Renew XY Health Program by Isa Herrera, MSPT

The Renew XY Health Program

The Renew XY Health Program™ for Men (the “XY Program”)

The Renew XY Health Program for Men was developed by Isa Herrera, MSPT, CSCS. The XY Program promotes a “whole body” approach to healing men’s pelvic pain and pelvic disorders that are often disguised or misdiagnosed as prostatitis.

The Renew XY Health Program focuses on physiotherapy for pelvic floor muscle (PFM) dysfunction in order to teach and train the patient to achieve relief from pelvic and related pain. The root of suffering for men with PFM dysfunction manifests in a number of complaints according to the XY Program Director including the following:

  • Muscle spasms
  • Trigger points
  • Scar adhesions
  • Painful sex and/or erectile dysfunction
  • Incontinence
  • “Burning” orgasms
  • Penile and testicular pain
  • Pelvic floor pain and weakness
  • Bowel and bladder dysfunction

The XY Program provides patients with a multidisciplinary approach to heal pain, and it provides tools, exercises, and techniques for patients to use depending on their individual symptoms. The XY Program is a “contract” between the patient and his therapist—a contract to commit to the healing journey and to put in the effort and commitment required to heal oneself on a daily basis.

Some of the techniques and tools include:

  1. Exercises, including pelvic floor and external pelvic muscle stretching, pelvic dilator stretching, deep and superficial massage, myofascial foam rolling, Pilates, and yoga exercises (using Pilates balls for strengthening);
  2. Pain relief methods, including trigger point and myofascial release; and
  3. Mind-body connection, including breathing techniques, meditation, stress reduction, and herbal remedies.

The XY Program recommends that patients maintain a “Pain and Progress Diary” to map their progress as they continue to take control of their pain management and eventually, heal themselves, using the techniques provided.

Excerpts from Ending Male Pelvic Pain, by Isa Herrera, MSPT, CSCS. (Copyright 2013, All Rights Reserved)


Myofascial pain is a phrase that many of us are hearing more about today. Myofascial pain can be described as pain, trigger points or spasms, or sensitive areas found between muscles and fascia. Everyone knows what muscles are but fascia is a little bit more esoteric. Imagine the human body without muscles, bones, blood and fat. What would be left is a skeletal form that looks like a human body but is made of connective tissue. Fascia is a complex network of connective tissue that surrounds everything in the human body.

Many of the men I treat who suffer from pelvic conditions have moderate to severe myofascial restrictions in the muscles that attach to the pelvis, hips, low back and to the pelvic floor muscles. These restrictions can be classified as spasms, adhesions, knots and painful trigger points. To release these restricted muscular areas I teach all my patients to use the foam roller release series that I have included in this book.

With a foam roller you can give yourself a deep tissue massage without the hefty price tag. It’s probably not as effective as a hands-on massage; however, you can do your foam rolling anywhere, anytime, and with practice your body will feel less painful, longer, softer and more flexible. You will experience relief from symptoms related to your prostatectomy surgery and other PFM related issues.

The foam roller works via the Golgi Tendon Organ (GTO) found in the area where muscles and tendon are. The GTO responds to changes in muscular tension. When you increase the pressure and/or tension in the muscles to the point where the muscle is overstrained, the GTO responds by relaxing the muscle. This is called autogenic inhibition. By exciting the GTO, muscles and fascia surrounding the muscles are able to relax helping to increase flexibility and range of motion and decreasing pain naturally.

The foam roller massage is one of my favorite self-treatment tools. It uses your own body weight to release myofascial pain and trigger points found in muscles. The foam roller is tube-shaped Styrofoam that varies in shape, density and hardness. It’s an inexpensive piece of equipment that is a necessary tool for men to combat conditions that afflict the pelvic floor. As you roll over your muscles, you release fascial restrictions as well as muscular trigger points and muscle spasms, which restrict blood flow and do not allow your body to get rid of toxins. The foam roller also helps to soften scar tissue and muscular adhesions below surgical sites.

Many of the men I treat love their foam roller exercises and tell me they feel their muscles become softer, their pain decrease and their stress diminish. The object is to find the restrictions in muscles, which tend to be hard, painful areas and to roll the painful areas slowly and deliberately for a minimum of two minutes until the pain decreases by at least 50%. Once you find a painful spot, you can also rock over the areas from side to side to increase the release of the muscle. Use the foam roller as a tool to get to know your body. You will be amazed at how many areas you will find in parts of your body that you have not thought about before. Before getting started, please read through the following charts which highlight the benefits, precautions and recommendations to consider before undertaking the foam roller series.

Foam Roller Sacral Rolling

Screen Shot 2014-10-13 at 4.01.35 PM

What to do:

  1. Balance on the foam roller with both hands behind you on the floor, placing your sacrum on the foam roller.
  1. Keep your hands close to the foam roller to avoid straining your shoulders.
  1. Without collapsing your shoulders, gently roll up and down on the sacrum. Remember to maintain good upright posture with the chest lifted.
  1. Roll one to two minutes over your sacrum. Focus on the painful spots and concentrate the rolling and rocking on that area.
  1. You can also lean to the left side of the sacrum and roll that part and then roll the right side.


  1. Relieves pain from the sacrum and promotes better sacroiliac bone alignment.
  1. Works on releasing the sacral fascia, which will indirectly bring chi/energy and pain relief to the muscles that have an intimate connection to the sacrum including PFMs.
  1. This is the area where the nerves that feed the pelvis, abdominal and PFMs live. By rolling the sacrum and releasing restrictions, spasms and pain, you help restore the nerve function of the PFMs and nearby muscles. This will help restore continence, sexual function and hardness of erections.
  1. Helps to restore proper bladder function and can improve leaking after prostatectomy surgeries.

 Foam Roller Piriformis and Gluteal Muscle Release

Screen Shot 2014-10-13 at 4.03.53 PM

What to do:

  1. Place the foam roller on the right buttock cheek with the ankle of the right foot across your left thigh.
  2. Balancing on the hands and left foot, slowly roll the gluteal and piriformis muscles from top to bottom.
  1. Avoid collapsing the shoulders.
  1. Roll one to two minutes over your gluteal and piriformis muscles. Focus on the painful spots and concentrate the rolling on that area.
  1. Repeat on the other leg.


  1. Relieves pain from the gluteal area and promotes better hip, pelvic and lumbar alignment and stability.
  1. Works on releasing the inner gluteal fascia, which will indirectly bring chi/energy and pain relief to the muscles that have an intimate connection to the gluteal muscles including the PFMs
  1. Relieves butt pain, sciatica and PFMs pain and tension.
  1. Helps release trigger points that can be contributing to pelvic pain.
  2. Helps to restore proper PFMs function.

Dead Bug Release

Screen Shot 2014-10-13 at 4.06.52 PM

What to do:

  1. Lie on your back, bring your knees to your chest and place one hand on the inside of each knee.
  1. While inhaling, imagine your sit bones coming apart and your pelvic muscles releasing and relaxing. Inhale for at least five seconds; exhale and repeat for
    five breaths.

Sit Bones Apart Release

Screen Shot 2014-10-13 at 4.08.49 PM

Sit Bones Apart Release

The X’s represent the location of the sit bones. This exercise is done in any position, but is described below lying down on the stomach because this facilitates the best release for most men.


  1. Lie down on your stomach and place your left hand on your left sit bone.
  1. As you breathe in, pull the left sit bone away from the right. Feel and imagine your pelvic floor muscles dropping outward, relaxing and releasing.
  1. Hold this release for five seconds and repeat for five breaths. Now try it with the right hand on the right sit bone.
  1. Which side gives you the better pelvic floor muscle release?