Testicular and post-vasectomy pain: pelvic floor physical therapy in NYC
An ache in one or both testicles. Pain that spreads to the groin, inner thigh or lower belly. Pain that started after a vasectomy and never fully settled. If your ultrasound and tests came back normal, the muscles and nerves of your pelvic floor may be part of the problem.
Or call (929) 590-3445. Talk to a clinician first. No referral needed.
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Medically reviewed by Dr. Adam Gvili, PT, DPT, on November 5, 2026
Does this sound familiar?
- A dull ache or sharp pain in one or both testicles
- Pain that spreads to the groin, inner thigh, lower belly or lower back
- Pain that gets worse when you sit, exercise, or after ejaculation
- Pain that started after a vasectomy, hernia repair or other surgery
- A pulling or heavy feeling, with a normal ultrasound
Why the pelvic floor can cause testicular pain
The testicles share nerves with the pelvic floor, the groin and the lower back. The pudendal nerve supplies both the pelvic floor muscles and the back of the scrotum. The genitofemoral and ilioinguinal nerves start in the lower spine and travel through the groin to the front of the scrotum and the cremaster muscle. The cremaster is the muscle that wraps the spermatic cord and lifts the testicle.
When the pelvic floor, hip or abdominal muscles are tight or guarded, or these nerves are irritated along their path, you can feel pain in the testicles even when the testicles themselves are healthy. This is called referred pain.
After a vasectomy, hernia repair or other surgery, the body can start guarding the area. The cremaster and pelvic floor muscles stay contracted, and the surrounding tissue becomes sensitive. That tension can keep pain going long after the tissue has healed.
When to see a doctor first
Sudden, severe testicular pain is an emergency: go to an emergency room right away. Also see your doctor first if you have swelling, a lump, a fever, or blood in your urine or semen. Physical therapy is not a substitute for that evaluation.
Working with your urologist
We work alongside your urologist. If you’ve been told everything looks normal, or that surgery is the next step, a pelvic floor evaluation can show whether muscles and nerves are part of the picture.
How we evaluate it
1. Free 15-minute call. Tell us about your symptoms and what you’ve already tried. We’ll let you know if we’re the right fit.
2. First visit (45 minutes). Your physical therapist will:
- Take a full history of your symptoms, tests and past treatments
- Assess the muscles, nerves and soft tissue involved, including the pelvic floor
- Explain what they found and your plan before you leave
The pelvic floor is a group of muscles that sit inside the pelvis, so the most accurate way to assess and treat them is directly. If it would help, your therapist may suggest an internal exam: one finger, in the rectum, always at your comfort. We explain each step before we do it, check in with you throughout, and you can pause, stop or say no at any time. Most people expect it to be uncomfortable and are surprised by how manageable it is.
What treatment can involve
- Hands-on release of tight pelvic floor, groin and abdominal muscles, internally and externally
- Gentle mobility work for the nerves that run to the testicles and groin
- Retraining your pelvic floor to relax
- Breathing and movement work
- Guidance on sitting, exercise and sex while you recover
- A home program from your first visit, so you can keep progressing on your own
Your team
Dr. Adam Gvili, PT, DPT, Founder. Every visit is 45 minutes, one-on-one, with your own physical therapist.
Dr. Joseph Mendoza, PT, DPTPelvic Floor Physical Therapist
Dr. Sam Vargas, PT, DPTPelvic Floor Physical Therapist
Frequently asked questions
Most men recover from a vasectomy without lasting pain, but some develop ongoing pain afterward. It has several possible causes, and your urologist should evaluate it. When muscles and nerves are part of it, physical therapy may help.
Because the pain may not be coming from the testicle itself. An ultrasound shows the structure of the testicle, but not tight muscles, irritated nerves or small areas of scar tissue. Tight pelvic floor muscles and irritated nerves can send pain to the testicles. After a vasectomy or other surgery, scar tissue and muscle guarding can also keep pain going. That’s what we assess.
Testicular pain is one of the most common symptoms of CPPS, so the two can overlap. If you also have pelvic, penile or urinary symptoms, see our CPPS page.
No. You can book directly. If you’re already seeing a doctor, let us know who they are. We’ll keep them in the loop, because the best care happens when your whole team is working together.
We’re an out-of-network practice. We’ll give you a superbill to submit to your insurance for possible reimbursement. A superbill is a medical receipt with procedure codes that shows your insurer what happened during your session. If your insurance needs supporting documentation, we’ll send it promptly. What you get back depends on your plan.
Going deeper: testicular pain
Pain after hernia repair
Groin surgery can affect the same muscles and nerves. If pain continues after you’ve healed, a pelvic floor and groin assessment can help show why.
Sitting, desk work and cycling
Long periods of sitting put pressure on the area between the scrotum and the anus, where several of these nerves run. Small changes to how and how long you sit can make a difference.
Pain after ejaculation
Your pelvic floor contracts during ejaculation. If it’s already tight, testicular or pelvic pain can flare afterward.
Related reading: chronic prostatitis and CPPS. You can also see all the conditions we treat.
Talk to a clinician first
Start with a free 15-minute call. Tell us what’s going on, and we’ll tell you honestly whether we think we can help.
Or call (929) 590-3445. Talk to a clinician first. No referral needed.