Why Do My Testicles Hurt After the Gym or Heavy Lifting?

Most men don’t talk about it — until it really starts to hurt. You hit the gym, lift heavy, maybe go hard on squats or deadlifts… and then later that day (or even during your session), there’s a strange ache in your testicles. It’s not sharp, but it’s noticeable. It lingers. And it’s unsettling.

As a pelvic floor therapist , I can tell you: this is more common than you think, and in many cases, the answer isn’t where you're feeling the pain; it's how you’re lifting, how you're breathing, and what’s going on with your core and pelvic floor system.

Let’s break it down, starting with a major player in all of this: the Valsalva maneuver.

The Valsalva Maneuver: Powerful but Risky

The Valsalva maneuver is something most lifters do without realizing it: holding your breath and bracing hard during a lift to create intra-abdominal pressure (IAP). It helps stabilize the spine under load, which is important for heavy lifts like squats and deadlifts.

But here’s the problem: when done excessively or without proper engagement of the pelvic floor and deep core, that pressure needs to go somewhere — and often, it’s directed downward, into the pelvis and scrotum.

What can this lead to?

• Bulging or strain at the inguinal canal (potentially triggering a hernia)

• Irritation of the spermatic cord or surrounding fascia

• Excess pressure on the pelvic floor muscles, which can refer pain to the testicles

• Aggravation of a varicocele (enlarged veins in the scrotum)

If your pelvic floor isn’t strong and responsive, meaning it can both contract and release effectively, then repeated Valsalva maneuvers during lifts can cause discomfort and dysfunction over time.

Fascial Connections: The Core Isn’t Just About Abs

This is where things get even more interesting. Your testicles are not just “hanging out” in isolation. They're connected, through fascial and neural pathways, to your abdominal muscles, pelvic floor, and even your breathing mechanics.

Key connections:

• The spermatic cord, which suspends the testicles, travels through the inguinal canal, a structure formed by layers of fascia and muscle including the transversalis fascia, internal obliques, and external obliques.

• These oblique muscles, along with the rectus abdominis and transverse abdominis, are part of your abdominal canister, the system responsible for stabilizing your trunk under load.

• All of these structures are directly connected to your pelvic floor, which works with the diaphragm and abdominals to regulate intra-abdominal pressure.

When you lift heavy, especially if your breathing is rigid or shallow, or you're over-bracing without pelvic floor coordination, tension can build up in these fascial planes. Over time, this can tug on the inguinal canal or cause subtle irritation or inflammation in the neurovascular structures that serve the testicles.

Signs You’re Lifting Without Pelvic Floor Support

If you’re experiencing testicular pain after workouts, watch for these patterns:

• Holding your breath through entire lifts

• Bulging or bearing down in the lower abdomen or groin during exertion

• A feeling of "heaviness" in your scrotum or lower pelvis after lifting

• Lower abdominal soreness or tightness that spreads into the groin

• Needing to pee more often or straining to fully empty the bladder (pelvic floor tension)

How to Fix It (Without Skipping the Gym)

Here’s where a little knowledge and body awareness can save you from a lot of discomfort:

1. Rethink Your Breathing Strategy

• Use a modified Valsalva: inhale deeply into your ribs and belly before the lift, engage your core and pelvic floor, then exhale gradually through the exertion.

• Don’t hold your breath for the entire rep range unless you're powerlifting max loads — and even then, only with proper technique.

2. Train the Core as a System

• Incorporate deep core training: think dead bugs, bird-dogs, Pallof presses, and diaphragmatic breathing.

• Don’t forget your obliques and transverse abdominis, they’re critical for controlling force transmission through the inguinal region.

3. Pelvic Floor Work Isn’t Just for Women

• Learn to engage AND release your pelvic floor muscles, especially if you tend to “clench” when lifting.

• Consider working with a pelvic floor therapist for a personalized assessment.

4. Load Progression and Recovery

• Respect your body’s limits. Sudden increases in load, volume, or intensity can overwhelm your fascial system.

• Give your body time to adapt. Pain is often a signal that tissues are being asked to do more than they can handle (at least for now).

When to Get Checked Out

Even with perfect form and breath control, testicular pain after lifting isn’t always “just muscular.” Be cautious and seek medical help if:

• The pain is sharp, severe, or sudden

• You feel a bulge in the groin or scrotum (especially one that appears with lifting)

• There’s swelling, redness, or warmth

• Pain lasts longer than 48 hours

• You have nausea or fever with the pain

It could be a hernia, epididymitis, varicocele, or (rarely) testicular torsion — all of which need medical attention.

Final Word

As a pelvic floor therapist, I’ve seen countless men ignore groin and pelvic pain, only to have it worsen or complicate into something more serious. Your pelvic floor, core, and breath all work together like a pressure management system. If one part isn’t functioning well, the strain will show up elsewhere, and sometimes, that “elsewhere” is your testicles.

So if you’re lifting heavy and feeling it where you shouldn’t, don’t tough it out. Tune into your body, train smarter, and give your pelvic floor the support it deserves.

Need help learning how to breathe and lift without causing pelvic pressure? Reach out to us at Pelvic Health Center in Madison, NJ to set up an evaluation and treatment! Feel free to call us at 908-443-9880 or email us at receptionmadison@pelvichealthnj.com.