What I do
Fewer than 15% of men in the United States who have a radical prostatectomy are referred to a pelvic floor physical therapist after surgery. The other 85% are sent home with a single instruction: "do kegels." No screening. No technique check. No protocol. No follow-up.
That gap is what The Ironhold Method exists to close. The 8-week program is not a new exercise. It is a structured sequence built from the same first-line clinical guidelines a pelvic floor PT would follow if you could see one — packaged into a private, at-home program men can actually run on their own.
Why screening comes first
The standard urology pamphlet assumes every man has a weak pelvic floor and needs strengthening. Modern pelvic floor research is clear that this is wrong for a meaningful subgroup. Between 20% and 40% of post-prostatectomy men have an overactive (hypertonic) pelvic floor — a muscle locked in tension rather than weakness. For these men, more kegels make symptoms worse.
This is the single most important clinical fact in male post-op recovery, and the one that almost never gets said out loud. The Ironhold Method begins with a self-screen — a structured questionnaire that maps your symptoms to one of three pelvic floor profiles: weak, overactive, or both. Your protocol is then matched to your profile. No one-size-fits-all.
Screen first. Match the protocol to the profile. Down-train before you load. Track the data so you know whether it is working.
How the protocol gets built
Every module of The Ironhold Method is built from published clinical sources. I do not invent exercises. I sequence and translate them. The methodology is straightforward:
Where each module comes from
- The exercise itself is taken from peer-reviewed pelvic floor PT literature or from a published clinical guideline (AUA, EAU, ICS).
- The dose — sets, reps, hold time, rest ratio — is set to match the consensus from systematic reviews of post-prostatectomy PFMT trials.
- The sequencing across the 8 weeks follows the down-train-before-load principle now standard in modern pelvic floor PT practice.
- The screening logic uses the same overactivity indicators clinicians use during in-person evaluation, adapted to a self-administered format.
- The tracker measures pad weight or leak count week over week so the data, not the wishful thinking, tells you whether to continue, modify, or escalate.
What I am not
The transparency line
I am not a physician. I am not a urologist. I am not a licensed pelvic floor physical therapist. I do not diagnose, prescribe, or treat medical conditions.
I am an educator. The Ironhold Method is an educational program. It is built on the same evidence base your urologist or pelvic floor PT would draw from, but it is not a substitute for either of them. If you are dealing with new pain, blood in the urine, fever, or any sudden change in symptoms, see your urologist before continuing the program.
What I focus on
- Post-radical-prostatectomy urinary incontinence (the core focus)
- Pelvic floor muscle training programming for men
- Pelvic floor overactivity (hypertonic pelvic floor) and down-training
- The screening step that is missing from standard post-op care
- Pre-operative pelvic floor preparation (prehab) for men scheduled for prostate surgery
- Functional integration of pelvic floor training with breath, posture, and load
The sources I work from
If you want to verify any claim in the program or in any article on this site, here is where the underlying material lives:
Primary clinical sources
- AUA / GURS / SUFU — Incontinence After Prostate Treatment Guideline (2024 update)
- European Association of Urology (EAU) Guidelines
- International Continence Society (ICS) — male LUTS standardization
- Cleveland Clinic — Hypertonic Pelvic Floor
- Renal & Urology News — Kegel Exercises After Prostate Surgery Called Into Question
- BJU International (2024) — Post-prostatectomy incontinence: a guideline of guidelines
- Frontiers in Surgery — Current Management of Post-RP Urinary Incontinence
- PMC — Preoperative exercise interventions to optimize continence
- ZERO Cancer — Beyond Kegels: Pelvic PT for Post-Prostatectomy
Read what I have written so far
- Kegels Not Working After Prostatectomy? Here's What Nobody Tells You
- Overactive Pelvic Floor in Men: Symptoms, Causes, and the Missing Treatment
- The Complete Guide to Post-Prostatectomy Incontinence
The Ironhold Method
An 8-week structured pelvic floor protocol. Screen first. Match the work to your profile. 60-day stay-drier-or-don't-pay guarantee.
See the protocol →Contact
For questions about the program, refunds, or sources cited in any article: marcusholloway.ironhold@gmail.com
I read every email myself. I cannot respond to medical questions about your specific case — for that, you need your urologist or a licensed pelvic floor PT. I can answer questions about the protocol, the sources, the tracker, and how the program works.