Pelvic floor: letting go is the workout

Every guide to the pelvic floor says the same thing: tense, hold, repeat. For bladder control, that's true. For bottoms, it's half the truth – what matters is the other half hardly anyone talks about: letting go, deliberately and on cue.

A pelvic floor that's constantly tense isn't strong. It's just tight. And it makes exactly the moments hard when you want to soften.

Two sphincters, only one listens to you

The anal canal is surrounded by two ring-shaped muscles. The external sphincter is skeletal muscle: you tense and release it consciously, like a fist. The internal one is smooth muscle and follows the autonomic nervous system. It doesn't open on command.

That's why “just relax” fails so often. The internal muscle responds to calm, time and slow, steady pressure. Stress and rushing tend to keep it closed. Consciously releasing the external sphincter and the pelvic floor while breathing calmly creates the conditions in which the internal one can give way too. You can't force it. You can practise it.

The lever is your breath

The diaphragm and pelvic floor work as a pair. When you breathe in, the diaphragm lowers and the pelvic floor gives a little downwards. When you breathe out, both rise again. Shallow chest breathing or holding your breath takes the movement out of this system – and the pelvic floor stays tight.

Belly breathing sounds like a yoga class. Still, it's the simplest way to even feel tension in your pelvis and let it go. And for many, a long, calm exhale is the fastest way to calm down overall.

Ten minutes on the mat

You need a mat, a bit of quiet and a few weeks of patience. No straining, no pushing. If an exercise feels uncomfortable, make the movement smaller.

1. Belly breathing lying down

On your back, knees bent, feet hip-width apart. One hand on your belly, one on your chest. Breathe in through your nose so that mainly the lower hand rises, then breathe out more slowly and for longer. Five minutes. As you breathe in, feel your pelvis widen a little.

2. Tense to feel the release

Tense your pelvic floor with about a third of your strength, as if holding in wind. Hold for three seconds, release completely, notice for ten seconds. Five rounds. Strength doesn't matter here; you're training the difference between tight and loose. Quite possibly you'll notice: you were never at zero before.

3. Reverse Kegels

The counterpart to the Kegel exercise. As you breathe in, let your pelvic floor gently sink down and widen, like the first moment of peeing. As you breathe out, it returns on its own. Don't strain, don't push with your belly. The movement is small, more a giving way than a doing. Eight to ten breaths.

4. Deep squat or happy baby

Both positions open the pelvis without you having to do anything. Either the deep squat, heels on the floor or on a rolled-up towel. Or on your back, knees towards your armpits, holding the soles of your feet. Stay for a minute, keep breathing into your belly. Your pelvic floor doesn't have to hold anything here.

Ten minutes a day is enough. Regularity beats the long Sunday session, and change comes over weeks, not overnight.

What to take to bed with you

Breathe out when it gets tight instead of holding your breath. Consciously relax your shoulders, jaw and glutes. You set the pace. Time is part of it, just like enough lube.

And pain is a signal. Pressure and stretching are normal, sharp or burning pain is not. Then pause instead of pushing through.

When physiotherapy is the better option

If pain persists during anal sex or bowel movements, your pelvis feels constantly tense, or there's blood, get it checked by a doctor. Your GP, a urologist or a proctologist can rule out causes such as fissures or haemorrhoids. For tension without an organic cause, pelvic floor physiotherapy is a good place to go. Specialised physiotherapists treat men too, and in Germany the treatment can be prescribed by a doctor.

As a gay man, you don't need to talk around anything there. “I have pain during anal sex” is a perfectly normal first sentence. Starting that way saves you and your treatment detours.

This text doesn't replace medical advice. If symptoms persist, talk to your doctor or a pelvic floor physiotherapist.