What Can Cause Testicular Pain and What You Can Do About It
Testicular pain can feel sharp, dull, heavy, achy, or even like a deep pulling in the groin. It is one of the most alarming symptoms men experience because the sensation is so sensitive and close to key reproductive structures. But what most men don’t realize is that testicular pain often has nothing to do with the testicle itself. The source can be the pelvic floor muscles, the fascia, the abdominal wall, the hip, or even the low back and spine. Understanding where this pain comes from is the first step toward long-term relief.
This is why so many men end up frustrated after negative ultrasounds or normal urologic tests. The issue is real, but the origin is often musculoskeletal.
This guide explains the most common causes of testicular pain and how pelvic floor physical therapy can help you get rid of it safely and naturally.
Pelvic Floor Muscle Tension
The pelvic floor muscles create a sling underneath the pelvis. They attach to the pubic bone, tailbone, perineum, and connective tissue that surrounds the spermatic cord and testicles. When these muscles become tight, overactive, or irritated, they can refer pain directly into the testicle.
This is extremely common in men who sit for long hours, clench their core or glutes throughout the day, lift heavy weights, or deal with chronic stress. Trigger points in muscles like the obturator internus, levator ani, and even the adductors release pain into the scrotum and groin. Many men notice their symptoms feel worse after workouts, sex, or prolonged sitting. Pelvic floor physical therapy helps by releasing trigger points, retraining muscle coordination, and restoring normal mobility so the nerves and soft tissues are not under constant pressure.
Nerve Irritation or Entrapment
Certain nerves supply sensation to the testicles. If those nerves become irritated anywhere along their path, the brain can interpret it as testicle pain even if the testicle is healthy.
The most common nerves involved include the ilioinguinal, genitofemoral, and pudendal nerves. The irritation might come from scar tissue (such as after an inguinal hernia repair), tight fascia in the abdomen or hip, core weakness, low back problems, or pelvic floor tension. These nerves also pass through small anatomical tunnels. Any swelling, muscle spasm, or postural compression can cause symptoms.
Pelvic floor therapy improves mobility around these nerve pathways, reduces muscular compression, and uses gentle techniques to calm the irritated nerve. By treating the entire nerve route rather than only the painful spot, symptoms often decrease quickly.
Fascial Restrictions and Tension
Fascia is the connective tissue that wraps every muscle, organ, nerve, and vessel. It links the abdominal wall to the pelvis, the pelvis to the hips, and the hips to the lower spine. Because fascia is continuous, tension in the lower abdomen or hip flexors can pull on the tissue surrounding the spermatic cord or testicle.
Men with history of abdominal surgeries, core weakness, prolonged sitting, or repetitive strain often develop fascial tightness without realizing it. This tightness can create a tugging sensation in the groin or scrotum, particularly with walking, standing from a chair, or transitioning in and out of the car.
Skilled pelvic floor therapists use manual fascial release to restore mobility through the abdomen, pelvis, and hips. When the fascial layers glide normally again, testicular discomfort often decreases dramatically.
Spine or Hip Referral
The testicles share nerve pathways with the lumbar spine and sacrum. A bulging disc, SI joint dysfunction, or hip joint irritation can refer pain into the groin or testicle. Many men with testicular pain also report low back stiffness, deep hip tightness, or pain with standing, walking, or bending.
It is possible to have a normal testicular ultrasound and still have symptoms because the real source is the spine. A pelvic floor physical therapist evaluates spinal mobility, gait mechanics, hip strength, and muscular imbalances to find the hidden driver of pain.
Post Ejaculation Pain
Some men experience testicular pain or scrotal heaviness after ejaculation. This often comes from pelvic floor muscle spasm or incomplete relaxation. During arousal, the pelvic muscles contract. Afterward, they are supposed to fully release. If those muscles stay tight, they can trap pressure around the spermatic cord and create pain.
Pelvic floor therapy helps retrain the muscles to relax properly and improves circulation to reduce post-ejaculatory discomfort.
When Testicular Pain Is an Emergency
Although most chronic testicular pain is musculoskeletal, sudden severe pain, swelling, nausea, or a high-riding testicle require immediate emergency evaluation to rule out torsion or infection.
If tests come back normal and the pain persists, pelvic floor physical therapy is the next step.
How Pelvic Floor Physical Therapy Helps Testicular Pain
A high-quality pelvic floor evaluation looks at the whole body, not just the testicle. Your therapist will assess:
• Pelvic floor muscle tension
• Abdominal wall mobility
• Core coordination
• Hip strength and flexibility
• Low back and sacral alignment
• Nerve pathways and fascial tightness
• Breathing mechanics and pressure management
Treatment may include manual pelvic floor release, abdominal and fascial work, nerve gliding, postural correction, hip mobility training, and relaxation strategies to calm overactive muscles. Most men see significant improvement because the root cause is finally addressed.
If you are experiencing testicular pain and want a solution that looks deeper than imaging, our clinic can help you find lasting relief. Reach out to schedule a comprehensive pelvic floor physical therapy evaluation so you can get back to feeling normal again. Feel free to call us at 908-443-9880 or email us at receptionmadison@pelvichealthnj.com.