Constipation and bowel dysfunction in men: pelvic floor physical therapy in NYC
Straining for a long time. Feeling like you haven’t emptied. Pain during or after a bowel movement. If your doctor has ruled out other causes, the muscles of your pelvic floor may not be relaxing when they should.
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?
- Straining, even when your stool is soft
- Feeling like you haven’t fully emptied
- Needing to change position or press near the anus to go
- Pain during or after a bowel movement
- Not knowing when you need to go
- Rectal pain or pressure, like sitting on a ball
- Leaking stool, or a sudden urge you can’t hold
How the pelvic floor affects bowel movements
To have a bowel movement, the pelvic floor muscles need to relax and open while your abdomen gently pushes. With dyssynergia, the muscles do the opposite: they tighten when they should let go. It’s a coordination problem, not a weakness, and coordination can be retrained.
Pelvic floor tension can also cause pain with bowel movements and ongoing rectal pain.
When to see a doctor first
See your doctor first if you have blood in your stool, black stools, unexplained weight loss, a sudden change in bowel habits, severe abdominal pain, or a family history of colon cancer. Physical therapy is not a substitute for that evaluation.
Biofeedback, hands-on
Biofeedback means getting real-time feedback on what your pelvic floor is doing, so you can learn to relax and coordinate it. We do it hands-on, without a machine: your therapist works with you, almost like a trainer for your pelvic floor muscles. Many patients come to us with a doctor’s referral for exactly this.
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 biofeedback to retrain how your pelvic floor relaxes and coordinates
- Hands-on release of tight pelvic floor muscles, internally and externally
- Toilet position and breathing techniques
- Bowel habit guidance, including timing, fluids and fiber, alongside your doctor’s advice
- Abdominal and breathing work
- 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
It can, when the pelvic floor is part of the cause. If your muscles tighten instead of relaxing when you try to go, that coordination can be retrained. Your doctor should rule out other causes first.
Dyssynergia means the muscles that should relax during a bowel movement tighten instead. It’s one of the most common reasons for straining and feeling like you haven’t emptied, and it’s a pattern we can retrain.
No. We do biofeedback hands-on, so you get feedback in real time from your therapist and learn what the right pattern feels like.
Tight pelvic floor muscles can make bowel movements painful. Conditions like fissures and hemorrhoids are treated by your doctor; we address the muscle side, which often plays a part.
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: bowel symptoms
Rectal pain and pressure
Ongoing rectal pain or pressure, sometimes described as sitting on a golf ball, often involves pelvic floor muscle tension, even when exams are normal.
Why straining makes it worse
Pushing hard tightens the very muscles that need to relax. Over time, straining can become a habit that keeps the problem going.
Toilet posture
Raising your feet on a small stool and leaning forward changes the angle of the rectum and can make it easier for the muscles to let go.
Related reading: male pelvic pain. 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.