The Male Pelvic Floor

We need to talk more about the male pelvic floor. There is a lot of information out there about issues that women have but men have issues too. And, they definitely have a male pelvic floor, so lets go through a few things that might happen to the male pelvic floor.

What Happens?

As men age, their prostate will inevitably enlarge.  Sometimes this happens with no repercussions but all too often, when the prostate enlarges it may press on the urethra, causing bladder issues to arise.  Other problems may occur such as erectile dysfunction, pain at the tip of or base of the penis, pain during erection, pain during ejaculation, inability to completely empty the bladder, and post void dribbling.  As changes in the body happen, alignment may change causing muscles to react either by overworking and becoming tight and ineffective or underworking making them much less supportive.

What sort of conservative treatment is available?

Though surgery and medications are an option, seeking out a conservative yet proactive approach to improving the health of the male pelvic floor is a great first option.  Pelvic floor physiotherapy is slowly becoming more recognized at helping both men and women address issues with pelvic floor issues such as incontinence, prolapse and pain.  A great first start is to find and try to activate your own male pelvic floor muscles.

Where are they?

The male pelvic floor muscles lie front to back between the pubic bone and the tailbone and side to side between your two sit bones.

Function

The male pelvic floor muscles help:

  • control bladder and bowel function (helps control the opening/closing of the urethra and the anus)
  • give support to your back, hip and pelvis
  • gives support to the organs (bladder, rectum, prostate and seminal vesicles)
  • aid in sexual function

Why do the muscles weaken?

  • lack of exercise – these muscles need to maintain proper muscle tone so if they aren’t utilized properly, they will weaken
  • obesity – an increase in weight can increase the load the pelvic floor muscles have to support
  • chronic straining – coughing or straining during bowel movements will put an increase in pressure, pushing down through the pelvic floor
  • surgery – abdominal surgery/prostate surgery

How do I find my male pelvic floor muscles?

First, notice how they work visually.  Stand in front of a mirror, naked.  Use these cues:  try and stop the flow of urine and try and stop the passing of gas.  What do you want to see?  You want to see an upwards lift from the scrotum and penis.

Next, when you are going to the bathroom next time, try and stop the flow of urine.  This is a test to see if your muscles are strong enough to do this.  Never do this regularly as it will interrupt the proper functioning of the bladder.  This is only a test to see how able your pelvic floor muscles are at this time.  This utilizes the pelvic floor muscles more closely associated with your urethra.

Next, try and stop the passing of gas.  This utilizes the pelvic floor muscles more closely associated with your anus.

How do I practice my male pelvic floor exercises?

Because your pelvic floor muscles have both slow twitch muscle fibres (used for holding for longer periods of time) and fast twitch muscle fibres (used for quick movements), your pelvic floor needs to be trained a couple of different ways.

Sitting in a chair with your feet flat on the floor, knees are slightly apart, lean forward and rest your elbows on your knees.  First, close and draw up the muscles around your urethra, as if you are trying to stop the flow of urine.  While still holding this, close and draw up the muscles around your anus, as if you are trying to stop the passing of gas.

Slow Twitch Muscle Fibres:  Hold this, working up to 10 seconds and repeat 10x

Fast Twitch Muscle Fibres:  Hold for one second, release completely, repeat 30x

The ‘release’ component is very important because overly tight muscles do not work well.  Perform these exercises 3x per day to begin with.  This will allow your body to become familiar with this movement.  Once you are more comfortable activating these muscles in the above position, add in other positions, such as:

  • standing
  • laying down
  • walking

How do I know if my muscles are stronger?

If you found that when you were testing whether or not you could stop the flow of urine, you can use this as a test.  Only test once every couple of weeks.

This article only addresses how to strengthen weakened pelvic floor muscles.  Sometimes, this is all that is needed.

What if this doesn’t change anything?

If you find that:

  • you aren’t sure if you are doing this right
  • this is not helping with your particular problem
  • this is making things worse

This means there are other areas of the pelvic floor that might need help.  This is the time to seek out help from a pelvic floor physiotherapist in your area.  Bladder and bowel habits, diet and overactive pelvic floor muscles can cause problems as well and these will addressed in future articles.