Should I Do Kegels?

If you’ve ever Googled pelvic floor exercises, you’ve probably been told to do Kegels. Tighten, hold, repeat. Problem solved. But for men, the answer to “Should I do Kegels?” is not always yes.

In fact, for many men dealing with pelvic pain, urinary hesitancy, erectile changes, or hard flaccid type symptoms, doing traditional Kegels can actually make things worse.

The pelvic floor is not just a muscle you squeeze. It’s a dynamic system that must contract, relax, lengthen, coordinate, and integrate with breathing, hips, and core strength. Before jumping into Kegels, it’s important to understand what the pelvic floor actually does and which type of contraction (if any) you truly need.

 

What Is a Kegel?

A Kegel is a voluntary contraction of the pelvic floor muscles, the muscles that support the bladder, bowel, and sexual function.

In men, these muscles help:

• Control urine flow
• Support erections
• Contribute to ejaculation
• Stabilize the pelvis and spine

But not all pelvic floor contractions are the same.

 

The Different Types of Pelvic Floor Contractions

1. Maximal Strength Contractions (Traditional Kegels)

This is the classic instruction: “Lift and squeeze as if stopping urine.” Hold for 5–10 seconds.

When you might need this:

• Urinary leakage (especially post-prostate surgery)
• Stress incontinence (leakage with coughing or lifting)
• Post surgical weakness
• True pelvic floor underactivity confirmed on exam

If the pelvic floor is objectively weak and unable to generate enough force, strengthening contractions can be helpful. But here’s the key: weak does not always mean painful.

2. Endurance Contractions

These are lower intensity holds for longer durations, 10–30 seconds at moderate effort.

Useful for:

• Men who leak later in the day
• Decreased stamina during physical activity
• Subtle postural support deficits

This type trains the pelvic floor to maintain tone without gripping aggressively.

3. Quick Flicks (Speed Contractions)

Short, rapid contractions followed by full relaxation.

Helpful for:

• Urge suppression
• Training reflex control
• Improving coordination

These are less about brute strength and more about timing and coordination.

 

4. Relaxation / Reverse Kegels (Lengthening)

This is where most men are surprised. A reverse Kegel is not a squeeze, it’s a controlled drop and lengthen of the pelvic floor, often paired with diaphragmatic breathing.

This is critical when:

• You have pelvic pain
• You have urinary hesitancy
• You strain to start urine
• You have pain after ejaculation
• You feel pressure, tightness, or clenching in the pelvis
• You have hard flaccid symptoms

In many men, the pelvic floor is not weak, it’s overactive and guarded. In these cases, doing traditional Kegels is like telling someone with a tight hamstring to keep flexing it. You reinforce the tension pattern.

Even though a reverse kegel is often paired with relaxation, there is a difference between these two types of contractions. Relaxation will occur when the pelvic floor lengthens during inhalation (breathing), without conscious usage of the muscle. In contrast, a reverse kegel is a type of muscle contraction where there is a conscious stretching or lengthening.

 

When You May NOT Want to Do Kegels

You may want to avoid traditional Kegels if you have:

• Chronic pelvic pain
• Perineal tightness
• Pain with sitting
• Constipation related to straining
• Pain with erections or ejaculation
• Urinary hesitancy
• Difficulty fully emptying
• Hard flaccid syndrome
• A history of anxiety-related pelvic tension

In these scenarios, strengthening without assessing tone and coordination can worsen symptoms. This is why male pelvic floor physical therapy matters. You need to know whether your pelvic floor needs to contract harder, or finally learn how to relax.

 

The Bigger Picture: The Pelvic Floor Is Not an Isolated Muscle

The pelvic floor works with:

• The diaphragm
• The abdominals and obliques
• The hips
• The lumbar spine
• The rib cage and thoracic spine

If these areas are dysfunctional, simply squeezing the pelvic floor won’t solve the problem. In fact, focusing only on Kegels can distract from the real issue.

 

What Often Matters More Than Kegels

1. Breathing Retraining

Most men with pelvic pain or overactivity breathe shallowly into the chest.

Proper diaphragmatic breathing:

• Reduces pelvic tension
• Improves coordination
• Restores pressure regulation
• Calms the nervous system

When the diaphragm moves properly, the pelvic floor moves with it. This is foundational.

2. Manual Therapy

Hands-on treatment can address:

• Trigger points in the pelvic floor
• Scar tissue
• Hip and adductor tightness
• Sacroiliac restrictions
• Abdominal tension
• Thoracic and lumbar spine stiffness

For men with chronic pelvic pain, manual therapy is often far more impactful than repetitive squeezing.

Sometimes the issue is not weakness, it’s poor tissue mobility and neural sensitivity.

3. Hip and Core Strengthening

The pelvic floor doesn’t work alone.

Weak glutes, poor hip control, or stiff adductors often overload the pelvic floor.

Key areas we commonly address:

• Glute medius and maximus
• Hip Adductors
• Hamstrings
• Abdominals and obliques
• Thigh and lower limb stability (exercise or sport dependent)

Improving hip stability frequently reduces pelvic symptoms, even without aggressive Kegel training. It’s also important to have a specialized pelvic floor therapist that can tell you what to strengthen and why.

 

4. Stretching and Mobility Work

Tight structures that commonly contribute to pelvic tension:

• Hip flexors
• Adductors
• Hamstrings
• Obturator internus
• Thoracic spine

Mobility allows the pelvic floor to function normally instead of guarding constantly.

 

5. Compound Movements and Heavy Carries

This is often overlooked.

Heavy carries, squats, deadlifts, and rotational training, when done properly, can restore natural pelvic floor function better than isolated squeezing.

Why?

Because the pelvic floor evolved to respond reflexively to load, breathing, and movement, not to repetitive isolated contractions in isolation.

Under proper coaching:

• Squats teach coordinated pressure control
• Carries improve core and pelvic integration
• Deadlifts restore posterior chain strength
• Rotational drills improve pelvic symmetry

When the entire system works well, the pelvic floor often normalizes.

 

So… Should You Do Kegels?

The real answer is:

It depends on your presentation.

If you are weak and leaking, Kegels may be appropriate. If you are tight and painful, they may not be. If you are somewhere in between, you may need:

• Strength in one position
• Relaxation in another
• Coordination during movement

That’s why guessing is risky.

 

Why Male Pelvic Floor Physical Therapy Is So Important

Men are often told to “do Kegels” without any assessment.

But male pelvic health is complex. Erectile function, urinary flow, pelvic pain, and performance are influenced by:

• Muscle tone
• Nervous system sensitivity
• Hip mechanics
• Spinal alignment
• Breathing patterns
• Psychological stress
• Load tolerance

A proper evaluation can determine:

• Is your pelvic floor weak?
• Is it overactive?
• Is it uncoordinated?
• Is it reacting to hip or spine dysfunction?

Once we identify the root causes, treatment becomes precise and not generic.

 

If you want more specifics about what occurs during a pelvic floor evaluation for physical therapy, please click this link:

For Men in NYC with Pelvic Floor Issues – What to Expect during a Physical Therapy Evaluation – Schafer Physical Therapy PLLC

 

Final Takeaway

Kegels are not inherently good or bad. They are a tool. But like any tool, they must be used appropriately. For many men, especially those with pelvic pain, urinary hesitancy, or hard flaccid symptoms, relaxation training, manual therapy, hip strengthening, breathing retraining, and compound movements may be more important than traditional Kegels.

If you’re unsure whether you should be doing Kegels, the safest and most effective step is to get evaluated by a clinician who specializes in male pelvic floor physical therapy. Your pelvic floor doesn’t need guesswork. It needs the right strategy.

If you’re dealing with pelvic symptoms and want clarity, working with a specialist in male pelvic health can help you determine exactly what your body needs, and just as importantly, what it doesn’t.

Thank you for reading! If you would like to set up an evaluation or a free 15 minute consultation please contact us at 240-626-6454 or philippe@philippeschafer.com