Men have a pelvic floor too. Most have never been shown how to use it. Here is how to find it, the first exercise, and how to know you have it right.
Your pelvic floor is a hammock of muscle that runs from your pubic bone to your tailbone. It wraps around the urethra and shuts off the flow of urine when it squeezes.
A kegel is that squeeze, done on purpose. It is small. A gentle squeeze and lift deep inside the pelvis. Nothing on the outside of your body should move.
Men who leak when they cough, sneeze, lift, or stand up. Men getting ready for prostate surgery, and men recovering from it. Those are the men I teach this to most.
The pelvic floor also plays a direct part in erections. It helps hold blood in the penis. A stronger pelvic floor supports erectile quality.
The urine cue. Imagine you are urinating and need to stop mid-stream. The muscles that would shut off the flow are your pelvic floor. Use it as a picture. Do not practice it on the toilet.
The gas cue. Imagine holding back gas in an elevator. That squeeze is the back part of your pelvic floor.
The lift cue. Picture the pelvic floor as an elevator. Draw it up one floor. Not ten.
When you have it, you feel a subtle squeeze and lift inside. Your belly stays soft. Your glutes stay relaxed. You keep breathing. If you are turning red, you are trying too hard.
Lie on your back with your knees bent and your feet flat. Gently squeeze and lift. Hold for two to three seconds. Let go completely and rest for ten seconds.
Do five of those, three times a day. It looks like too little. It is not. You are teaching your brain to find the muscle, and that comes before strength.
Dr. Meg Cochran, DPT shows the first pelvic floor exercise for men, lying down, with the cues that make it click.
The pelvic floor does two jobs. It holds steady for a long walk, and it reacts fast to a sneeze. Those are different muscle fibers.
Slow holds build endurance. Quick squeezes, a fast pulse and release, build speed. You need both.
Bearing down instead of lifting. If it feels like pushing out, it is backwards.
Holding your breath. If you cannot breathe and hold the squeeze together, ease off.
Squeezing your abs. Put a hand on your belly. If it tenses, the wrong muscles are helping.
Doing too many too soon. More is not better. A tired pelvic floor is a weak one.
Only doing slow holds. Without quick squeezes, a cough still gets through.
Relaxing matters as much as squeezing. End each session with five slow belly breaths and let the pelvic floor soften and drop.
If kegels cause pain, or you have pelvic pain to begin with, stop and see a pelvic floor physical therapist. Some men need to learn to relax this muscle before they strengthen it.
Once you can find the muscle every time, the work moves in a set order. Longer holds. Then sitting. Then standing. Then walking. Lying down is where you learn it. Upright is where you need it.
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Dr. Meg Cochran is a licensed Doctor of Physical Therapy specializing in pelvic floor rehabilitation, and treats men after prostate surgery through Where You Are Physical Therapy in Oxford, Mississippi.
This article is educational and is not medical advice, a diagnosis, or a substitute for in-person care. Follow your surgical team's instructions. If you have urgent symptoms including severe pain, fever, unexpected bleeding, or a sudden change in function, contact your healthcare provider.
The first week after prostate surgery, written out step by step by Dr. Meg. What to do with the catheter in. What to skip. What to have in the house. Enter your email and it opens right away.
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Educational content. Not medical advice.
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