Free guide from De Luca Beauty

The pelvic floor guide for men

A straight explanation of what it does, why it changes after surgery or with age, how to train it properly, and what to do when that is not enough.

What it actually is

Your pelvic floor is a sling of muscle running from your pubic bone at the front to your tailbone at the back, like a hammock across the base of your pelvis. It holds up the bladder and bowel, it is what you clench to hold on when you cannot get to a loo, and it works with your deep abdominal muscles to stabilise your lower back.

It is a muscle group like any other. It weakens when it is not used, and it responds to training. The difficulty is that you cannot see it working, which makes it uniquely easy to get wrong.

Why it changes

• Prostate surgery. The most common reason men come to us. Surgery can disturb the mechanism that keeps you continent, and the pelvic floor takes on more of that job afterwards. Training it is standard advice both before and after the operation.
• An enlarged prostate. Very common with age, and it changes how the bladder empties.
• Everything else. Age, a chronic cough, repeated heavy lifting, constipation and straining, and carrying extra weight all add load over years.

What it looks like when it is weak

• Leaking when you cough, sneeze, lift or exercise
• Dribbling shortly after you have finished at the urinal
• Needing the loo urgently, or planning around where one is
• Back pain, or feeling unstable through your middle
• Erections that are not what they were, since the same muscles play a part in maintaining one

Men are far less likely than women to mention any of this to anybody. It is common, it is treatable, and it is not something you have to put up with.

How to do them properly

Most people have been told to “do your pelvic floor exercises” and never shown how. Here is the technique.

Finding the right muscles

Imagine stopping yourself passing wind, and at the same time drawing up as if stopping the flow of urine. That lift is the movement. Do not actually practise stopping mid-flow on the loo, as it can upset how the bladder empties.

The two kinds of squeeze

• Slow holds. Draw up, hold for as long as you comfortably can up to ten seconds, then fully release. Rest for four seconds. Repeat up to ten times.
• Quick squeezes. Draw up sharply and let go straight away. Repeat up to ten times. These are what catch a cough or a sneeze.

Three sets a day is the usual recommendation, and it takes months rather than weeks to notice a difference.

The four mistakes almost everyone makes

• Holding your breath. You should be able to talk normally throughout.
• Squeezing the wrong things. Buttocks, thighs and stomach should stay relaxed. If they are joining in, you are not isolating the right muscles.
• Never fully letting go. The release matters as much as the lift. A pelvic floor that cannot relax causes its own problems.
• Stopping too soon. Most people give up before the point where anything would have changed.

Why they often do not work

This is the part nobody tells you. Doing pelvic floor exercises on your own is genuinely difficult, for three reasons.

• They are hard to get right unsupervised. Research consistently finds a large proportion of people are not contracting the right muscles when they think they are, and there is no way to tell from the outside.
• They are easy to forget. Three sets a day, every day, for months, with nothing visible happening for weeks. Most people drift off within a fortnight.
• They are hard to make harder. Muscles strengthen when you progressively increase the load. With a squeeze you cannot see, there is no weight to add.

None of that means the exercises are pointless. They are the right first step and worth doing properly. It means that if you have been doing them and nothing has shifted, that is a very common place to be, and it is not because you have not tried hard enough.

Where the chair comes in

We now have a BetterPelvi chair at the salon. You sit on it fully clothed for twenty-eight minutes. Nothing is removed, nothing is inserted, and you do not have to do anything.

The chair contracts the pelvic floor for you, far more deeply and far more often than you could manage on your own, which takes the three problems above off the table: the right muscles are worked whether or not you can find them, you cannot forget to do it, and the intensity can be raised as you go.

It is not a medical treatment and it is not a replacement for seeing your GP. It is a way of training a muscle group that is otherwise very hard to train.

Download this guide as a PDF to keep or print.

De Luca Beauty, 26 Warley Hill, Brentwood, Essex CM14 5HA · 01277 848456 · delucabeautyuk@gmail.com
General information only, and not a substitute for advice from your GP or a pelvic health physiotherapist.