Most men think of their “core” as abs and sit-ups. But the core is much more: it’s a team of muscles, including the diaphragm, deep abdominals, back stabilisers, and the pelvic floor.

When this system works well, it supports continence, sexual function, and posture. When it’s out of sync, the result can be leakage, pelvic pressure, or erection difficulties.

The Core–Pelvic Floor Connection

Your core is like a pressure system:

Top → diaphragm
Sides → deep abdominals & spinal stabilisers
Bottom → pelvic floor muscles

Every time you breathe, lift, or strain, these muscles manage intra-abdominal pressure. If the system is unbalanced, the pelvic floor takes the hit.

What Happens When Pressure Isn’t Managed

1. Leaks (Urinary Incontinence)

When lifting weights, coughing, or running, poorly managed pressure pushes down on the bladder. If the pelvic floor can’t respond in time, leakage occurs.

2. Pelvic Pressure & Prolapse

Excess downward pressure can create heaviness or bulging in the pelvic area.

3. Erections & Sexual Function

The pelvic floor helps trap blood in the penis for firm erections. If pressure and coordination are off, erections may be weaker or harder to maintain.

How Physiotherapy Helps

1. Pressure Awareness

Learning how to exhale during effort (instead of holding your breath) reduces strain on the pelvic floor.

2. Core–Pelvic Floor Training

A physiotherapist teaches how to coordinate breathing, abdominals, and pelvic floor. This means your muscles work with each other instead of against.

3. Strength and Relaxation

It’s not just about tightening, an overactive core or pelvic floor can be just as problematic as a weak one. Balance is key.

4. Tailored Rehab

For men after prostate surgery, with pelvic pain, or experiencing leaks with sport, physio provides structured, evidence-based exercises for safe return to activity.

Lifestyle Strategies That Help

Breathe out on effort (lifting, pushing, or pulling).
Avoid straining on the toilet, use a footstool to reduce pressure.
Keep strong overall: glutes, hips, and core all support the pelvic floor.
Manage stress, it increases muscle tension and pressure.

Erections, leaks, and pressure problems aren’t just about age, they’re about how well your core and pelvic floor work together. With physiotherapy, breathing strategies, and tailored core training, you can take back control of your pelvic and sexual health.

✨ Struggling with leaks, pressure, or erection changes? Book a confidential consultation with our men’s pelvic health physiotherapists at Renard Clinic for personalised, evidence-based care.ic.