What do these muscles do?  

The pelvic floor muscles help to support the pelvic organs – the bladder and the lower part of the bowel.  These muscles assist in the opening and closing of the outlets from these organs. 

When the pelvic floor muscles are strong we can control starting, stopping, and slowing the flow of urine. Strong pelvic floor muscles allow us to control passing wind (gas) and bowel motions (faeces, stools, poo). Pelvic floor muscle strength is also important for sexual functioning in men. 

Diagram Male Pelvic Floor Muscles

Where are they?

The pelvic floor muscles are a group of muscles that are attached to the pubic bone at the front, sit bones (ischial tuberosities) at each side and the tailbone (coccyx) at the back.

How do you exercise pelvic floor muscles? 

It is best to find a position where you can feel the muscles contract effectively. Often sitting in a firm chair, and leaning slightly forwards or standing up may be suitable. Keep your legs apart to avoid tightening the inner thigh muscles when trying to contract your pelvic floor muscles. It is also important to avoid pulling in your abdominal muscles or holding your breath as this will prevent you from contracting your pelvic floor muscles effectively. 

First tighten the muscles around the back passage (anus) as if to hold in gas, then tighten the muscles around the urethra as if you are stopping the flow of urine. Next use these muscles to pull the testicles gently upwards.  Hold this contraction while you count to three and then gently relax the muscles.  Rest for a moment and then repeat seven more times. 

How do I know if the muscles are working properly?  

When in the toilet start passing urine and then try and stop or cut off the flow. This action is performed by your pelvic muscles. Next empty your bladder and then do a pelvic floor muscle contraction. You may find that you now have a better awareness of how this muscle feels when you contract it. This action should not be done every time you go to the toiletand is not a pelvic floor muscle exercise.This action is used only to identify the pelvic floor muscle action. 

Some men observe that if they stand in front of a mirror that they can see a slight lift of the testicles and a dip and lift of the penis when they contract their pelvic floor muscles. 

How many exercises should I do per day? 

Pelvic floor muscle training to increase muscle strength is more about doing the exercise well rather than doing lots of exercises.

A commonly suggested exercise program is to do two sets of 8-12 contractions, three times per day. Pelvic floor muscle training needs to be adapted to the individual, and can change over time, particularly if the muscles were quite weak before the program commenced. A pelvic floor physiotherapist can prescribe an individualised exercise program that will progressively work to increase muscle strength.

If leakage is occurring with activities such as getting out of a chair or coughing, brace the muscles first. This is done by tightening or contracting the pelvic floor muscles before you cough, lift, sneeze, get out of a chair or do whatever else it is that makes you leak.   

Can the muscles be too strong? 

The muscles in our body work in a reciprocal way. We have muscles that bend our limbs and an opposite group of muscles that straighten them. With our pelvic floor muscles, it is important to be able to contract and relax the muscles. Overly tight pelvic floor muscles can lead to pain. This pain can be made worse by attempting to further strengthen the pelvic floor muscles. A pelvic floor physiotherapist can help to treat pelvic pain resulting from muscle strength imbalances.  

How long does it take for the muscles to get strong? 

This will depend on the strength of the pelvic floor muscles when you commence your strengthening program, and if your muscle weakness is affected by damage or injury to the pelvic nerves. It will often take a few weeks or longer before a change in muscle strength is noticed. 

Many people are not able to contract their pelvic floor muscles effectively. It is often very helpful to have an assessment and receive professional advice from a pelvic floor physiotherapist.  

What else helps? 

In addition to training the pelvic floor muscles it is important to address factors that can strain and potentially weaken your pelvic floor muscles. 

These factors can assist in addressing pelvic floor muscle problems:

  • quitting smoking to reduce coughing
  • addressing constipation to avoid straining on the toilet 
  • bracing the pelvic floor muscles before lifting something heavy
  • aiming to achieve a body weight within the healthy weight range 
  • seeking professional advice from a pelvic floor physiotherapist 

Contact us for more information. 

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Kylie – parent of a child that wets the bed 

Kylie rang our service as she was concerned about her five-year-old daughter, Mia, who was wetting the bed. Kylie had tried limiting Mia’s drinks in the late afternoon and evening and was also getting up at night to wake Mia and take her to the toilet.

Our advisor explained that it may take children until they around 5 ½ years old before they gain bladder control during sleep. Kylie was advised to encourage Mia to drink well throughout the day and was cautioned against cutting out drinks in the afternoon and early evening. Kylie was discouraged from waking Mia at night to take her to the toilet. Kylie was provided with information on obtaining a referral from Mia’s doctor to a bedwetting clinic if Mia continues to wet the bed past 5 ½ years of age.

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Anastasiya’s story

“As a mum of two young children, I have experienced the joys of two pregnancies and postpartum recoveries. I was shocked after the birth of my first child to discover that my pelvic floor muscles had become weak. I sought advice from Bladder and Bowel Health Australia and learnt the importance of exercising these muscles. This knowledge helped, and because I was better informed second time around, I have now fully restored the dignity of my body and truly enjoyed the changes - and my motherhood. Thank you, Bladder and Bowel Health Australia, for informing young families about bladder and bowel health issues.” 

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Doreen – carer of her husband who has dementia 

Doreen was becoming exhausted caring for her husband Tom, who has dementia. Tom was not always making it to the toilet on time and needed his trousers to be changed several times a day. Every day Doreen was also washing bedlinen and the four towels that Tom was laying on at night as he was soaking through his pull-up pants. 

Tom was receiving a high-level Home Care Package, and Doreen was able to arrange with their provider for some of Tom’s package to be allocated to funding continence assessment and management.  

Our advisor went to Tom’s home and conducted a thorough continence assessment. A continence management plan was developed with input from Doreen, and appropriate incontinence aids and linen protection were organised. Doreen is relieved that Tom’s incontinence has reduced, and her washing load has lessened. Doreen is now confident that she can continue caring for Tom in their home. 

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Gary – experiencing leakage after his recent prostate surgery 

Gary met with one of our Bladder and Bowel Health advisors, as he was concerned about his urine leakage that was persisting after his radical prostatectomy five weeks earlier.   

Gary discussed his concerns with the advisor and was reassured that he was making good progress towards regaining bladder control. This reinforced the information he had received from his urologist. Gary was encouraged to switch to a smaller incontinence pad rather than continuing to wear the pull- up incontinence pants he had worn since his surgery. The advisor arranged some smaller pads for him to trial and provided details on where he could buy them close to his home. 

Gary was encouraged to drink plenty of fluid (particularly water) and to increase his fruit and vegetable intake to avoid constipation. Gary was uncertain if his pelvic floor muscles were working properly and he was referred to a pelvic floor physiotherapist. Gary left the clinic in a brighter frame of mind, confident that he was improving and had clear strategies to further support his recovery.