Most exercises are considered gender neutral. Except for kegels — those exercises that strengthen pelvic floor muscles. They have long been tagged as "just for women," but older men may be wise to reconsider as they can help with some common unpleasantries that can come with age. "Men can also have issues with these muscles, which can cause urinary leakage, bowel issues, and even erection problems," says physical therapist Celia Brunette with Harvard-affiliated Spaulding Rehabilitation Center.
What is the pelvic floor?
Your pelvic floor area is made up of thin layers of muscle and tissues that stretch like a sling from your tailbone to your pubic bone. It does a lot every day. The muscles' primary job is to support the abdomen, bladder, and colon, and help with urine and bowel movements. In men, these muscles also are activated during erections, orgasms, and ejaculations. Problems can arise when pelvic floor muscles become too weak or too tight.
Weakness can happen because of age, as with other muscles, but other causes include bladder, bowel, or prostate surgery, constipation, and chronic coughing from conditions like asthma, bronchitis, or smoking. Weak pelvic floor muscles can lead to stress incontinence where urine leaks when you cough, sneeze, or are participating in an activity like lifting something heavy or even hitting a golf or tennis ball.
On the other end, tight pelvic floor muscles can result from prolonged sitting, general muscle tension and stress, and even musculoskeletal problems with your back and hips. A tense pelvic floor is like trying to open your fist after keeping it clenched all day. "It would be very hard to relax your grip, and you would lose function of your hand," says Brunette.
These tight muscles often can trigger pelvic pain, urgent and frequent needs to urinate, leakage, incomplete emptying, or straining during bowel movements. You also may suffer from sudden pain in your low back, hips, or genital area, or have pain during and after intercourse.
How kegels work
"Pelvic floor muscles are treated like with other muscles," says Brunette. "If you strain your back, you massage and stretch the muscles to get them healthy. The same approach applies here." Kegels can be performed while lying down, sitting, or standing, and unlike other exercises, the movements and sensations are subtle. Imagine how you would stop the flow or urine, or to hold back gas. The goal with kegels is to contract and hold only those muscles and not rely on other muscles like the abdomen or buttocks.
Don't go it alone
Brunette says you should not try kegels on your own at first because if not performed correctly, the exercises could make muscles worse, or not help at all.
Talk with your doctor to make sure there are no medical issues related to your symptoms, such as prostate problems or a urinary tract infection. If your doctor recommends kegels, he or she can direct you to a physical therapist who can evaluate your needs and design an individual program. A typical routine consists of a set amount of "hold" time, followed by adequate rest between reps. "The therapist teaches you how to perform the kegels and draws up a schedule to follow in terms of number of repetitions and sets, so you can then do them at home," says Brunette.