Kentucky Horses Trick

Description

A growing number of men searching for natural approaches to erectile dysfunction have encountered a phrase that sounds unusual at first: the “horses trick” or “Kentucky horses trick.” Like many viral health terms circulating on social media and wellness forums, this one has accumulated a mix of genuine curiosity, incomplete explanations, and enthusiastic anecdotes — alongside a real, clinically studied mechanism that deserves serious attention.

The term does not refer to anything specific to Kentucky or to horses themselves. It is a social media label — a curiosity-gap hook that points toward a specific pelvic floor exercise technique for men. And while the name lacks any official standing in medical literature, the underlying physiological principle it describes is supported by peer-reviewed randomized controlled trials, published in journals including BJU International and the British Journal of General Practice.

This guide unpacks what the “Kentucky horses trick” actually is, explains the verified anatomy and physiology behind it, reviews the clinical trial evidence in detail, describes who it is likely to help and who it is not, and places it within the broader context of what the current evidence says about non-pharmaceutical approaches to erectile dysfunction.

What Is the “Kentucky Horses Trick”?

The “horses trick” for erectile dysfunction is a colloquial name for pelvic floor muscle training (PFMT) — specifically a two-phase technique that targets the bulbocavernosus and ischiocavernosus muscles at the base of the penis. The movement pattern the technique involves is sometimes compared to the way a horse flicks or engages its hindquarters — a visual association that appears to have spawned the nickname as it spread through online health communities.

The “Kentucky” modifier that sometimes appears in searches is a geographic curiosity-gap variant with no clinical significance — it does not refer to a specific protocol developed in Kentucky, a breed of horse, or any regional variation of the technique. It is simply an SEO mutation of the “horses trick” search cluster that reflects how health information propagates online through iterative reframing.

What the technique actually involves, stripped of the branding, is this: a structured pelvic floor exercise sequence in which the man first learns to release and relax the pelvic floor muscles (sometimes called a reverse Kegel or the “push out” phase), followed by a deliberate, controlled contraction of the same muscles — specifically the two muscles most directly involved in maintaining penile rigidity during erection. The contraction is similar to the sensation of stopping urination mid-stream, though it should be practiced outside of actual urination to avoid disrupting normal bladder function.

According to clinical descriptions from Bolt Pharmacy and published pelvic floor research, there is no official clinical terminology called the “horse trick” in medical literature. However, the underlying physiological rationale — strengthening specific pelvic floor musculature to support erectile function — is not only plausible but has been tested in formal clinical trials with measurable results.

The Anatomy of Erection: Why the Pelvic Floor Matters

To evaluate the “horses trick” with intellectual honesty, it is essential to understand the role the pelvic floor actually plays in erectile function — because this is where the technique’s biological rationale either holds up or falls apart.

Most discussions of erectile dysfunction focus on arterial blood flow — the vessels that deliver blood to the penis. This is appropriate, as vascular insufficiency is the most common underlying contributor to ED in men over 40. What receives far less attention, however, is the second half of the erection equation: venous occlusion — the ability to trap blood inside the erectile tissue once it arrives.

During an erection, blood fills the corpora cavernosa (the two spongy chambers running the length of the penis). For the erection to become and remain firm, the venous drainage from this tissue must be mechanically compressed. This compression is performed primarily by two muscles of the pelvic floor:

The bulbocavernosus muscle — wraps around the base of the penis and compresses the deep dorsal vein, preventing blood from draining out of the engorged tissue. It also contracts rhythmically during ejaculation.

The ischiocavernosus muscle — originates at the ischial tuberosities (the bony “sitting bones”) and inserts along the sides of the penis. During erection, its contractions increase intracavernous pressure — the hydraulic pressure inside the erectile chambers — and help maintain rigidity beyond what arterial flow alone can achieve.

Research published in Scientific Reports (2021) confirmed this mechanism directly: “Contractions of pelvic floor muscles, in particular the ischiocavernosus and bulbocavernosus, produce an intracavernosal pressure increase and influence penile rigidity.” The same paper noted that the bulbocavernosus muscle contracts synchronously with the external anal sphincter, which is why some pelvic floor exercises use anal sphincter engagement as a teaching cue.

The clinical implication is straightforward: if these muscles are weak, poorly coordinated, or hypertonic (chronically over-tensed), the venous occlusion mechanism is compromised. Blood may enter the penis adequately but drain too quickly for a firm erection to be maintained. This pattern — sometimes described as venous leak — produces a recognizable clinical presentation: erections that begin normally but cannot be sustained, or erections that are insufficiently rigid from the outset despite adequate arousal.

Men who experience this pattern are, in principle, the ideal candidates for pelvic floor muscle training.

The Clinical Evidence: What Randomized Trials Actually Found

This is the section that separates the “horses trick” from the vast majority of ED home remedies circulating online. Unlike herbal supplements, dietary hacks, or device-based gimmicks, pelvic floor muscle training for erectile dysfunction has been evaluated in peer-reviewed, randomized controlled trials — the gold standard of clinical evidence.

The Dorey Studies: Landmark Clinical Evidence

The most frequently cited body of evidence on this topic comes from a series of studies by physiotherapist Grace Dorey and colleagues at the Somerset Nuffield Hospital in the United Kingdom, published in the British Journal of General Practice and BJU International.

The primary randomized controlled trial enrolled 55 men with erectile dysfunction (median age 59.2 years, range 22–78 years) from a urology clinic. Twenty-eight participants were randomized to an intervention group that received pelvic floor muscle exercises with manometric biofeedback and lifestyle change recommendations. Twenty-seven controls received only lifestyle advice.

The primary outcome measure was the erectile function domain of the International Index of Erectile Function (IIEF) — a validated, widely used clinical instrument for assessing erectile function severity.

At the three-month assessment, the erectile function of men in the intervention group was significantly better than in the control group (p < 0.001). When the control group was subsequently given the intervention, they also improved significantly (p < 0.001). After six months of blind assessment, the results were:

• 40% of men had regained normal erectile function
• 35.5% showed meaningful improvement though not full normalization
• 24.5% failed to improve

The published conclusions stated that “pelvic floor exercises should be considered as a first-line approach for men seeking long-term resolution of their erectile dysfunction” — a striking statement from a peer-reviewed clinical trial.

The Dorey 2005 pilot randomized trial found 67% of participants improved at 12 weeks compared to 30% in the lifestyle-advice-only control group — a statistically significant difference that held even when controlling for baseline characteristics.

The research team also noted that contractions of the ischiocavernosus and bulbocavernosus muscles “produce an increase in the intracavernous pressure and influence penile rigidity,” and that the bulbocavernosus muscle “compresses the deep dorsal vein of the penis to prevent the outflow of blood from an engorged penis” — the anatomical mechanism directly targeted by the exercises.

Systematic Review Evidence

A systematic review and meta-analysis published in the British Journal of Urology International (2019) examined multiple trials of pelvic floor muscle training for erectile dysfunction and concluded that PFMT showed improvements in erectile function scores, particularly in men with mild to moderate ED. The review noted that combining pelvic floor exercises with lifestyle modifications — weight loss, smoking cessation, increased physical activity — produced better outcomes than exercises alone.

A 2024 study published in a sexual medicine journal evaluated biofeedback pelvic floor training specifically for erectile dysfunction management. Thirty men presenting with ED were assessed using the IIEF and quality-of-life measures before and after receiving biofeedback pelvic floor training. The results showed significant improvements in both erectile function domain scores and maximum squeezing pressure of the pelvic floor, supporting the direct relationship between pelvic floor muscle strength and erectile quality.

A 2024 Korean narrative review in Exercise Science identified seven randomized controlled trials on pelvic floor exercise for erectile dysfunction. While noting heterogeneity in study design and populations, the authors concluded that PFMT shows “applicability as a method for treating erectile dysfunction” and recommended further well-powered RCTs, particularly examining combined PFMT and pharmacological approaches.

Important Caveats in the Research

Intellectual honesty requires acknowledging the limitations of the available evidence alongside its strengths. The Dorey studies, while landmark, involved relatively small sample sizes. The 2024 Korean systematic review found that most existing RCTs involved men with post-prostatectomy ED — a distinct population from general ED — where results were more mixed. Studies combining PFMT with biofeedback produced more consistent results than PFMT alone, suggesting that guided, feedback-assisted training may be meaningfully superior to unsupervised home practice.

The honest summary is this: pelvic floor training has real, peer-reviewed clinical evidence supporting its use for selected men with erectile dysfunction — particularly those with mild to moderate ED, venous leak characteristics, or pelvic floor weakness as a contributing factor. It is not a universal solution, and it will not produce meaningful results for men with severe vascular disease, neurogenic ED, significant hormonal deficiency, or those who have undergone radical prostatectomy without nerve-sparing techniques.

How the Technique Is Performed: Step-by-Step

The clinical protocols used in the Dorey trials and subsequently described in pelvic floor physiotherapy practice follow a consistent structure that the “horses trick” replicates in simplified form. The key steps are:

Step 1: Identify the Target Muscles

The first and most commonly skipped step is learning to correctly identify the bulbocavernosus and ischiocavernosus muscles before attempting to strengthen them. The most practical identification cue: attempt to stop urination mid-stream. The muscles you engage to do this are the target muscles. (Note: this identification technique should only be used to learn the muscle location — regular practice of stopping urination can disrupt normal bladder function and should not become a training habit.)

An alternative cue: contract the muscles as if trying to prevent passing gas, then extend that engagement slightly forward toward the base of the penis. The goal is to feel a distinct “lifting and squeezing” sensation at the perineum and penile base, not a general abdominal or gluteal contraction.

Step 2: The Relaxation Phase (The “Reverse Kegel”)

What distinguishes the “horses trick” protocol from a standard Kegel exercise is the deliberate emphasis on the relaxation phase first. Many men, particularly those with chronic pelvic tension or stress-related pelvic floor dysfunction, actually have hypertonic (over-tightened) pelvic floor muscles rather than weak ones. Teaching contraction to a hypertonic pelvic floor without first addressing the tension can worsen symptoms.

The relaxation phase involves intentionally releasing and “opening” the pelvic floor — a gentle downward pressure or “push out” sensation, as if gently bearing down without straining. This should be held for three to five seconds before moving to the contraction phase. Men with pelvic pain or discomfort should seek guidance from a pelvic floor physiotherapist before proceeding, as hypertonicity requires a different therapeutic approach than weakness.

Step 3: The Contraction Phase

Following the relaxation phase, perform a firm, deliberate contraction of the pelvic floor — the same movement as stopping urination, held for three to five seconds at maximum controlled effort. The emphasis should be on squeezing and lifting at the base of the penis and perineum specifically, not on broadly tensing the abdomen, buttocks, or thighs. Accessory muscle recruitment (tensing the legs, holding the breath, gripping the abdominals) means the targeting is off.

Step 4: The Training Protocol

Based on the Dorey clinical protocol and subsequent pelvic floor physiotherapy guidelines, an effective training program involves:

• Three sets of 10 repetitions daily (each repetition = 3–5 second hold contraction, 3–5 second relaxation)
• One set of “quick flicks” — rapid, short contractions without full relaxation between them — to train fast-twitch muscle fiber recruitment
• Consistency over 8–12 weeks minimum before expecting meaningful results
• Progressive increase in hold duration (toward 10 seconds) as strength improves

The Dorey trials used manometric biofeedback — pressure measurement through an anal probe — to confirm correct muscle engagement and provide real-time training feedback. This biofeedback element was identified as a meaningful contributor to outcomes. Men who practice unsupervised at home will likely achieve more modest results than those working with a trained pelvic floor physiotherapist, though home practice still shows measurable benefit in compliant individuals.

Who Is Most Likely to Benefit

Pelvic floor muscle training is not appropriate for all men with erectile dysfunction. Based on the clinical research, the men most likely to benefit share several characteristics:

Mild to moderate ED with maintenance difficulty. Men who report erections that start adequately but cannot be sustained — who describe “losing rigidity” during intercourse — are presenting with a pattern consistent with impaired venous occlusion. This is the mechanistic target of PFMT, and these men are the most likely responders.

Younger men with no major organic disease. The Dorey trials enrolled a broad age range (22–78), but outcomes tended to be better in men without severe cardiovascular comorbidities. Younger men with psychogenic or performance-anxiety-driven ED often have intact vascular function but impaired pelvic floor engagement under sexual conditions — making PFMT a particularly logical first-line approach before considering pharmacotherapy.

Men with post-surgical pelvic floor disruption. Although evidence in the prostatectomy population is mixed, some studies show benefit for men who have undergone pelvic surgery — where nerve-sparing procedures preserved potential erectile function but post-surgical pelvic floor disruption impairs its expression.

Men seeking a non-pharmaceutical, low-risk first approach. PFMT has an excellent safety profile. It does not interact with medications, carries no systemic side effects, and if performed correctly under guidance, poses minimal risk. For men who prefer to explore non-pharmacological options before or alongside medication, it represents a genuinely evidence-supported choice.

Who Is Unlikely to Benefit

Equal clinical honesty requires identifying the populations where pelvic floor training is unlikely to produce meaningful results without addressing other underlying causes:

Men with severe arteriogenic ED. If the primary problem is significantly impaired arterial inflow — insufficient blood reaching the penis due to atherosclerosis, diabetes-related vascular disease, or other severe circulatory pathology — strengthening venous occlusion muscles will not compensate. These men need the arterial problem addressed first, typically through cardiovascular risk factor management, PDE-5 inhibitors, or vascular interventions.

Men with significant hypogonadism. Testosterone is required for the nitric oxide signaling that initiates the erectile cascade. Men with clinically confirmed low testosterone need hormonal evaluation and potentially testosterone therapy before non-pharmacological approaches are likely to produce results.

Men with neurogenic ED. Spinal cord injuries, multiple sclerosis, pelvic nerve damage from surgery, and other neurological causes of ED affect the neural signaling that PFMT depends on. If the neural signal cannot reach the pelvic floor muscles effectively, strengthening them has limited benefit.

Men with pelvic pain or suspected pelvic floor hypertonicity. This is a particularly important caution: some men’s ED is associated with a pelvic floor that is chronically over-contracted rather than weak. Performing additional contraction exercises on an already hypertonic pelvic floor can worsen pain and dysfunction. Any man with chronic pelvic pain, perineal discomfort, or pain during sexual activity should seek evaluation from a pelvic floor physiotherapist before beginning contraction-focused exercises.

How Pelvic Floor Training Compares to Other ED Approaches

Placing PFMT in context requires an honest comparison to the most commonly used ED treatments.

PDE-5 inhibitors (sildenafil, tadalafil, vardenafil). These remain the first-line pharmacological treatment for erectile dysfunction, with efficacy rates of 60–80% across the general ED population. They work by blocking the enzyme that breaks down cGMP, prolonging penile smooth muscle relaxation and blood inflow. They address the arterial and endothelial sides of the erectile equation but do not directly strengthen the pelvic floor musculature involved in venous occlusion and rigidity maintenance. PDE-5 inhibitors and PFMT work through different mechanisms and are not mutually exclusive — combining them may produce additive benefit, particularly for men with both vascular and pelvic floor contributions to their ED.

Lifestyle modification. Cardiovascular exercise, weight loss, smoking cessation, alcohol reduction, and stress management are all supported by clinical evidence for improving erectile function. A 2018 systematic review found that physical activity interventions produced significant improvements in IIEF erectile function domain scores across multiple studies. These approaches address the upstream vascular and metabolic factors that contribute to ED, while PFMT addresses the downstream mechanical factors. Both are complementary rather than competing.

Psychotherapy and sex therapy. For men with primarily psychogenic ED — where performance anxiety, relationship stress, or psychological factors are the primary driver — cognitive-behavioral therapy and sex therapy are the appropriate first-line interventions. PFMT may be useful as an adjunct that gives men an active, physical practice to engage with their ED between therapy sessions.

Intracavernosal injections and vacuum devices. These second and third-line mechanical approaches bypass the physiological mechanisms entirely — they produce erections through direct pharmacological or hydraulic means. They are appropriate for men who do not respond to first-line approaches but are not necessary for men with mild to moderate ED that responds to less invasive interventions.

Realistic Expectations and Timeline

One of the most common reasons men abandon pelvic floor training prematurely is unmet expectations about how quickly results appear. The clinical trial data sets a realistic benchmark:

The Dorey randomized controlled trial showed statistically significant improvement at the three-month assessment, with continued improvement through six months. Most participants who ultimately responded did not experience noticeable change in the first four to six weeks. The minimum meaningful practice period before evaluating results is 8 to 12 weeks of consistent daily training.

This timeline is longer than many men expect, particularly those accustomed to the rapid onset of pharmacological ED treatments (sildenafil’s onset is 30–60 minutes). The difference reflects the nature of what is being achieved: PFMT is building structural muscle strength and coordination over weeks of progressive training, not triggering an immediate physiological response. The trade-off is that the improvement, when it comes, is durable — reflecting genuine muscle development rather than a temporary pharmacological effect that reverses when the medication clears the system.

Men who combine consistent pelvic floor training with lifestyle improvements (exercise, weight management, sleep optimization) and who work with a trained pelvic floor physiotherapist for at least the first several sessions show better outcomes than those who practice in isolation from a written description alone.

When to Seek Medical Evaluation

Pelvic floor training is a low-risk, non-invasive approach that most healthy men can explore safely. However, certain clinical situations warrant professional medical evaluation before or alongside attempting any home-based ED intervention:

Erectile dysfunction that persists for three months or more should be evaluated by a physician, as it may indicate underlying cardiovascular disease, diabetes, hormonal deficiency, or other treatable conditions. ED is recognized as an early warning marker for cardiovascular events — the endothelial dysfunction that impairs penile blood flow often precedes cardiac events by several years, making it a clinically important signal that deserves proper evaluation rather than only home management.

Men who experience sudden onset ED with chest pain or shortness of breath should seek emergency care, as this combination may indicate a cardiac event. Men who develop a prolonged, painful erection lasting more than four hours (priapism) require immediate emergency medical attention regardless of the cause.

Any man considering combining pelvic floor training with prescription medication — particularly PDE-5 inhibitors — should discuss this with a healthcare provider, particularly if they are taking nitrate medications (which are contraindicated with PDE-5 inhibitors), antihypertensives, or have known cardiovascular disease.

Final Assessment: Does the “Kentucky Horses Trick” Work?

The honest answer is: the technique itself — pelvic floor muscle training targeting the bulbocavernosus and ischiocavernosus muscles — has genuine, peer-reviewed clinical evidence behind it. The Dorey randomized controlled trials, published in respected urology and general practice journals, found that 40% of men with ED who followed a structured pelvic floor exercise program for six months regained normal erectile function, with a further 35.5% showing meaningful improvement. Those are not trivial numbers for a non-invasive, zero-cost, no-side-effect intervention.

The “Kentucky horses trick” branding is a social media label, not a clinical term. The underlying technique it points toward is a legitimate physiotherapeutic approach with a coherent anatomical rationale and an evidence base that most natural ED remedies cannot match.

What the evidence does not support is framing PFMT as a universal ED cure. Men with severe vascular disease, significant hormonal deficiency, neurogenic causes, or post-prostatectomy ED without nerve sparing are unlikely to achieve meaningful results from this approach alone. For these men, working with a physician to identify and treat the underlying cause remains the appropriate path.

For men with mild to moderate ED — particularly those experiencing maintenance difficulty rather than complete failure, those with no major organic comorbidities, and those seeking a non-pharmaceutical first step — pelvic floor muscle training is the most evidence-supported natural intervention in the current literature. Used consistently, correctly, and with realistic expectations, it deserves serious consideration as part of a comprehensive approach to erectile health.

The information in this article is for educational purposes only and does not constitute medical advice. Men experiencing persistent erectile dysfunction should consult a qualified healthcare provider for proper diagnosis and individualized treatment. Erectile dysfunction can be an early indicator of cardiovascular disease, diabetes, and other conditions warranting medical evaluation.

References

• Dorey G, Speakman M, Feneley R, Swinkels A, Dunn C, Ewings P. (2004). Randomised controlled trial of pelvic floor muscle exercises and manometric biofeedback for erectile dysfunction. British Journal of General Practice, 54(508):819–825. BJGP.
• Dorey G, et al. (2005). Pelvic floor exercises for erectile dysfunction. BJU International. doi:10.1111/j.1464-410X.2005.05690.x
• Scientific Reports. (2021). A prospectively collected observational study of pelvic floor muscle strength and erectile function using a novel personalized extracorporeal perineometer. Nature. https://www.nature.com/articles/s41598-021-97230-6
• Pelvic floor muscle training improves erectile dysfunction and premature ejaculation: a systematic review. ScienceDirect. 2019.
• Kim KL. (2024). The Role of Pelvic Floor Muscle Exercise in Erectile Dysfunction. Exercise Science. 33(2):121–130. doi:10.15857/ksep.2024.00066
• Evaluation of improvement of patients with erection dysfunction managed with biofeedback pelvic floor training. (2024). Tandfonline. doi:10.1080/20905068.2024.2400609
• Bolt Pharmacy. (2026). What Is the Horse Trick for Men’s Erectile Dysfunction? https://www.boltpharmacy.co.uk/guide/what-is-the-horse-trick-for-men-erectile-dysfunction
• Wireless Life Sciences Alliance. (2026). Kegel Exercises for Men with Erectile Dysfunction: What Clinical Studies Show. https://wirelesslifesciences.org/kegel-exercises-for-men-with-erectile-dysfunction/
• Bolt Pharmacy. (2026). Do Kegel Exercises Help Erectile Dysfunction? Evidence and Guidance. https://www.boltpharmacy.co.uk/guide/do-kegel-exercises-help-erectile-dysfunction