An interview with Luca Fornari, creator of MyoMentia
1. What are the most common misconceptions men have about pelvic health?
That it's only a thing for people with vaginas. Every time you lift a box, sit hunched at work, or have sex, your pelvic floor is involved because it supports the internal organs and connects to major muscle groups. It's a body part like any other, and the same principles that resolve dysfunction like pain or incontinence also apply to prevention and performance.
2. How does the brain influence pelvic floor dysfunction and recovery?
The brain influences almost everything, but not equally. We can't control our heartbeat because it runs on unconscious nerves, but we can contract our biceps on demand because those run on conscious ones. The pelvic floor is innervated by both, which makes it one of the more neurologically interesting regions in the body. Testicles rise automatically in cold weather but many men can raise them intentionally. Erections arise spontaneously but can also be driven by thought and anticipation. That dual control means dysfunction here is rarely just a tissue problem because we're dealing with layered circuits of conscious thought, spinal reflexes, and local nervous system regulation all at once. This is why I don't think we can talk about men's pelvic health without getting into the neuroscience.
3. What role does movement play in addressing pelvic pain that surgery or medication alone can't?
Surgery and medication save lives, but we often reach for them before fully exploring what the body can do on its own. Physical movement is one of the most powerful inputs the body receives because it drives neuroplastic adaptation, restores tissue extensibility, and returns motor control to areas the nervous system has learned to ignore. The evidence for conservative care at the pelvic floor is strong and the ceiling for what movement can achieve is higher than most people assume. A guy realizing his pelvic floor has been compensating for a weak core every time he hits the gym, or noticing that the tension he carries during stress shows up physically in ways he never connected before, that's the kind of discovery that doesn't come from a prescription. That's what I find beautiful about physical therapy: getting better using your own means without outside reliance.
4. For someone dealing with pelvic floor issues, what is one thing they can start doing today to better understand what's going on?
Breathe. I know how hipster and annoying that sounds, but if the torso is a canister and the diaphragm is the lid, the pelvic floor is the bottom. They move together and paying attention to the breath is the most direct way to start feeling that pressure system in action. Does the pelvic floor drop and soften on a deep inhale or does it brace and hold? That question alone is a straightforward way to check in with the parts you can voluntarily control and start asking honest questions about the parts you can't. From there you can connect the breath to bigger movements. What happens to that pressure system when you squat heavy, when you've been sitting for hours, when you're turned on? That's where it gets interesting and where most people realize they've never actually paid attention to any of it.
5. What do you wish more men knew about the connection between pelvic health and overall well-being?
Socrates said it's a shame for a man to grow old without seeing the beauty and strength his body is capable of. That line stuck with me going into physical therapy school. Pelvic pain, sexual dysfunction, surgical recovery, toileting issues: these are neurological problems, and conservative care actually works on them. Almost nobody talks to men about any of it. Not because the biology is different, but because we've built a version of masculinity that treats help-seeking as weakness, and the pelvic floor bears the cost of that more than most people realize.
Disclaimer: Luca Fornari is a Doctor of Physical Therapy (DPT) student sharing educational content. Nothing here is medical advice and he is not a licensed provider. If you're dealing with symptoms, please see a qualified clinician.