulder pain or stiffness lasts more than a few weeks, see a PT. Early treatment prevents long-term disability.

I Can’t Get Rock Hard Anymore: Guide to Erectile Dysfunction and Proven ED Treatments

If you have ever thought to yourself, “I can’t get rock hard anymore,” you are not alone. Many men experience this problem at some point in their lives, and the medical term for it is erectile dysfunction or ED.

In fact, most men will experience erectile issues at some point, making it a common and manageable condition.

What Is Erectile Dysfunction and Why I Can’t Get Rock Hard Anymore

Erectile dysfunction means having trouble getting or keeping a firm enough erection for sexual intercourse. It can happen occasionally, but when it becomes frequent, it is usually a sign of an underlying issue.

An erection depends on a smooth connection between the brain, hormones, blood vessels, nerves, and emotions. If even one part of this system is not working properly, the result can be erection problems.

Causes of Erectile Dysfunction: From Physical Causes to Psychological Treatments

Physical causes of ED

Heart disease and cardiovascular disease problems reduce blood flow to the penis, making them major risk factors for ED.
Abnormal blood sugar levels, as seen in diabetes, can damage blood vessels and nerves, contributing to erectile dysfunction.
Diabetes, obesity, and high blood pressure put strain on blood vessels and are common medical conditions linked to ED.
Physical factors such as injuries or surgeries can affect sexual function.
Physical problems like hormonal imbalances or chronic illnesses can also lead to ED.
Low testosterone and neurological conditions, including damage to the spinal cord or spinal cord injury, can disrupt nerve signals necessary for erections.
Certain medications including antidepressants, blood pressure drugs, and antihistamines, may cause ED as a side effect.
ED can be a symptom of an underlying medical condition, so identifying and addressing these medical conditions is important for effective treatment.
Testosterone replacement may be considered for men with low testosterone levels, but it is most effective when hormone deficiency is present.

Psychological causes of ED

Mental health conditions such as anxiety and depression can interfere with sexual function and contribute to erection problems.
Relationship problems, including poor communication and unresolved conflicts, can negatively impact sexual performance and overall intimacy.
Low sex drive or reduced sexual desire often accompanies erectile dysfunction, especially when psychological factors or hormonal imbalances are involved.
Sexual problems can include both erectile dysfunction and issues like premature ejaculation, and these conditions may overlap.
Cognitive behavioural therapy and other psychological treatments are effective in addressing these mental health factors.

Lifestyle Changes That Improve Erections and Cardiovascular Health

Healthy living makes a real difference for ED treatment. Doctors often recommend lifestyle changes before or alongside medication. Lifestyle changes are often recommended to treat erectile dysfunction, and treating erectile dysfunction may involve a combination of these strategies. These include:

Eating a balanced diet that supports cardiovascular health
Exercising at least 30 minutes most days of the week
Quitting smoking and limiting alcohol
Getting enough quality sleep
Reducing stress through mindfulness, meditation, or therapy

These steps improve circulation, lower blood pressure, and enhance energy levels which all support stronger erections.

How Certain Medications and Treatments Can Help You Get Hard Again

When lifestyle changes are not enough, medical support is available.

Oral ED treatments like Viagra, Cialis, Levitra, or Stendra improve blood flow and make it easier to get an erection with sexual stimulation
Other medications may be used to manage ED, especially when first-line treatments are not suitable or effective, and should be considered with attention to possible interactions and safety.
Vacuum erection devices and penile injections provide alternatives when pills are not effective
Penile implant is a permanent surgical option for men who have not responded to other therapies; it involves placing a device inside the penis to allow for an erection.
Other treatments such as psychological therapies, including cognitive behavioural therapy, sex therapy, or psychosexual counselling, can help address underlying psychological or emotional issues contributing to ED.
Sex therapy is a psychological treatment option that can help men and couples address relationship or emotional factors affecting erectile function, often involving techniques like sensate focus and support from qualified therapists.

When to Seek Medical Advice for Erectile Dysfunction

Erectile dysfunction can feel frustrating and even distressing, but you do not have to face it alone. Occasional erection problems happen to many men, but persistent difficulty getting or maintaining an erection means it is time to seek medical advice. A healthcare professional can identify the underlying causes of erectile dysfunction and guide you to the most effective treatment options. Interested in reading – Are Guys Embarrassed When They Can’t Get It Up?

Reach out to a doctor if you suddenly develop erectile dysfunction or if ongoing erection problems disrupt your sex life or relationship. Erectile dysfunction often signals a more serious health condition such as high blood pressure, heart disease, diabetes, kidney disease, or multiple sclerosis. When you address these health problems early, you improve your sexual performance and protect your overall health.

Talk to your healthcare provider if you take certain medications such as beta blockers or other blood pressure drugs, or if you use recreational drugs. These substances affect blood flow and sexual function, and your doctor can help you weigh the risks and explore safer alternatives.

During your visit, your doctor will review your medical history, ask about your sexual activity, and evaluate both physical and psychological factors that contribute to erectile dysfunction. They may recommend erectile dysfunction medications or suggest psychological treatments like cognitive behavioural therapy if emotional issues play a role. In many cases, you can improve blood flow, strengthen cardiovascular health, and enhance your erections by making lifestyle changes such as eating a balanced diet, exercising regularly, and maintaining a healthy weight.

Erectile dysfunction is common and has many possible causes. By seeking medical advice, you take a proactive step toward improving your sexual health, building confidence, and enjoying a more satisfying sex life. Do not wait to reach out. Help is available, and effective treatments can restore your performance and quality of life.

Frequently Asked Questions About Erectile Dysfunction

Can erectile dysfunction be cured naturally?

For some men ED improves naturally through lifestyle changes such as better diet, exercise, and stress reduction. The outcome depends on the underlying cause.

At what age do erection problems usually start

Erectile dysfunction can affect men at any age but it becomes more common after age forty. Research shows that about half of men over fifty experience some degree of ED.

Is heart disease linked to erectile dysfunction?

Yes. Heart disease and other cardiovascular health problems reduce blood flow to the penis which often leads to ED. In fact, erectile dysfunction can be an early warning sign of hidden heart issues.

Can anxiety or stress cause ED?

Absolutely. Mental stress triggers adrenaline which restricts blood flow and prevents an erection. Psychological treatments such as therapy or counselling can be very effective.

What is the best ED treatment available?

The best treatment depends on the cause of erectile dysfunction. Many men respond well to oral medication. Others find that lifestyle changes, therapy, or a combination of treatments is most effective.

Key Takeaway

Thinking “I can’t get rock hard anymore” can feel discouraging, but it does not mean the end of your sex life. Erectile dysfunction is common; it is not your fault, and most importantly it can be treated. By making lifestyle changes, understanding the causes of erectile dysfunction, and exploring the right ED treatments, you can restore confidence and enjoy intimacy again.

Take the Next Step

If you are ready to address erectile dysfunction and take control of your sexual health, the team at Pelvis NYC is here to help. Our specialists focus on personalised care for men dealing with erection problems, cardiovascular health issues, and related conditions.

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Prostatectomy Pain: What You Should Know About Recovery

If you’re preparing for a prostatectomy or have just had one, you’re probably wondering: “How much pain will I feel—and how long will it last?” That’s a very normal question. A prostatectomy, often used to treat prostate cancer, is a common surgery that can be life-saving. But like any major operation, it comes with its own recovery process.

The good news is this: while prostatectomy pain is part of healing, most men find it gets better more quickly than they expect. Let’s walk through what recovery usually looks like, what side effects are common, and how tools like physical therapy can help you get back on your feet.

Why Prostate Surgery Happens

Doctors most often perform prostate surgery to treat prostate cancer. The procedure removes the prostate gland, and when caught early, it can be very effective. Certain risk factors, such as underlying health conditions like diabetes or autoimmune diseases, may influence the decision to proceed with surgery or additional treatments. In some cases, doctors may also add treatments like hormone therapy or radiation to ensure they address all cancer cells. If there are remaining cancer cells or complications after surgery, further treatment such as radiotherapy or hormone therapy may be necessary to achieve complete eradication of the disease.

While surgery is an important step in treatment, it can also bring short-term challenges such as pain, urinary leakage, and changes in sexual function.

Types of Prostate Surgery

Prostatectomy as a Surgical Procedure – Prostatectomy is a surgical procedure to remove the prostate gland, and there are several possible approaches, each with its own advantages and considerations.
Open Radical Prostatectomy – This traditional approach involves a single larger incision in the lower abdomen to access and remove the prostate. Open radical prostatectomy is often compared to minimally invasive techniques, with differences in recovery time, pain, and potential complications.
Radical Retropubic Prostatectomy – A type of open surgery performed through an incision in the lower abdomen, allowing direct access to the prostate. This surgical procedure is commonly used and enables the surgeon to remove nearby lymph nodes if necessary.
Laparoscopic Surgery – Laparoscopic surgery is a minimally invasive technique that uses small incisions, a laparoscope (a thin tube with a camera), and specialized instruments to perform procedures such as prostatectomy.
Laparoscopic Radical Prostatectomy – This minimally invasive approach uses laparoscopic surgery to remove the prostate. Laparoscopic radical prostatectomy is less invasive than open surgery and is often compared to robotic radical prostatectomy.
Robotic Radical Prostatectomy – A form of minimally invasive surgery where the surgeon uses robotic assistance to perform the procedure with enhanced precision. Robotic radical prostatectomy may offer benefits such as reduced blood loss, less pain, and faster recovery compared to traditional methods.
Laparoscopic/Robotic Prostatectomy – A minimally invasive approach with small abdominal incisions. Usually comes with less lower abdominal pain and a quicker recovery.
Radical Perineal Prostatectomy – Done through an incision between the scrotum and anus. Effective in some cases but can cause more localized discomfort.

What Pain Feels Like

Most men describe prostatectomy pain as:

A sore or pulling feeling in the lower abdomen
Discomfort when sitting, moving, or standing
Irritation or bladder spasms while the urinary catheter is in place or when it’s removed, often due to the presence of the catheter itself
Some trouble with bowel movements in the first week or two

After surgery, the urinary catheter acts as a urine drain, carrying urine from the bladder while the area heals.

Post-Operative Care

After prostate cancer surgery, such as a radical prostatectomy, following a thorough post-operative care plan is crucial for a safe and effective recovery. Your care team will provide specific instructions tailored to your needs, but there are some general guidelines that most patients should keep in mind.

First, take care of your surgical incisions by keeping the area clean and dry. Watch for signs of infection, such as redness, swelling, or unusual discharge, and let your doctor know if you notice anything concerning. Avoid soaking in baths or swimming pools until your healthcare provider says it’s safe.

Activity restrictions are common after surgery. While gentle movement, like short walks, helps prevent blood clots and supports healing, you should avoid heavy lifting, strenuous exercise, or sudden movements for several weeks. Listen to your body and gradually increase your activity level as you feel stronger.

Managing pain is another important part of post-operative care. Take pain medications as prescribed, and don’t hesitate to reach out to your care team if you experience severe pain or discomfort that isn’t improving. Staying ahead of pain can help you move more comfortably and recover faster.

Regular follow-up appointments are essential after prostate cancer treatment. Your doctor will monitor your progress, check your PSA blood test results, and watch for any signs of complications or remaining cancer cells. These visits are also a good time to discuss any concerns about urinary control, sexual function, or emotional well-being.

Finally, don’t underestimate the value of support—whether from family, friends, or professional counselors. Recovering from prostate cancer surgery is a journey, and having a strong support system can make a big difference in your overall well-being.

By following your post-operative care plan and staying in close contact with your healthcare team, you’ll give yourself the best chance for a smooth recovery and a return to normal life.

The First Few Weeks of Recovery

Recovery looks different for everyone, but common experiences in the first few weeks after surgery include:

Urinary leakage, especially when coughing or sneezing
Fatigue and a slower pace than usual
Mild abdominal swelling or tenderness
Some discomfort when going to the bathroom

During this time, a catheter is placed to help the bladder heal, and it is connected to a drainage system that includes a leg bag for daytime use and a night bag for overnight urine collection. The leg bag is worn discreetly under clothing and should be emptied regularly, while the night bag is larger and designed for use while sleeping. Proper care of both bags is important to prevent infection and ensure effective drainage.

The catheter is usually removed within 1–2 weeks. When the catheter is removed, you may feel a brief sensation, and it is common to experience some urine leakage or frequent urination as your bladder and pelvic muscles adjust. The process of having the catheter removed is straightforward, and your care team will provide instructions for post-removal care.

Frequent urination is also common in the initial weeks after surgery as the bladder’s capacity and control improve. Temporary weight gain may occur due to fluid shifts after surgery, but this usually resolves within about a week. Gentle activity—like short walks—is important to keep blood moving and prevent blood clots (DVT).

Catheter Removal and Urinary Leakage

When the catheter comes out, it’s common to have difficulty controlling urine flow. This happens because your pelvic floor muscles need time to regain strength. The sphincter muscles, especially the external sphincter, play a crucial role in maintaining urinary control, and strengthening these muscles is important for preventing leakage.

Urinary incontinence is a common complication after catheter removal, which can affect physical comfort, emotional well-being, and social activities. Your care team may suggest pelvic floor exercises (like Kegels), supportive underwear, or absorbent pads for peace of mind. Recovery is gradual, but with consistency, most men see big improvements over time.

How Physical Therapy Helps Prostatectomy Pain

One of the most powerful tools for recovery is pelvic floor physical therapy. After surgery, the muscles supporting your bladder and pelvic region—including those around the pubic bone, a key anatomical landmark—may be weak, leading to pain and leakage.

A pelvic floor therapist can guide you through targeted exercises that:

Strengthen bladder-control muscles
Reduce leakage when coughing or lifting
Easelower abdominal soreness
Support healthy bowel movements
Help restore sexual function by improving blood flow and nerve response (note: removal of the seminal vesicles during surgery can affect ejaculation and orgasm sensations)

Think of it as rehab for your pelvic region. Just like athletes train to recover after injury, you can retrain your body to heal more comfortably.

👉 For expert care, Pelvis NYC offers specialized pelvic health therapy for men, helping patients manage pain, regain bladder control, and return to normal life with confidence.

Bowel Movements and Bathroom Issues

Having a regular bowel movement is an important part of recovery after surgery and can help prevent complications such as constipation or diarrhea. Constipation and discomfort with bowel movements are common after surgery, especially with pain medication. Staying hydrated, eating fiber-rich foods, and using stool softeners (if your doctor recommends them) can make things easier.

Potential Complications

Most recoveries go smoothly, but possible complications include:

Blood clots such as deep vein thrombosis (DVT) if mobility is limited; prevention includes early movement, compression stockings, and medication to reduce the increased risk of clots.
Urinary tract infection is a common concern while the urinary tract heals, especially with catheter use, and there is an increased risk of infection after surgery. If symptoms arise, a urine culture may be performed to diagnose the infection and guide treatment.
Lymph fluid buildup causing swelling, which can occur after removal of lymph nodes or a lymph node during surgery, sometimes leading to fluid pooling in the patient’s abdomen.

In severe cases, complications like infection or fluid buildup in the patient’s abdomen may require specialized intervention.

Follow your doctor’s instructions closely, take medications as prescribed, and contact your provider if you notice unusual pain, infection signs, or trouble with erections.

Sometimes, radiation may also be recommended after surgery to lower the risk of cancer returning. Radiation induced complications, such as cystitis or tissue changes, can also occur and may require specific management.

Returning to Sexual Activity

Intimacy is a major concern for many men after prostate surgery. Nerve damage during the procedure can affect erections, making them weaker at first. Recovery can take months, but many men improve with medications, devices, or therapies designed to support sexual function. However, certain medications may not be suitable for men with a history of heart disease, so patients should discuss these options with their doctor. Patience and open communication with your partner and doctor are key.

Long-Term Pain and Support

While most men feel significantly better after a few weeks, some experience ongoing prostatectomy pain from scar tissue or nerve irritation. If that happens, your doctor can recommend treatments to help. In severe cases, further treatment such as additional therapies or interventions may be necessary to manage persistent pain or complications.

Regular follow-up care is also essential. Expect PSA blood tests and routine check-ins to monitor recovery. If urinary leakage, erectile dysfunction, or emotional stress continue, support through physical therapy or counseling can make a big difference.

Final Thoughts on Prostatectomy Pain: Healing Takes Time

Recovering from prostate surgery is as much about patience as it is about physical healing. There will be ups and downs, but with time, most men regain control, reduce pain, and return to the activities that matter most.

👉 Here’s the bottom line:

Prostatectomy pain is normal but usually improves quickly.
The first few weeks are the toughest.
Physical therapy speeds recovery and helps with leakage and intimacy.
With the right care, most men return to normal life—including sexual activity.