Pelvic Health Physiotherapy for Men: Not Just Kegels and Not Just for Women

When you hear "pelvic floor," you might think it’s something only women deal with but that’s not true.

Men have pelvic floors too, and when these muscles aren’t working properly, it can lead to bladder leaks, constipation, pelvic pain, or sexual problems.

Pelvic health physiotherapy helps these muscles work their best and it’s not just about Kegels, and definitely not just for women.



It can help men of all ages including athletes, fathers, workers, students, and seniors who may be dealing with pelvic pain, leakage, constipation, or recovery after prostate surgery.

Many men feel confused or even embarrassed to talk about these symptoms. But you’re not alone and you don’t have to just live with it.

In this blog, we’ll explain what the pelvic floor does, the common issues men face, and how pelvic health physiotherapy can help with real solutions backed by research and international guidelines.

What is the Pelvic Floor? 

Think of the pelvic floor muscles like a hammock at the bottom of your pelvis.
These muscles support important organs like the bladder, bowel, and prostate.
In men, they also play a big role in:

• Controlling urine and bowel movements
• Erection and ejaculation
• Core strength and stability
• Breathing and posture

These muscles work all day without us even noticing — until something goes wrong.

Conditions Pelvic Health Physiotherapists Treat in Men

Pelvic health physiotherapy helps men with a wide range of concerns.
Some of the most common concerns are:

Leaking when you cough, sneeze, or lift something? Or needing to rush to the toilet suddenly and often?

This could be a sign of:

• Stress incontinence
• Urge incontinence (overactive bladder)
• Post-prostate surgery incontinence

Research shows that pelvic floor muscle training is effective for treating male incontinence, especially after prostate surgery.  According to the European Association of Urology (EAU) and International Continence Society, pelvic floor physiotherapy is a first-line treatment

If you're:

• Going to the bathroom more than 8 times a day
• Waking up at night to pee (nocturia)
• Feeling a sudden strong urge to pee

These are signs of OAB, which can often be improved with pelvic health physiotherapy for:

• Bladder retraining
• Pelvic floor muscle control
• Lifestyle changes guided by your pelvic health physiotherapist
  
  

3. Constipation and Bowel Straining

Hard to empty your bowels? Straining too much? Feeling like you haven't fully emptied? That might mean your pelvic floor isn’t relaxing properly.

Pelvic Health Physiotherapy helps by:

• Teaching toileting positions
• Breathing techniques
• Improving coordination of muscles
  
  

4. Diastasis Recti Abdominis (DRA) in Men

Yes, men can get DRA too. This is when the abdominal muscles separate, often from:

• Heavy lifting 
• Weight gain
• Poor core control 

Pelvic Health physios assess core and pelvic floor coordination, and design safe exercises to close the gap and prevent injury.

5. Chronic Low Back or Hip Pain

Did you know your pelvic floor is part of your core? Studies show that pelvic floor dysfunction can contribute to back and hip pain, especially when regular physio hasn’t helped.

Pelvic health physiotherapists assess the entire core system — including breath, pelvic muscles, and posture — to support improved function and long-term recovery.

Pain in the penis, testicles, rectum, tailbone, or groin? Feel like you're sitting on a golf ball?

You may have even been diagnosed by a medical doctor as having chronic pelvic pain syndrome or nonbacterial prostatitis.

Men with this condition often go through:

• Negative urine tests
• Antibiotics that don’t help
• Frustration and no clear answers

But pelvic floor physiotherapy can help relieve pain by:

• Releasing tight pelvic muscles
• Treating nerve tension (like pudendal nerve irritation)
• Teaching pelvic relaxation exercises and breathing techniques
  

7. Post-Prostate Surgery Recovery (Prostatectomy)

After prostate surgery, it’s common to have:

• Bladder leaks
• Erectile dysfunction
• Pelvic pain

Physiotherapy before and after surgery is proven to:

• Improve continence
• Support sexual function
• Reduce pain and tension

A 2014 study in The Lancet showed that pre-op pelvic floor training led to faster continence recovery after prostatectomy.

International guidelines (EAU, AUA, ICS) recommend pelvic physiotherapy as part of standard care after prostate surgery.

What About Athletes?

High-impact sports like running, basketball, weightlifting, and cycling can stress the pelvic floor.

In men, studies show pelvic floor issues are underreported, but common in elite athletes, especially with:

• Groin pain
• Hip dysfunction
• Hernias
• Leakage during effort
  
  

Pelvic Health Physiotherapy helps by:

• Improving core control
• Enhancing load transfer
• Preventing future injuries 
• Hence aiding improved recovery and performance

Let’s Talk About Sexual Health

The pelvic floor also plays a role in:

• Erection and ejaculation
• Blood flow to the genitals
• Pelvic sensation
  
  

Weak or tight pelvic muscles can impact your sexual health. Pelvic Health Physiotherapy can assist in maximizing pelvic floor function to improve:

• Erectile function
• Orgasm
• Pelvic confidence

Final Thoughts: You’re Not Alone

Many men suffer in silence, thinking things like:

“This is just part of aging.”
“I’m embarrassed to talk about it.”
“There’s no real solution.”

But help is available, and is backed by research.

Pelvic health physiotherapists like Natalie Lehto and Wendy Handcock at Fit for Life Physiotherapy in Burlington are specially trained to assess and treat MEN dealing with these issues in a respectful, supportive, and evidence-based way.

Whether you’re recovering from prostate surgery, managing pelvic pain, or want to improve your bladder/bowel or sexual function — know that you don’t have to go through it alone.

Your body is worth it.
Your health matters.
Let’s get you back to feeling like yourself again.

Natalie Lehto is a registered physiotherapist with 20+ years of orthopaedic clinical experience and a passion for helping others achieve their physiotherapy goals. She is also Rostered with the College of Physiotherapists of Ontario to provide Pelvic Health Physiotherapy. Natalie has a special interest in working with runners to help them feel their best and reach their goals!  Interested in working with Natalie? Book in here.

References:

1. Hunter KF, Moore KN, Cody DJ. (2007). Pelvic floor muscle training for preventing and treating urinary incontinence in men. Cochrane Database of Systematic Reviews.
2. Filocamo MT, Li Marzi V, Del Popolo G, et al. (2005). Effectiveness of early pelvic floor rehabilitation treatment for post-prostatectomy incontinence. European Urology, 48(5), 734–738.
3. Centemero A, Rigatti P, Giraudo D, et al. (2010). Preoperative pelvic floor muscle exercise for early continence after radical prostatectomy: a randomized controlled study. European Urology, 57(6), 1039–1043.
4. Dorey G, et al. (2005). Pelvic floor muscle exercises for erectile dysfunction. BJU International, 96(4), 595–597.
5. Nygaard I, Shaw JM. (2016). Physical activity and the pelvic floor. American Journal of Obstetrics and Gynecology, 214(2), 164–171.
6. Tariq SH, Haleem A, Mohiuddin K. (2020). Pelvic Floor Dysfunction in Male Athletes: Review and Recommendations. Journal of Sports Sciences, 38(20), 2354–2361.

Guidelines & Position Statements

1. European Association of Urology (EAU) Guidelines
   Guidelines on Urinary Incontinence and Male LUTS (Lower Urinary Tract Symptoms)
   
   
2. International Continence Society (ICS)
   Recommendations on pelvic floor muscle training and pelvic pain management
   
   
3. American Urological Association (AUA)
   Guideline: Incontinence After Prostate Treatment (2020)