Pelvic Floor Condition
Pelvic Floor Dyssynergia
By Dr. Anthony J. Gordon, Doctor of Acupuncture | Last reviewed September 2026
You push, but it feels like you are pushing against a closed door. Even soft stools are hard to pass, you strain, and you often feel you have not finished. Fiber and laxatives have not solved it. Pelvic floor dyssynergia means the muscles tighten when they should relax, and it is a coordination problem that can be retrained.
Prefer to talk it through? Call (516) 597-5400. Most new patients are seen within one to two weeks.
Overview
Understanding Pelvic Floor Dyssynergia
To have a bowel movement, the abdominal muscles gently push while the pelvic floor, especially the puborectalis and anal sphincter, relaxes and opens. In pelvic floor dyssynergia, also called dyssynergic defecation, that coordination is reversed or incomplete. The pelvic floor tightens or fails to relax as you push, so stool meets resistance.
The result is chronic constipation, straining, a feeling of blockage, needing to change position or use a finger to help empty, and a sense of incomplete evacuation. A similar pattern can affect urination. Over time, straining raises pelvic floor tone further and can lead to rectal pain, hemorrhoids and pelvic aching. Dyssynergia is often diagnosed with anorectal manometry and a balloon expulsion test.
The standard treatment is biofeedback therapy with a pelvic floor PT or GI specialist. Dr. Gordon works alongside that care by releasing tension and trigger points that make it harder for the muscles to relax, and by calming the nerve signals that keep them on guard.
Pelvic Floor Dyssynergia at a Glance
Also called
Dyssynergic defecation, anismus, paradoxical puborectalis contraction
Who it affects
Men and women of all ages, common in people with long-term constipation
Diagnosed with
Anorectal manometry, balloon expulsion test, sometimes defecography
Standard care
Biofeedback therapy with a pelvic floor PT or GI specialist
What Dr. Gordon addresses
Pelvic floor tension, trigger points, rectal and perineal pain, nerve reactivity
The Gap in Care
What Tests Check, and What They Can Miss
Constipation is often treated with fiber and laxatives alone. When the pelvic floor is not relaxing, softer stool does not fix the resistance at the exit.
What routine testing is looking for
- Colon disease or slow transit
- Structural problems such as rectocele
- Thyroid and metabolic causes
- Medication side effects
What often keeps symptoms going
- A puborectalis that tightens instead of relaxing
- High resting tone in the pelvic floor
- Trigger points that make relaxing painful
- Straining habits that reinforce the pattern
- Breath holding while pushing
These are assessed directly and through testing ordered by your GI specialist, and Dr. Gordon treats the muscle side.
Signs & Symptoms
Does This Sound Like You?
Symptoms vary from person to person. These are the patterns Dr. Gordon sees most often.
Straining with soft stools
Pushing hard even when stool is not hard.
Feeling of blockage
A sense that something is in the way at the exit.
Incomplete evacuation
Feeling you have not finished and needing to return to the bathroom.
Needing to help with position or pressure
Changing position or pressing on the perineum or vagina to empty.
Rectal or perineal pain
Aching after bowel movements or straining.
Urinary hesitancy
A similar difficulty relaxing to start urination.
Root Causes
The Four Drivers Dr. Gordon Looks For
Most people have more than one of these in play. Finding which one leads makes treatment more efficient.
Reversed coordination
The pelvic floor tightens or fails to relax while the abdomen pushes.
High pelvic floor tone
Muscles already tight at rest are harder to relax on demand.
Trigger points and pain
Pain when the muscles stretch causes more guarding and tightening.
Learned habits
Years of straining, holding and hurrying reinforce the pattern.
Your First Visit
How Dr. Gordon Evaluates Pelvic Floor Dyssynergia
The initial evaluation runs 60 to 75 minutes. You leave with a clear picture of what is driving your symptoms, a written plan, a realistic timeline, and in most cases your first treatment.
Records and history review
Dr. Gordon reviews your GI workup, including manometry, balloon expulsion or defecography results, and your bowel history.
Breathing and pushing pattern check
Dr. Gordon looks at how your abdomen and breathing work when you bear down.
External pelvic floor assessment
The pelvic floor muscles are examined from the outside, with no internal exam. With you draped for comfort, gentle pressure around the perineum, sit bones, tailbone and inner thighs checks tone, tenderness and trigger points.
Bowel habits and toilet posture
Dr. Gordon reviews timing, diet, straining habits and how you sit on the toilet.
Plan and coordination
A clear plan, plus communication with your physician or pelvic floor PT when that helps your care.
When to see a physician first
- Fever or chills with pelvic or urinary symptoms
- Inability to urinate
- Visible blood in the urine or stool
- Sudden, severe pelvic or abdominal pain
- Unexplained weight loss
- New numbness in the saddle area or loss of bladder or bowel control
If you have any of these, contact your doctor or go to the nearest emergency department.
Bring to your first visit
Records
Recent lab results, imaging reports and specialist notes. These can also be faxed ahead.
Treatment history
A short list of what you have tried and what did or did not help.
Clothing
Something comfortable and loose fitting.
Treatment
How Dr. Gordon Treats It
These are the tools Dr. Gordon uses most often for pelvic floor dyssynergia, chosen from your exam findings.
Primary approach
Intrapelvic & Extrapelvic Dry Needling
Dr. Gordon holds ASE certification in both intrapelvic and extrapelvic dry needling. Treatment releases the puborectalis and surrounding pelvic floor muscles so they can relax more easily during bowel movements. The needles go in through the skin of the buttock, perineum or inner thigh, never through the vagina or rectum.
Learn about pelvic floor treatmentNerve focus
Neuro-Functional Acupuncture
Electro-acupuncture along the sacral nerve pathways that help regulate bowel function and pelvic floor tone.
See servicesBetween visits
Toilet Training & Team Coordination
Breathing, toilet posture and habit changes, coordinated with your biofeedback therapist or GI specialist.
Referring provider? Contact the clinicWhat to Expect
A Typical Recovery Arc
Visits 1 to 3
Reduce resistance
Dr. Gordon lowers pelvic floor tension so relaxing during bowel movements becomes easier.
Visits 4 to 8
Support retraining
Combined with biofeedback, coordination improves and straining decreases.
Visits 9 to 12 and beyond
Maintain the pattern
Regular, easier emptying becomes the norm. Visits are spaced out.
Most patients are seen weekly or every other week during active care. Individual results vary with how long symptoms have been present and how reactive they are. Progress is reassessed at every visit.
Not sure how to describe it? Put your pain or discomfort into words before your visit
"Dr. Gordon is thoughtful, thorough and incredibly knowledgeable. He has significantly helped me with pain management and pelvic floor issues. I am grateful to have his expertise in my corner."
Dina Isola, Google Review
Pelvic Floor Dyssynergia Questions
Answers About Pelvic Floor Dyssynergia
Still unsure whether this is the right fit? Reach out before you book and Dr. Gordon will talk through your history with you.
Biofeedback is the standard treatment for dyssynergia. Dr. Gordon's care works alongside it by reducing tension that makes relaxation harder.
They may help stool consistency, but they do not fix muscles that are not relaxing at the exit.
Usually with anorectal manometry and a balloon expulsion test ordered by a GI specialist.
Straining over time can contribute to hemorrhoids and fissures. Improving coordination reduces straining.
Most people need eight to twelve sessions, often in parallel with biofeedback.
It can. Some people have a similar difficulty relaxing to urinate.
Before You Book
General Questions
The clinic is an out-of-network practice. The initial evaluation is $300 and follow-up visits are $250. After each visit you receive a detailed superbill to submit to your PPO plan for possible reimbursement. FSA and HSA cards are accepted, and the clinic can run a complimentary benefits check before your first appointment. The check is a courtesy, so please confirm your coverage with your plan. See Insurance & Fees for details.
The first evaluation is 60 to 75 minutes and usually includes treatment. Follow-up visits run 45 to 60 minutes.
Yes. Call (516) 597-5400 or send a message through the contact page. This is especially helpful if your case is complex and you want to understand the approach before committing to a full evaluation.
1508 Union Turnpike, Suite 133, North New Hyde Park, NY 11040, with free parking on site. The clinic is an easy drive from Manhasset, Great Neck, Garden City, Lake Success, Floral Park and Mineola. Early morning, evening and weekend hours are available.
Most people feel a quick muscle twitch or a deep ache that lasts a few seconds. That twitch is a normal sign the trigger point is releasing. Mild soreness for 24 to 48 hours afterward, similar to a hard workout, is common. Depth, angle and stimulation are adjusted to your comfort.
Both use the same fine, sterile, single-use needles. Dry needling targets specific trigger points and tight bands in muscle based on your exam. Neuro-functional acupuncture targets nerve pathways, often with gentle electrical stimulation, to calm nerve sensitivity. For pelvic floor dyssynergia, Dr. Gordon commonly uses both.
When performed by a trained, licensed provider with detailed knowledge of anatomy, it has a strong safety record. Tell Dr. Gordon if you take blood thinners, have a bleeding disorder, are pregnant or have a weakened immune system so he can plan accordingly.
It is a technique that reaches the deep pelvic floor muscles, including the levator ani, obturator internus and coccygeus, to release trigger points and restore normal muscle function. The needles go in through the skin of the buttock, perineum or inner thigh, never through the vagina or rectum. Dr. Gordon holds ASE certification in this technique, which few practitioners in New York have.
Yes. Your privacy and comfort come first. When undressing is needed for the area being treated, you are fully draped. Needles are placed through the skin only, and nothing is ever inserted into the vagina or rectum. You can pause or stop at any time.
Yes. Pelvic floor dyssynergia can affect people of every gender, and Dr. Gordon treats adults of all genders and identities.
It helps to have had a medical workup so serious causes have been checked. If you have not seen a physician for your pelvic symptoms yet, call the clinic to talk through the best order of steps.
About Dr. Anthony J. Gordon
Dr. Anthony J. Gordon is a Doctor of Acupuncture licensed in New York and board certified. He holds ASE certification in intrapelvic and extrapelvic dry needling, along with advanced certifications in Functional Dry Needling and Neuro-Functional Acupuncture. With more than 18 years of clinical experience and over 3,000 complex cases treated, he focuses on pelvic, spinal and orthopedic conditions that have not responded to standard care, and works closely with each patient's physicians and physical therapists.
Read Dr. Gordon's full bioFurther Reading
What Your Pelvic Floor Has to Do With Constipation
From the blog: Some constipation comes from pelvic floor muscles that tighten when they should relax. How dyssynergia works, how a GI doctor tests for it, and what helps.
Book an Evaluation for Pelvic Floor Dyssynergia
Book an evaluation with Dr. Gordon and address the muscle tension that keeps your pelvic floor from relaxing.
Early morning, evening and weekend appointments available. Free on-site parking.
Symptoms