Doing pelvic floor muscle exercises should help improve continence problems in men. Exercises should be practiced regularly, and it may take some weeks for the benefit to be seen. See your doctor for a medical check and advice if urinary symptoms do not improve.
Key points about pelvic floor training:
- Once the pelvic floor muscles become weak, your ability to hold urine and/or wind during physical activity is compromised.
- Pelvic floor muscle weakness can be improved with training.
- Like any other muscle of the body, the more you use and exercise them, the better they will function.
- Improvement in pelvic floor muscle strength will take 3-6 months of regular training of the muscles.
Where are my pelvic floor muscles and what do they do?
The pelvic floor muscles are a layer of muscles stretching from your pubic bone at the front to your tailbone at the back. They form the floor of your pelvis and support the pelvic organs.
Your pelvic floor muscles help:
- support the pelvic organs (bladder and bowel)
- maintain bladder and bowel control and help prevent accidents
- control problems such as frequency and urgency
- empty your bladder and bowel
- gain and maintain an erection
- contribute to core stability.
Why do my pelvic floor muscles become weak?
Factors contributing to pelvic floor muscle weakness include:
- prostate surgery
- some neurological conditions
- Parkinson's disease
- constipation and straining to empty your bladder or bowel
- persistent heavy lifting
- a chronic cough (from smoking, chronic bronchitis or asthma)
- being overweight
- lack of general fitness
- lack of use (not exercising the pelvic floor muscles).
Once your pelvic floor muscles become weak, your ability to hold urine and/or wind during physical activity is compromised. Like any other muscle of the body the more you use and exercise them, the better they will function.
How can I train my pelvic floor muscles?
The best results will be achieved by seeking help from a physiotherapist (with training in continence) who will design an individual training programme especially suited to you. Pelvic floor exercises may also be useful if you are on a bladder training programme.
Where are they?
The first step is to correctly identify the muscles.
- Sit comfortably – your thighs, buttocks and tummy muscles should be relaxed.
- Squeeze and lift inside as if you are trying to hold back urine, or stop yourself passing wind.
- If you aren't sure if you have found the correct muscles, try to stop your flow when passing urine, then restart it. Only do this to identify the correct muscles to use – this is a test, NOT an exercise.
Important: If you are unable to feel a definite tighten and lift action in your pelvic floor muscles you should seek professional advice from a specialised pelvic floor physiotherapist or continence advisor.
What exercises can I do?
At first you may need to perform these exercises while sitting. As the muscles strengthen you can progress to exercise standing up. Like any activity, start with what you can achieve and progress from there.
If you can feel the muscles working, exercise them by:
- Squeezing/tightening and drawing in and up around both your anus (back passage) and urethra (bladder outlet). Lift up inside and try to hold this contraction strongly for as long as you can (1–10 seconds). Keep breathing! Now release and relax. You should have a definite feeling of letting go.
- Rest for 10 seconds – repeat Step 1, and remember it is important to rest. If you find it easy to hold, try to hold longer and repeat as many as you are able. Work towards 10 long, strong holds. This is 1 set.
- Now try 5–10 short, fast and strong contractions.
While you are doing these exercises:
- don't hold your breath
- don't push down instead of squeezing and lifting
- don't pull your tummy in tightly
- don't tighten your buttocks and thighs.
Try to set aside 5–10 minutes in your day for this exercise routine, and remember, quality is important. A few good contractions are more beneficial than many half-hearted ones and good results take time and effort. Remember to use the muscles when you need them most. That is, always tighten before you cough, sneeze, lift, bend, get up out of a chair, etc.
How do I improve on my exercises?
Increase the length of time and number of holds you do in succession before experiencing muscle fatigue. Work towards 10 long, strong holds. Improvement in pelvic floor muscle strength will take 3–6 months of regular exercises.
- keep your weight within a healthy range for your height and age
- seek medical advice for chronic cough
- develop good bowel habits.
There are health professionals qualified to help you with bladder control problems. Ask your GP for advice.
Pelvic floor training for men Continence NZ
Pelvic floor disorders Physiotherapy NZ
Pelvic floor muscles - a patients guide Family Doctor NZ