The Male Pelvic Floor in Sport

by Magdalena Grabek, Men’s & Women’s Health Specialist at Six Physio Moorgate & Monument.

Men suffer from similar issues to women when it involves their pelvic floor: bowel, bladder, sexual dysfunction and pelvic pain are all symptoms. Furthermore, these not only effect the elder population, young men can experience urinary urgency, discomfort after ejaculating etc.

If you are an active man, cycling, lifting weights at the gym or spending hours sitting at your desk, read on!

Weight Lifting

The pelvic floor muscles will automatically contract when participating in any sporting activity that involves the trunk and legs. As part of the body’s core system of stability and movement, the pelvic floor plays a significant role in all physical exertion and that role is heightened with the increased intensity and effort required during various exercises. For example weight lifting needs strong and responsive core muscles to brace against the effort required to lift, any weakness or miss-timed contractions may put this area at risk.


Cycling is associated with constant perineal pressure from the narrow, unpadded seat or crossbar and can be the underlying cause of lower urinary symptoms (for example voiding dysfunction or erectile dysfunction). Increased levels of cycling has been linked to more urological complaints, perineal pain, or numbness.

Research shows a 70% average reduction in blood flow through the penile artery when participants were cycling on an average bike saddle. Furthermore, 61% of interviewed cyclists reported numbness in the genital region, and 24% complained of erectile dysfunction.

Most bike seats make you sit on the perineum, the segment between the pubic and ischial bones of your pelvis and the internal part of your genitals. This area of your body was not designed to be weight-bearing so can generate extreme perineal pressure.

Cycling-related male pelvic floor tension, compression, circulation, or sensation issues that result in numbness, discomfort, pain, or urogenital dysfunction can benefit from pelvic floor physiotherapy and bodywork to help restore normal blood flow, tone, feeling, and function.


During high-impact activities such as running, a well functioning male pelvic floor can withstand this impact, contracting and relaxing approx. 3000 times on a 30min run. The faster you run the more reflexive your pelvic floor needs to be, so if you’re suffering from any pelvic floor dysfunction, Physiotherapy can help by educating and training these muscles.


As with any Initial Physio assessment we start by taking a thorough history, including symptoms experienced, interventions already tried and what tests have been carried out.

We often find males have an overused and contracted pelvic floor, lifted higher than it should be. There is a tendency to overuse the oblique abdominals and not let them relax, creating unnecessary pressure in the pelvis. Sometimes we find they hold their diaphragm as tightly as their pelvic floor leading to poor breathing patterns.  The word ‘relax’ is simply not in their vocabulary!

The assessment will include careful observation and documentation of lumbar spine, hips, muscle strength and connective tissues. Then the education begins, introducing lifestyle modifications to a fitness routines or breathing techniques. The biggest challenge is to eliminate the ‘bear down’ with exertion and teach lifting and supporting instead.

The pelvic floor can be a hard concept to master. There is a lack of awareness of pelvic floor muscle function and its impact on men’s lives. In the past, most disorders were associated with aging and men were looking for a solution at the pharmacy. Today with research and a better understanding of the pelvic floor, physiotherapy is developing an important role to help men to maintain their healthy style of life.

If you have no particular pelvic floor dysfunctions and you are simply curious, a pelvic floor assessment and training can be a wonderful way to gain awareness of this important set of core muscles and explore the relationship with the rest of your body.

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