Search Knowledge Base by Keyword
Pelvic Floor Muscle Strengthening (Kegels) for Males (or if you have a Penis)
The pelvic floor muscles are a group of muscles which extend from the pubic bone in the front to the tailbone in the back, and side to side at the sitz bones (which are the bony structures you feel when you sit). These muscles are like a trampoline and form the bottom of your abdominal container. They are in the shape of a kite, similar to two triangles, back to back. The triangle in the front is called the urogenital triangle, and the back, the rectal triangle. The front triangle has the urethral (where urine exits) and the back triangle has the rectal opening.
You can refer to the picture above of the pelvic floor muscles while you are learning how to do these exercises. It may helpful to visualize where these muscles are and how the muscle fibres are oriented.
Key Points on Pelvic Floor Strengthening:
- The front and back triangles are connected and will contract together.
- Based on your symptoms, you can focus on one triangle (front triangle for urinary incontinence, back triangle for fecal incontinence).
- Close your eyes as you are visualizing the contraction since these muscles work well under visual guidance.
- To contract the front triangle, imagine that there is a blueberry sitting at the opening of your urethra (where urine exits). Squeeze the blueberry and draw it inward towards your bellybutton.
- Other cues for the front triangle include shortening your penis, drawing the train into the station, and pulling your penis into your body. Or you can also imagine you are stopping the flow of urine (never actually stop the flow of urine on the toilet, this can prevent you from completely emptying your bladder).
- You can verify that you are doing this correctly by standing in front of a mirror and visualizing your penis being pulled in towards your body.
- To contract the back triangle imagine you are stopping the passage of gas or as if you are drawing in a marble into your rectum.
- Other cues you may connect with include drawing your pubic bone and tailbone together and inwards or drawing your two sitz bones together and inwards.
- To start, test how long you can hold the contraction without feeling the muscles let go and add one second to this starting point. Slowly, over the following weeks, you can build up to 10-second holds.
- Hold each area for up to 10 seconds without feeling the muscles let go and repeat up to 30 times, once per day.
- You should rest for 10 seconds in between each contraction.
- Make sure you are not holding your breath or using your buttocks, inner thighs or abdominal wall.
- Nobody should see any movement while you are doing your pelvic floor contractions.
- Start practicing your pelvic floor contractions in a lying position and progress to different positions (sitting, standing) and during various functional activities (sit-stand, squat, lift) when you feel ready.
- Coordinate your pelvic floor contractions with your breath. Breathe in and relax your pelvic floor, breathe out and contract your pelvic floor.
- It will take daily practice for 3-4 months to see the benefits.
- These muscles take a little bit of concentration, but with some effort, your brain will make a better connection.
Please note: Kegels are NOT always indicated and can sometimes aggravate your symptoms.
When your pelvic floor muscles are tight and weak, the tension is treated before the weakness. Once the muscles have reached a normal resting tone, and are able to relax fully, their strength is reassessed and strengthening exercises may be prescribed.
If your symptoms are not improving, or you think you have tension in your pelvic floor, seek out the help of a Pelvic Health Physiotherapist (link) who has training in internal palpation of the pelvic floor muscles. A customized program (not just Kegels) will be designed for you based on the physiotherapist’s subjective and objective findings.