Continence Foundation of Australia

What are the pelvic floor muscles?

The pelvic floor is a group of muscles that stretch like a hammock from the pubic bone at the front, to the coccyx (tailbone) at the back and from one ischial tuberosity (sitting bone) to the other (side to side).

A male’s pelvic floor muscles support his bladder and bowel. The openings from these organs (the urethra from the bladder and the rectum from the bowel) pass through the pelvic floor. The pelvic floor muscles wrap firmly around these passages to help keep them shut.

When the pelvic floor muscles are strong they help prevent the leaking of urine (wee) and faeces (poo). The pelvic floor muscles also help with sexual sensation and function.

PELVIC FLOOR PROBLEMS

Pelvic floor problems can occur when the pelvic floor muscles are stretched, weakened or too tight.

Weak pelvic floor muscles

Pelvic floor muscles can be weakened by:

• surgery for bladder or bowel problems
• constipation
• being overweight
• persistent heavy lifting
• high impact exercise
• long-term, persistent coughing (such as smoker’s cough, bronchitis or asthma)
• ageing.

In almost all cases, weakened pelvic floor muscles can be strengthened with pelvic floor muscle exercise.

Pelvic floor muscles that are too tight

A hypertonic pelvic floor occurs when the muscles in the pelvic floor become tense and unable to relax. Many people who have a tense pelvic floor may experience constipation, painful sex, urgency and pelvic pain.

A women’s, men’s and pelvic health physiotherapist can help you manage or treat your hypertonic pelvic floor.

PELVIC FLOOR MUSCLE EXERCISE

The benefits of pelvic floor muscle exercise (also known as Kegel exercises)

The pelvic floor muscles are like other muscles in the body – they become stronger with regular exercise.

• Men with stress incontinence (men who wet themselves when they cough, sneeze or are active) will find pelvic floor muscle exercises can help improve their symptoms.
• Pelvic floor muscle exercise may also be of use for men who have an urgent need to pass urine more often (called urge incontinence).
• Men who have problems with bowel control might find pelvic floor muscle exercises can help the muscle that closes the anus (back passage). This muscle is one of the pelvic floor muscles.

It is recommended that you exercise your pelvic floor every day to help strengthen them and work more effectively.

Finding the right muscles

Before you start pelvic floor muscle training you need to identify the muscles to train. There are several ways to do this:

• When you go to the toilet, try to stop or slow the flow of urine midway through emptying your bladder. If you can do this you are squeezing the correct muscles. Only try this method once per week. If you do this too often your bladder may not empty the way it should.
• Sit or lie down with the muscles of your thighs, stomach and buttocks relaxed. Squeeze the ring of muscle around the anus (back passage) as if you are trying to stop passing wind. Now relax this muscle. Squeeze and let go a couple of times until you are sure you have found the right muscles. Try not to squeeze your buttocks.
• Stand in front of a mirror with no clothes on. Pull in your pelvic floor muscles strongly and hold them. You should see the penis draw in and your scrotum should lift.

Watch the video above to help find your pelvic floor muscles.

Finding the pelvic floor muscles can be difficult and it does take practice to squeeze the right muscles in the right way. If you don’t feel a distinct ‘squeeze and lift’ of your pelvic floor muscles, ask for help from a Nurse Continence Specialist or a Women’s, Men’s and Pelvic Health Physiotherapist.

How to do pelvic floor muscle exercise

Once you can feel your pelvic floor muscles working, you can start exercising them:

• Pelvic floor muscle exercises can be done anywhere – while sitting, standing or lying down.
• Squeeze and draw in the muscles around your anus (back passage. Lift them UP inside. You should have a sense of “lift” each time you squeeze your pelvic floor muscles. Try to hold them strong and tight as you count to 8. Now, let them go and relax. You should have a distinct feeling of “letting go”. If you can’t hold for 8, just hold for as long as you can.
• Repeat “squeeze and lift” and let go. It is best to rest for about 8 seconds in between each lift up of the muscles.
• Repeat this “squeeze and lift” as many times as you can, up to a limit of 8 to 10 squeezes. This equals one set.
• Try to do three sets of 8 to 10 squeezes each day.

While doing pelvic floor muscle training:

• keep breathing
• only squeeze and lift
• do NOT tighten your buttocks
• keep your thighs relaxed.

Pelvic floor exercises are most effective when individually tailored and monitored. If you are not sure that you are doing the squeezes right, or if you do not see a change in symptoms after three months, ask for help from your GP, a Women’s, Men’s and Pelvic Health Physiotherapist or Nurse Continence Specialist.Visit the Pelvic Floor First website for more information on pelvic floor exercises and ways to modify your exercise routine to suit your pelvic floor strength.

Below are exercises that should be done 3 times a day. They can be done almost anywhere and anywhere.

SEEK HELP

The exercises described above are only a guide and may not help if done incorrectly or if the training is inappropriate. Talk to your doctor, men’s, women’s and pelvic health physiotherapist, or contact the National Continence Helpline on 1800 33 00 66 for further advice.

You can search for a list of men’s, women’s and pelvic health physiotherapists on the Australian Physiotherapy Association website and on our service provider directory.