Pelvic floor exercises for men - stage one

The pelvic floor muscles sit at the bottom of your pelvis, between your legs. They are attached between the tailbone (coccyx) at the back to the pubic bone at the front and to each of your sit bones at the sides. This creates a hammock to support the pelvic organs such as the bladder and the bowel.

These muscles work to help to keep the bladder and bowel openings closed to stop leakage. They relax when you can pass urine and empty your bowels.

Pelvic floor muscles are like every other muscle in the body. They can become weak or damaged with injury, and enjoy regular exercise to stay strong and healthy.

How to contract the pelvic floor muscles (PFM)

1. Get into a comfortable position, either lying on your back or sitting, with your thighs and buttocks relaxed.
2. Keep your breathing natural, make sure you do not hold your breath. It might be helpful to breathe out when contracting the pelvic floor muscles.
3. To contract the pelvic floor muscles, start by drawing your penis into your pelvis to shorten it. Once you can do that, then try to also imagine you are trying to stop yourself passing urine. You should feel the testicles/scrotum lift and utethra (pee tube) and anus tighten. Keep breathing normally and do not pull your belly in or hold your breath.
4. You can check/feel the muscles working by placing your finger tips on the skin behind the scrotum (perineum).  You should feel the perineum lift up and away from your fingers.
5. You can also check by standing in front of a mirror without clothes on. You should see the base of the penis pull up towards your tummy.
6. After contracting the PFM it is important to fully relax in a controlled way. Let the penis lengthen, feel your testicles drop, the back passage relax and imagine the flow of urine starting. Do not push or strain.

Your exercise program

Now that you know how to contract the PFMs you can put them into action with two types of exercise. This should include slow exercises for endurance and fast exercises for power. It is important to do both. They should be practiced at least 4-5 times each day.  Try them in a variety of different positions.

• Lie on your back with your knees bent and feet comfortably apart (this is the first stage – easiest position)
• Sit up tall on a firm chair with your feet flat on the floor (Second stage – more challenging)
• Stand (third stage)

Slow Exercises

Pull up gently with your PFMs.  Hold for as long as you can (up to 10 seconds).  Make sure that you continue to breathe normally.  Your buttocks and abdomen should stay relaxed.  Fully relax the muscles, rest for a count of 6 seconds (or longer if needed) and then repeat as many as you can (up to 10).

How long can you hold?          ........... Seconds

How many times can you repeat?        ........... Times

Fast Exercises 

Pull up quickly and strongly with your PFMs, hold for 1 second and then relax. Ensure the muscles have relaxed properly and then repeat up to 10 times.

Build this up to 10 over a few weeks

How many fast contractions?   ................Times

Exercise Progressions

Each week try to gradually build up your exercise program – this can be by adding 1-2 seconds on a hold, or 1-2 repetitions for the slow and the  fast exercises. As it becomes easy to hold 10 seconds x 10 with 10 fast exercises when lying down, move on to practicing in sitting, and then move to standing.

In order to build muscle, exercises should be done with a good technique (breathing normally, using the correct muscles) but should still be challenging, if it becomes very easy move onto the next stage.

Further progressions can be found in the NHS Fife pelvic floor exercises stage 2 and 3 leaflets.

Other useful strategies

The Knack

Tighten your pelvic floor quickly just before and during activities such as lifting, coughing, sneezing or shouting.

Reduce pressure on the bladder

When moving from sitting to standing or getting out of bed, there may be an increase in pressure on the bladder which causes you to leak. Reduce this pressure by exhaling on the effort and use the large muscles of the arms and legs to assist you.

When getting out of bed:

• Roll onto your side
• Drop your legs over the edge of the bed
• Use your hands to push up from the bed and exhale as you do so

When standing from a chair:

• Move your bottom forward slightly to the edge of the chair
• Place your feet shoulder width apart
• Lean forward to get your nose over your toes
• Push up through your legs and exhale as you do so

Post void (post pee) dribble

.  If you experience this type of leakage, try this:

After you have emptied your bladder, try pulling up your pelvic floor muscles strongly and let go 2-3 times while still over the toilet. This should help to move any urine left behind in the utethra (pee tube) and allow it to flow into the toilet, instead of leaking out as you start moving

Warning

Stopping the flow of urine midstream does work your pelvic floor, and can be a helpful way of understanding if you are using the correct muscles for your exercises. If you cannot stop the flow initially, you can try this as a test once a month, to check your technique or progress.

However, this should not be done on a regular basis or used as a daily exercise.  It may interfere with normal bladder function.

Further Resources

Prostatescotland.org.uk – pelvic floor exercises following prostate surgery

Pelvic Floor Exercises - Videos and Information - Prostate Scotland

Male Pelvic Floor | Exercises | Continence Foundation of Australia