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originally published: November, 2017

birmingham health physiotherapy
Rescued from Hard Flaccid Syndrome by Men’s Health Physiotherapy

Rescued from Hard Flaccid Syndrome by Men’s Health Physiotherapy

As I already did a google review for Gerard and Lisa at the Birmingham Men’s Physio clinic at the stunning Barefoot yoga studio in Birmingham I am now ready to do a blog that hopefully may save even one man from some of the hell that my wife and I went through. I have included the google review below but I now feel able to talk about my Hard Flaccid Syndrome.


Apart from pelvic pain, pain on ejaculation, premature ejaculation and decreased volume and strength , I had lost my normal jet and was left with a weak dribble. Intimacy with my wife became almost impossible awkward and embarrassing. At 42 I no longer felt like a man or a husband.

Worrying also was the physical changes that had happened to my little friend, it was definitely retracted or smaller, skin looked different, weirdly the pigment or colour changed and at times it looked either bruised or engorged. It was rarely ever completely soft or flaccid but when I had an erection it was never completely hard. Sometimes having a wee was embarrassing as I would almost have to look for it and pull it out. Touching it was very sensitive so I basically stopped although this made things worse as the sensitivity was spreading to my testicles and lower tummy. I was still a young man but I felt I would never make love to my wife again or have my little friend back. I thought things couldn’t get any worse but then noticed I was having to wee about every 30 mins. My work colleagues used to joke that maybe I needed my prostate checked, it was funny for the 1st few times but wore out quickly.

My wife and I saw many great specialists who did lots of urology tests and said everything was fine. The lowest point was having to have a battery of STD tests. My wife and I had been together a long time but going through the sexual medicine testing put a real strain as in the back of our minds there was always a nagging doubt that maybe “ one of us had been unfaithful”. It is only recently we have discussed how bad this made us both feel.

As I was also getting back pain I went and saw a Physio and they asked me about any bladder problems and I said I had some pain down there and went to the loo probably too often. To my absolute amazement they said “ You should see a Men’s Health Physio who might be able to help and the guys in Birmingham are only an hour away “. I went on the website and read all the blogs and although there was lots about pelvic pain there wasn’t much about all the changes I had noticed in my little friend , however a phone call with Gerard and some emails reassured me he sounded like he knew what he was talking about. Was also reassuring that he had another Men’s health physio Lisa and I thought if there are two of them they must at least be seeing lots of other men like me.


My wife and I headed to Birmingham for a Men’s health Physio appointment, we joked but somewhat uncomfortably that our trips away used to be for romance, good food and wine and lots of sex. That almost made me cry.

The Physio clinic was unusual as it when you walked in it was very chilled, calm and relaxed. We got to know some of the yoga studio receptionists or instructors and what great people they were. They had no idea what we were seeing Gerard for but they always tended to say , Gerard, Fiona ( no idea what she did until I saw the website ) and his team are fab and patients seem to travel quite a distance to see them. Since then we have recommended one of my wife’s friends to see Fiona for female pelvic pain. We seem to have become experts on conditions we would rather know nothing about.

After a detailed questioning, the level of detail was quite staggering and something new to my wife and I. All the tricky questions like penis changes, ejaculation, intimacy were handled well and with Gerard and it was obvious he wasn’t doing this for the 1st time. He also spoke to my wife and really put her at ease. He was the 1st person to ask me “ had my penis changed in structure and was it different”.

The physical assessment included looking at my back , abdomen ( which was really sore and sensitive ) looking at my pelvic floor with an Ultrasound unit like in pregnancy and doing an internal pelvic floor assessment. This wasn’t too bad and Gerard was happy for my wife to stay in the room as I was well covered up and he just chatted to her when he was doing it. As before it was obvious he had done this before. All the people before had almost pushed my wife out of the room. This was different. Yet to meet anyone else who can do a pelvic floor assessment and talk to two people at the same time. Made it all a lot less stressful though which I think was his aim.

I had heard of Hard Flaccid before but always wondered if it really existed as I could never find anything on google about it but had seen it mentioned in one forum. Without me mentioning it Gerard thought I had pelvic pain definitely but also Hard flaccid. The way he described it , and I’m not a medical person , is that if there is pain for a long time in the pelvis and nerves get irritated or inflamed ( pudendal & others ) then the tissues those nerves supply can get affected i.e the penis. He said it was a bit like if you had lots of pain in your wrist or hand and never moved it again or did anything with it then the wrist and hand would get more painful, sensitive, change colour and get swollen. This made sense to me.


What did the treatment consist of. I did lots of gentle massage to my abdomen, perineum ( under part) and eventually to my penis and testicles. Eventually the sensitivity went although it got worse initially. I did a lot of reverse kegels or pelvic floor relaxation and breathing exercises to relax my pelvic floor. Gerard used the Ultrasound machine to ensure I was doing them correctly and this helped a lot. I used an EZ magic wand to do some gentle pelvic floor relaxation and after about the 3rd time felt pretty ok with this. My wife just never let me put it in the dishwasher, the atmosphere in our house was a lot lighter as I was getting better. Gerard encouraged me to get more active, manage my stress better and use headspace. He also encouraged my wife to use headspace. Weirdly it felt like he was including both of in the treatment as he would also ask my wife who she was each time we attended. He also encouraged her to do some exercise and get back to things she enjoyed. We were directed to some great reading material like headache in the pelvis and teach us to sit still and a pain book called explain pain. Gerard also suggested if I really wanted to know more to read some patient information on complex regional pain syndrom . I was getting to know a lot about how my body had reacted to all this pain, stress and anxiety. The bladder retraining was tough but I stuck with it and also bought a squatty potty to destress my pelvic floor when on the loo. I was making progress.


I was getting better, happier and home was better but I was still worried about having sex and this was making me stressed again. Gerard said that we should treat returning to sex like if we were returning to running or another sport. If we hadn’t done it for months and months we should go back gently and pace ourselves, it’s unlikely we would go back running 10 km if we hadn’t run in 6 months. He left the rest up to us but we started with some gentle non penetrative intercourse and over some weeks progressed this. He also said like running we’d get minor setbacks but to not agonise about them as this was normal. He was right we had some setbacks but got back to being intimate.

My little friend is now looking normal, my pelvic pain is probably 90% better, I get the odd flare up mainly if I’m stressed at work or have a few weeks where I don’t exercise. My wife and I are intimate when we want and that is better than ever. I wee when I want and I feel like a man in his early 40’s again.

I need to thank 3 people, firstly my wife for hanging in there and coming to every appointment , the physio who told me about Men’s health physio in Birmingham and Gerard for going way above what he needed to for me and my wife. What him, Lisa and their colleagues do is a very different type of physio but they have given me and my wife our life back. Hopefully reading this may make it easier for the next man to find out some information about Hard flaccid and get help quicker. J Anderson


Goggle review


“I had quite nasty pelvic pain for probably 2 years and despite seeing 2 very good specialists had no real idea what was causing pain in my private areas and was really affecting me being able to be intimate with my wife. Sitting was a nightmare and I was going to the loo all the time. Gerard did a very detailed examination including my pelvic floor which was actually pretty comfortable. He took time to explain how my symptoms were related to my pelvic floor being in spasm, my back and hips being very stiff and me being very very stressed anxious & on edge all the time and I'd given up all my fun activities & exercise. I can't believe I'm now better from that nightmare time, The pain has gone give or take the odd day, I can sit ok, I'm back in the pool and I'm not afraid to be intimate with my wife. To be honest I was very on edge the 1st time I went for " Men's Health Physio" but their clinic at Barefoot Yoga is very chilled and relaxing and even the yoga people who work there are friendly and put you at ease. Everyone seems happy to be there. Gerard was brilliant, got me moving, using Head Space, did some work on my back and hips,got me happy doing some pelvic floor relaxing work at home. Prob best thing he dd was got me learning more about what was going on. It also re-assured me that he works with other Physios who see a lot of pelvic pain patients . FrustratinglyIt took my months to find a Physio who would see me and they have 2 in their clinic who do this . Was also reassuring we he said that if needed his colleague Lisa would see me for an-other view point. Doing a public review hasn't been easy but my wife and I feel Gerard has helped us rescue my life and our lives from the Hell of Pelvic pain and if this review helps one or two more men it will have been worth it. In one way I wish I'd never had to find a Physio like Gerard but I'm glad I did and hopefully it will be easier for others to find him and his team in Birmingham.”



Link: Men's Health Clinic Information

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