What is Erectile Dysfunction?

Erectile Dysfunction (ED) is the ongoing difficulty achieving or maintaining an erection firm enough for sexual activity. While occasional difficulties are common for many men, persistent ED can impact confidence, relationships, exercise participation, and overall wellbeing.

ED becomes more frequent with age, chronic disease, high training load, pelvic floor dysfunction and prolonged periods of stress. Australian data suggests that erection difficulties affect around one in five men, with rates increasing significantly after the age of 40. Men with cardiometabolic conditions such as diabetes and hypertension experience ED at far higher rates than the general population.

Although often thought of as a vascular or hormonal issue, ED frequently has musculoskeletal, pelvic, neurological and lifestyle drivers, making conservative rehabilitation an effective first-line option for many men.

Symptoms of Erectile Dysfunction

Symptoms vary from person to person. You may notice:

  • Difficulty achieving an erection
  • Difficulty maintaining an erection
  • Reduced firmness or stability
  • Decreased penile sensation or responsiveness
  • Challenges with sexual confidence or performance
  • Erections that are inconsistent, brief, or less frequent than usual

Many men first recognise changes during periods of stress, reduced sleep, illness, increased training load, or following pelvic surgery or cancer treatment.

How Erectile Dysfunction is Assessed

Most ED assessment begins with your history and a functional examination of pelvic, neuromuscular, and soft tissue factors. A male pelvic health–focused evaluation may include:

  • Pelvic floor strength, coordination and relaxation testing
  • Assessment of penile tissue mobility, scar sensitivity, and fascial tension
  • Lumbar, hip and sacral movement screening
  • Circulatory and muscular load patterns affecting blood flow
  • Lifestyle, exercise, and stress considerations
  • Post-prostatectomy or post-treatment functional review (when relevant)

Medical assessment may also be appropriate when chronic disease, hormonal issues or prostate-related symptoms are present.

Treatment & Recovery

Most men experience meaningful improvement with targeted, non-invasive care, especially when addressed early. Treatment focuses on restoring optimal blood flow, pelvic function, tissue mobility, and neuromuscular control.

Pelvic Floor Training & Functional Rehabilitation

Pelvic floor muscle training improves the function of key muscles involved in erection rigidity and venous occlusion. Rehabilitation may include:

  • Strengthening of the bulbospongiosus and ischiocavernosus muscles
  • Endurance holds to improve sustained firmness
  • Quick-flick contractions for reflexive erectile support
  • Relaxation training when pelvic tension or hypertonicity is present
  • Functional integration during movement, breath and core tasks

This forms a foundational part of ED recovery for many men.

Exercise Programming & Cardiovascular Conditioning

Structured exercise improves endothelial function, metabolic health, and overall sexual performance. Programs may include:

  • Moderate-vigorous aerobic training
  • Strength and stability work
  • Pelvic mobility and hip flexibility routines
  • Load management for athletes with high training volume
  • Return-to-sport planning where needed

Regular exercise is one of the strongest non-pharmacological supports for ED.

Manual Therapy & Soft Tissue Release

Hands-on therapy addresses musculoskeletal and fascial contributors to erectile quality, including:

  • Release of pelvic floor hypertonicity
  • Myofascial treatment through the adductors, glutes, deep hip rotators and abdominal wall
  • Mobilisation of penile fascial tissues and scar regions (when indicated)
  • Techniques to reduce tension around the neurovascular pathways involved in erections
  • Restoration of mobility in post-surgical or post-treatment tissue

This helps optimise blood flow, reduce restriction, and normalise pelvic mechanics.

Lifestyle, Stress & Recovery Support

Sleep, stress management, nutrition, and pacing of training loads all influence erection quality. Many men benefit from:

  • Stress reduction strategies
  • Improved sleep hygiene
  • Load monitoring around endurance and strength training
  • Support with behaviour change and self-management habits

Where appropriate, clients are referred for psychological, urological or GP support.

When to Seek Help

Book an assessment if you experience:

  • Persistent difficulties achieving or maintaining erections
  • Reduced firmness, sensation or responsiveness
  • ED following pelvic surgery, prostate treatment, or trauma
  • Erections that worsen with sitting, stress, heavy training or pelvic tightness
  • Associated pelvic pain, urinary changes or tension symptoms

Early intervention helps prevent chronic functional changes and supports better long-term outcomes.

Get Support

The Athlete’s Guild provides male pelvic health focused care for Erectile Dysfunction using:

  • Pelvic floor rehabilitation
  • Manual therapy and soft tissue work
  • Scar therapy
  • Low-level laser therapy
  • Exercise prescription
  • Functional movement and mobility retraining

Book with Trent Renshaw at Coffs Coast Sports Physiotherapy for a comprehensive, respectful and evidence-informed approach to restoring sexual function, confidence and performance.

Book Now at Coffs Coast Sports Physiotherapy

Key Takeaways

  • ED is common and treatable with conservative care.
  • Cardiometabolic health and pelvic floor function are major contributors.
  • Athletes may experience ED due to pelvic load, tension or saddle pressure.
  • Targeted pelvic rehabilitation can significantly improve erectile quality.
  • Early assessment supports faster, more complete recovery.