Pelvic floor exercises for men

What are your pelvic floor muscles?

The pelvic floor muscles are located between your legs, stretching between the pubic bone at the front and the base of spine (coccyx) at the back.

Within the PDF below, see Figure 1: Diagram of the Pelvic Floor Muscles.

A man’s pelvic floor muscle supports both his bladder and bowel. Importantly it also helps to control both the tube that takes urine outside of the body (urethra) and the back passage (anus).

What can happen if the pelvic floor muscle weakens?

A weakened pelvic floor muscle can cause problems such as urinary incontinence, incontinence of stool or difficulty controlling wind.

Why do the pelvic floor muscles weaken?

Lack of exercise

like any other muscle in the body, the pelvic floor muscles need regular exercise to maintain good tone. If they are not exercised regularly, they may become stretched and weak so that they no longer work well. The following things can cause your pelvic floor muscles to become weak:

• Pelvic surgery - for example surgery to your prostate gland, back passage or bowels.
• Straining to open your bowels - the ‘pushing down’ movement when you strain to open your bowels can overstretch your pelvic floor muscles and make them weaker.
• Being overweight - extra weight puts more pressure on your pelvic floor muscle. You can find out whether you are an acceptable weight for your height using the BMI calculator on our physiotherapy website: www.gloshospitals.nhs.uk/physio/health or your GP or healthcare professional will be able to advise you.
• Having a chronic cough - every cough puts pressure on your pelvic floor muscles.

Why should I do pelvic floor muscle exercises?

Pelvic floor muscle exercises can help strengthen your muscles so they can support your bladder and bowels properly. This can improve bladder and bowel control, reducing or stopping any leakage.

How to find your pelvic floor muscles

It is important to be sure you are exercising the right muscles.

• Sit or lie comfortably with the muscles of your thighs, bottom and stomach relaxed.
• Tighten the muscles around your back passage as if you are trying to control diarrhea or wind. Relax the muscle again. Practice this movement several times until you are sure you are exercising the correct muscles. Try to not to squeeze your buttocks, tighten your thighs or contract your tummy muscles.
• Imagine you are trying to stop the flow of urine midstream, at the same time you should feel your testicles pull upwards into your body. Relax the muscle again. You can do this ‘for real’ while passing urine but do not do this more than once a fortnight, otherwise it may interfere with normal bladder emptying.

If you have had surgery recently and you still have a catheter (a tube inserted to help you to pass urine) in place, wait until this has been removed by your nurse or doctor before trying the exercises.

How should I do pelvic floor muscle exercises?

Pelvic floor muscle exercises can be done anywhere and anytime. You can perform them standing, squatting or lying down, but at first you may find it easier to do the exercises sitting down:

• Sit on a firm chair, toilet seat or toilet lid.
• Make sure that your feet are flat on the floor and your legs are slightly apart.
• Tighten the muscles around your back passage and at the same time, imagine you are trying to stop the flow of urine midstream and pull your testicles upwards in towards your body.
• Hold this for as many seconds as you can (up to a maximum of 10 seconds), at the end of the hold there should be a definite feeling of ‘letting go’.
• Rest for 10 seconds before repeating the exercise.

Try to avoid:

• Holding your breath.
• Pushing down instead of squeezing and lifting up.
• Tightening your tummy, buttocks or thighs.
• Pushing out urine.

Pelvic floor muscles tire easily and you may notice that it takes a lot of concentration to begin with to do these exercises correctly.

If you can only hold the contraction for a count of 3, then every time you do your exercises, contract the muscles for a count of 3. Gradually try and work up to 4, then 5.

Once you feel confident doing the exercises while you are sitting, try doing them in other positions, such as standing or squatting. When standing you may also be able to feel the base of the penis pull slightly inwards towards your tummy.

Remember to tighten your pelvic floor muscles during and after any activity that makes you leak such as when rising from a chair or when you need to open your bowels.

If you are still not sure please contact one of the specialist physiotherapists. The number is at the end of this page.

How often and how many?

Try and do 8 pelvic floor muscle exercises in one go (remember to hold each contraction for as long as you can manage).

You need to do 3 sets of 8 pelvic floor exercises a day. This means you should aim to complete 24 exercises every day.

Remember

• Drink plenty of fluid (at least 6 to 8 cups a day) but try to cut down on caffeinated drinks such as tea and coffee as this can stimulate the bladder.
• Avoid constipation and being overweight as it can put extra strain on the pelvic floor muscles.
• Contract your pelvic floor muscles when you think you may leak if you are lifting, coughing or laughing and hold on until the action is over.
• You will probably not notice an improvement for several weeks and the pelvic floor muscle exercises will not give the best results until you have been practicing them for 3 to 6 months. To get the most benefit it is important to keep doing the exercises every day.

If you see little or no change in your symptoms after trying the exercises for 3 months, it is recommended that you seek help from a health professional, such as a specialist physiotherapist.

Contact information

If you have any questions or concerns, please contact your local specialist physiotherapist by email at:

ght-tr.menshealth.physio@nhs.net

For more information visit:

Website: www.gloshospitals.nhs.uk/our-services/services-we-offer/physiotherapy/womens-and-mens-health-physiotherapy/

You can self refer online to see a physiotherapist at

www.gloshospitals.nhs.uk/physio

Further information

How can I make myself healthier?

Website: www.gloshospitals.nhs.uk/physio/health

Expert Self Care Ltd

Please visit https://apps.apple.com and search for the Expert Self Care – CONfidence app for more information about continence and the support available.