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Treatment of Hard Flaccid Syndrome 

As a physical therapist, I wanted to share my perspective on treating hard flaccid syndrome.


Surprisingly, the emergence of Hard Flaccid Syndrome (HFS) as a clinical diagnosis is still relatively new to many medical professionals. However, as a men’s pelvic health physical therapist, I've treated men with hard flaccid syndrome in the clinic for years.


The vast majority of my patients were left frustrated and concerned when they were unable to get a proper diagnosis from their medical doctor. Often patients are told everything looks “normal” and that there is nothing they can do. If you've had similar experiences and don't know what to do, give me a call.  Physical therapy can be very effective at reducing the clinical manifestations of HFS which often include:


  1. Constant semi-erect/semi-flaccid penis with the patient stuck in limbo between an erect and flaccid penis. 

  2. Pain in the shaft of the penis as well as the pelvic floor area from the base of the penis to sit bones.

  3. Weak, painful, or unable to ejaculate.

  4. Decreased sensation or control of the penis and surrounding pelvic floor muscles.

  5. Pale appearance of the penis shaft and head.

The prevailing thought was that HFS was only caused by excessive masturbation. However, this is often not the case as I have seen several cases that are related to sexual trauma, pelvic floor muscle dysfunction, and athletic injuries.


As the pelvic floor muscles become tight and sensitive they can create a cascade of autonomic symptoms that can influence and dampen sexual arousal and activity.


Treatment of HFS relies on a thorough evaluation from a Men’s Health Physical Therapist who can properly identify the involved musculature. After identifying contributing factors it then becomes rehab just like any area of the body:

  • Decrease muscle guarding/tightness

  • Increase blood flow and awareness of the area

  • Gradually restore function of muscles (control, strength, endurance)

  • Return to being sexually active

Other Men's Pelvic Floor Conditions

Let's face it, most men don't even know they have a pelvic floor.  This lack of awareness is what leads many men down a path of undiagnosed pain management and frustration.

First, what is the pelvic floor?  I like using the NIH pelvic floor definition:

"The “pelvic floor” is the group of muscles that form a sling or hammock across the floor of the pelvis. Together with surrounding tissues, these muscles hold the pelvic organs in place so they can function correctly. The pelvic organs include the bladder, urethra, intestines, and rectum."


Pelvic floor dysfunctions can manifest as a variety of symptoms including testicular pain, penile pain, abdominal pain, urinary incontinence, post-ejaculatory pain, and sexual dysfunction.

At Mayberry Physiotherapy I work with a variety of patients dealing with Peyronie's Disease, Post-Prostatectomy Pain Management, Interstitial Cystitis, misdiagnosed pelvic pain disorders, and Hard Flaccid Syndrome.  

Two Men Fishing
Mens Health:  Pelvic Pain & Urinary Incontinence: Service

Ready to Schedule a Consultation?

My practice serves patients across Anne Arundel County Maryland from Edgewater to Annapolis and Severna Park where my office is located as well as Glen Burnie and Baltimore. If you’re ready now to schedule your physical therapy session the process to select a PT service, date, and time is quick and easy.  Get started by filling out the form below.  

Thank you! 


I've received your consultation request.  I'll reach out before the end of business today or I'll reach out first thing the next morning.


Dr. Nate

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