What are pelvic floor muscles?
They are the layer of muscles that extend from your pubic bone at the front to your tail bone (coccyx) at the back. Your pelvic floor provides the base to your pelvis (below your abdomen) and supports your bladder and bowel, as well as having a role in erectile function during intercourse.
Why train the pelvic floor muscles with exercise?
Many men suffer with weakness of the pelvic floor. If this happens you may experience a variety of symptoms including:
- Leaking urine during activity, for example when you sneeze, cough or laugh (known as stress urinary incontinence).
- A need to go to the toilet repeatedly during the day or night (known as frequency).
- An urgent need to visit the toilet and leaking before you get there (known as urgency incontinence)
- An inability to control the passing of wind or stool from your back passage.
- Erectile dysfunction (the pelvic floor helps you maintain erections).
- Reduces ‘post micturition dribble’
Why do the muscles weaken?
Factors leading to pelvic floor weakness or incontinence include:
- Prostate or pelvic surgery
- Straining to open your bowels due to chronic constipation
- Being overweight
- Chronic cough
Why should I do the pelvic floor exercises?
The pelvic floor can be strengthened to increase the support of the pelvic organs. This can improve bladder and bowel control and reduce/cure any leakage.
Identifying the pelvic floor muscles
It’s important to know where the pelvic floor muscles are, so that you are sure you’re exercising the correct ones. To identify the pelvic floor muscles, tighten your back passage as if you’re trying to stop yourself passing wind; at the same time, imagine you’re trying to stop yourself passing urine. You should have a sense of squeezing, pulling the back passage up and in. If you look in a mirror you may see the base of your penis retract slightly in your body and your testicles rise a little. Do not tighten your thighs or buttocks and do not hold your breath.
How do I do pelvic floor exercises?
You can exercise your pelvic floor anywhere and anytime. They can be performed lying, standing or moving but to start it may be easier to do the exercises sitting down. Make sure you’ve found the correct muscles, and know how it should feel when you tighten them, before trying these exercises.
There are two sets of exercises – slow and fast.
Slow pelvic floor muscle exercises
- Slowly tighten the muscles as described above.
- Try to hold this lift for up to 10 seconds. Keep breathing normally.
- Slowly relax the muscles and rest for 5 seconds.
- Aim to repeat the lift and rest up to 10 times.
Fast pelvic floor muscle exercises
- Repeat the same action, but this time try to tighten the muscles as quickly as possible.
- Hold the lift for one second and then let go.
- Try to do up to 10 of these short, fast lifts.
You may find that the muscles are very weak initially and that it takes a lot of concentration to exercise them. In addition, you might find that you can’t hold the lift for ten seconds. Just hold it for as long as you can and try to build up to ten
seconds. It’s more important to do the exercises properly than to do them for the full ten seconds.
How often should I do my exercises?
Practise these exercises three times a day - try to make them part of your daily routine. It will take up to four months of regular exercise to regain the strength in your pelvic floor muscles. Once your symptoms have improved, continue with the exercises once a day for the rest of your life.
How long should I continue with the exercises?
Continue pelvic floor exercise once daily for the rest of your life in order to keep these muscles fit and healthy.
Being constipated or overweight can strain the pelvic floor muscles. A balanced diet is important. You should try to drink 6-8 cups of fluid a day. Avoid tea, coffee or fizzy drinks if you have frequency or urgency.
Tighten the pelvic floor muscles before lifting anything heavy or if you are going to sneeze or cough.
If you have urgency, tighten your pelvic floor muscles when you have the desire to empty your bladder and only move when the desire has passed.
If you need more help with identifying your pelvic floor muscles or progressing your exercises, ask your Consultant or GP to refer you to a Specialist Continence Physiotherapist or Continence Adviser.
Dorey, G and Dorey, C (2001) Use it or lose it: a self-guide for men. London: Neen Healthcare
Versi, E and Christmas, TJ (1998) Bladder Disorders. Abingdon: Health Press
If you or the individual you are caring for need support reading this leaflet please ask a member of staff for advice.
© North Bristol NHS Trust. This edition published September 2019. Review due September 2021. NBT002673