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Specialized Physical Therapy to Treat ED


Pelvic floor exercises, also known as Kegels, are most widely associated with women, but they can do a world of good for men as well. These muscles provide critical support for the organs of the pelvic floor, which in men consist of the bladder and the bowel and in women include the uterus and vagina as well as the bladder and bowel.

In women, the rigors of childbirth are a leading cause of pelvic floor dysfunction, which in turn can morph into urinary or fecal incontinence as well as problems with sexual function. In men, traumatic injury, often sustained during sports play, can lead to pelvic floor dysfunction, which can also arise in both sexes because of a lack of exercise.

Digital drawing of the pelvic bone.

In men, the pelvic floor muscles play a significant role in urinary and bowel continence as well as in erectile function. 

Weakened pelvic floor muscles in men can also lead to erectile dysfunction, a problem that can be overcome with concerted efforts to strengthen those muscles through exercise. Stronger pelvic floor muscles also guard against urinary and fecal incontinence, which can be serious problems for elderly men just as they are for women.

What Do the Pelvic Floor Muscles Do?

Forming the bottom of your body’s core, the pelvic floor muscles consist of a band of interconnected muscle tissue, not unlike a hammock, that provides the foundation for the organs of the pelvis, as described earlier. The foremost role of these muscles is to provide support for these organs. However, according to Park Sports Physical Therapy in Brooklyn, the muscles have other roles as well. These include:

  • Sphincter control: Weakness in the pelvic floor muscles translates into weakness in the sphincters that allow you to hold in urine or feces until it’s appropriate to eliminate that waste. Loss of sphincter control leads to incontinence.
  • Sexual function:  The muscles of the pelvic floor also play a key role in sexual function, which in men focuses primarily on erectile and orgasmic function. Weakness in the pelvic floor can lead to ED.

Symptoms of Pelvic Floor Dysfunction

Commons symptoms of pelvic floor dysfunction, according to Cleveland Clinic, include the feeling that you cannot complete a bowel movement, the need to have several bowel movements over a relatively short period of time, and constipation or straining pain during bowel movements.

Other symptoms include a frequent need to urinate, urination that stops and starts at multiple intervals, painful urination, and urinary dribbling. Still other symptoms are lower back pain for which no other cause can be found, persistent pain in the overall pelvic region, genitals, or rectum, and pain during intercourse for women.

Kegels for Men 

Kegel exercises are named for the late American gynecologist Arnold H. Kegel who first developed them as a nonsurgical treatment for female genital relaxation. Although these exercises were first designed for women, they work equally well for men and can help improve male sexual function. And they also combat urinary and fecal incontinence in both men and women.

Before you get started with these pelvic floor exercises, you’ll need to locate and gain control of the muscles that you’re going to be targeting. To identify the operative muscle group, stop urination in midstream or tighten the muscles you need to keep from passing gas. The muscles you clenched to accomplish these tasks are the muscles of the pelvic floor.

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Kegels for men can be done in almost any position, according to MayoClinic.org, but for beginners it might be advisable to start while lying down. Contract your pelvic floor muscles as hard as you can and maintain this position for three seconds. Then relax these muscles for another three seconds. Repeat this two-step exercise at least 10 times.

As you become more accustomed to performing these exercises, you can move up from the floor and try to do them while sitting, standing, or walking. Ideally, you should try to do three sets of 10 repetitions — clenching followed by relaxation — each day.


Diagram of a mans bladder.

Pelvic floor exercises can strengthen the muscles and nerves that control erectile function. 


How These Exercises Combat ED

If it’s not clear to you exactly how these exercises improve erectile function and help to keep ED at bay, physical therapist Erin Weber explains: “Pelvic floor physical therapy can address the muscular and nerve function required to achieve and maintain an erection.”

Weber, a doctor of physical therapy at Physio Logic in Brooklyn, New York, told MensHealth.com that this targeted physical therapy can help a man “to strengthen and engage his ischiocavernosus muscle, which is responsible for building and keeping penile rigidity.” The more this muscle is exercised, the greater a man’s control over his erectile function becomes.

‘Pelvic floor physical therapy can address the muscular and nerve function required to achieve and maintain an erection.’

— Erin Weber, Physical Therapist

Physio Logic, Brooklyn, New York

Other Aspects of Pelvic Floor Exercise

Also in an interview with MensHealth.com, physical therapist Francesca Warner said that pelvic floor physical therapy “is much more than range of motion exercises, soft tissue mobilization, and home exercises.”

Warner, a doctor of physical therapy, works extensively on pelvic floor rehabilitation with both men and women. She told MensHealth that patient education and lifestyle modification form a critical component of her work with patients.

Warner points out that it’s important for patients to learn more about breathing and relaxation techniques. “Your diaphragm and your pelvic floor muscles are connected, therefore proper breathing is paramount.”

Some patients, says Warner, tend to hold stress in their pelvic region, just as others do in their shoulders and neck. This type of stress can exacerbate pelvic pain, so it’s important to learn relaxation techniques that help them to rid themselves of this pressure. Relaxation strategies such as meditation and mindfulness can help patients to avoid straining when going to the bathroom and ease the almost-involuntary clenching of muscles during the day.

Easing Prostatitis Pain 

For men who go to their doctors with complaints of persistent pelvic pain, which can be accompanied or not by urinary problems, the most common diagnosis is prostatitis, according to Restorations Physical Therapy. Some acute cases of prostatitis are caused by bacterial infection, but the vast majority of chronic pelvic pain syndrome cases are said to arise from weakness in the muscles of the pelvic floor. Strengthening these muscles through exercises described elsewhere in this article can help to ease the discomfort of this syndrome.

Viagra May Be Able to Help

Men who are struggling with erection problems, whether intermittent or persistent, can usually find relief by using Viagra or one of the other oral ED drugs known as PDE5 inhibitors. To get these medications, you’ll need a prescription, which you can obtain from your regular doctor.

You can fill the prescription at the local pharmacy or choose instead to order the drug from a reliable online facilitator such as Viamedic.com. If you have a doctor’s prescription, you can fax it or scan and email it along with your order to Viamedic. If you don’t yet have a prescription, Viamedic can set up a complimentary online consultation with a licensed U.S. physician who can authorize a prescription if appropriate. This saves you the price of a trip to the doctor’s office. To learn more, visit Viamedic’s Male Impotence page.

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About Don Amerman

Don Amerman has spent more than three decades in the business of writing and editing. During the last 15 years, his focus has been on freelance writing. For almost all of his writing, He has done all of his own research, both online and off, including telephone and face-to-face interviews where possible. Don Amerman on Google+