What is a pelvic floor?
The pelvic floor is a group of muscles that stretch between your ‘sit bones’ - otherwise known as your ischial tuberosities -, your pubic bone, and your coccyx.
In men, the pelvic floor consists of three layers of muscles, each with different functions.
The deepest layer of pelvic floor muscles plays an important role in supporting the pelvic organs, helping to keep your bladder and intestines inside your body. This deep layer of your pelvic floor also helps to regulate pressure inside your abdomen as you breathe, and during ab workouts.
The middle layer of pelvic floor muscles, also called the urogenital diaphragm, helps coordinate your pelvic bones and sacrum to function as a stable base from which you can move your legs and trunk. This middle layer is also responsible for controlling urination. This is why exercises that improve strength and control of this layer can be highly effective for men with urinary incontinence, for example as a result of prostate surgery. In fact, pelvic floor muscle training should be the first line in treatment of male urinary incontinence.
If you suffer from urinary incontinence, look for a pelvic health physiotherapist near you. A skilled pelvic health physio can guide you to improve the strength and control of your urogenital diaphragm and restore continence.
The most superficial layer of the pelvic floor (the muscles closest to the surface) includes two muscles that wrap around the base of the penis just in front of the prostate gland: the ischiocavernosus and bulbospongiosus. These important muscles control blood flow in and out of the penis. When ischiocavernosus and bulbospongiosus contract, they constrict the base of the penis and prevent blood from flowing out of it, increasing blood pressure within the penis and facilitating erection.
How does my pelvic floor effect my erections?
In an early edition of Gray’s Anatomy (the classic anatomy textbook that the TV show was named for) the ischiocavernosus was called ‘erector penis’. Strength of these muscles commonly declines with age, and men who have greater control and strength in these two muscles are able to achieve erection more easily, and their erections are harder.
What’s more, we have evidence that targeted strengthening of these muscles increases penile rigidity in men of all ages, and this is also true for men with erectile dysfunction as a result of prostate surgery.
How to target ischiocavernosus for better erections
It’s actually quite simple to target the ischiocavernosus muscle.The most effective way to explain how to do this is to think about shortening the penis. If you try to do this, you’ll feel the ischiocavernosus contracting around the base of your penis, behind the scrotum. If you look, you’ll also see your penis actually retract slightly into your body.
You can also use a tactile cue to very effectively target and load the ischiocavernosus muscle (you’ll want to do this when you’re alone and will not be disturbed for a few minutes).
Hold the end of your penis between your fingertips, so the penis is at around 30 degrees to your torso. Pull very gently with your fingers, as if pulling the penis out by its root.
Now try to pull the penis back into the body or shorten the penis directly against the pressure of your fingers. This effectively activates the ischiocavernosus muscle, and what’s more, the pull from your fingers provides load for the muscle, which is essential for strengthening.
Just like any other strength training program, you should do two to three sessions per week on non-consecutive days, and gradually progress the load.
A combination of maximal effort, short duration contractions and submaximal effort, longer duration contractions allows targeting of both fast and slow twitch muscle fibres. In turn, this allows for the sustained tone required for an erection, as well as the short powerful contractions and reflexive responses necessary for ejaculation.
Start with one set of five maximal contractions, plus two sets of 15 lighter contractions. Rest for two minutes between sets. The whole program should take around five to six minutes to complete.
Do this two to three times per week, on non-consecutive days Like any muscle strengthening program, you need to gradually progress exercise intensity to keep increasing strength.
This is easy to do with ischiocavernosus training, by simply pulling slightly harder on your penis, to increase the resistance against which your ischiocavernosus muscle has to work to retract the penis.
For urinary incontinence training, simply maintain your relative (maximal and submaximal) effort levels.Bear in mind that erectile dysfunction and urinary incontinence both have several other potential causes besides muscle weakness, and you should consult a healthcare professional if strengthening exercises are not effective within three months.
Raphael Bender is founder of Breathe Education. He has a Masters degree in Clinical Exercise Physiology (Rehabilitation), a Bachelor degree in Exercise and Sports Science, a Diploma of Pilates Movement Therapy and STOTT PILATES full certification. He’s also the host of the Pilates Elephants podcast, along with his co-host Cloe Bunter.