Transcript of Video
Let’s talk for a minute about your pelvic floor. Your pelvic floor is that hammock of muscles that the urethra, the rectum, for women the vagina, pass through. So for women, when you urinate, pass gas, have a bowel movement, have intercourse, that group of muscles should get out of the way, and you want them strong enough and under control that when you need them, they’ll help you keep from leaking urine, keep from passing gas, finish a bowel movement.
Well, men, you also have the same pelvic floor structure. So when you urinate, ejaculate, pass gas, have a bowel movement, those muscles need to get out of the way, and you want them strong enough and under your control that they’ll help you keep from leaking urine, keep from passing gas, finish your bowel movement. One aspect that we need to discuss is those patients who have a very tight pelvic floor all the time, and that’s patients who can not relax your pelvic floor. If we were to go into a female’s vagina and feel, those muscles are really tight and really can be tender when you feel them. For a man, I touch the space between the scrotum and the rectum, I can tell if that muscle is really tight and if the male is able to relax that muscle. So take-home message is men and women both have pelvic floor muscles. They can be either really lax and you’re having issues because you’re leaking, or they can be really tight, causing pelvic pain, or prostatitis, chronic pelvic pain for men.
So we recommend the same pelvic floor muscle exercises for men as we do for women. They’re also called Kegel exercises. I like to call them exactly what they are, they’re pelvic floor muscle exercises. And we give the same advice to men on how to do their pelvic floor exercises as we do for women. Women ask about some of the devices, especially things that you see on TV, Kegel weights or eggs or things. I think those are extra expenses, and I think they’re a waste of your money because you ought to be able to contract that muscle without having anything to help you do that. It’s an internal movement. If you focus on your rectum and try to squeeze your rectum shut, that’s your pelvic floor muscle.
Sometimes you will hear the Pilates instructor or the yoga instructor say, “Engage your pelvic floor.” Again, that is that hammock of muscles, and when you go to engage that pelvic floor, you want to try to isolate it and only contract that muscle. Often what they’re asking you to do is actually lift your pelvis off the floor. So when you do that, you are engaging the pelvic floor muscle and other muscles at the same time, so you will be exercising both sets of muscles and in essence somewhat diluting your effect. If you’re totally focusing on only your pelvic floor, then you isolate that muscle and try not to use any other muscles while you are exercising.
I’m often asked about pelvic floor exercises: “How do I know if I’m doing it right?” Well, the hard part about that is nobody knows but you whether you’re doing it. I would be happy and so would my colleagues here to do an exam on you and see if you’re doing them correctly, but the best way to know for sure that you have a handle on the right muscle and you’re doing it correctly is to come in, let’s do an exam, touch and feel while you’re doing it, and let me coach you on how to do your pelvic floor muscles and do them correctly.