You know treatment for prostate cancer can save your life. But some of its side effects, particularly incontinence, can feel downright unmanly. And even if you were in shape previously, cancer treatment can sap your energy, as well as put you at risk for muscle and bone loss. The solution: Get moving.

Use the Squeeze Play
The prostate sits right in the middle of your plumbing, and during radiation treatment or surgery, some of your valves — particularly the band of muscles known as the urinary sphincters, which control the flow of urine from your bladder — may be damaged. This can cause temporary (though occasionally permanent) urinary incontinence. Additionally, the rectum can be damaged during radiation, which can result in bowel problems, such as diarrhea.

The good news: There’s a workout for that. Kegel exercises help tone the pelvic floor muscles, which support the bladder and bowel. The stronger these muscles, the better your bladder and bowel control. A study published in the Journal of Urology found that men who did Kegel exercises before and after surgery were more likely to have regained continence three months after their surgery.

First, identify the right muscles. Sit comfortably and relax your thighs, buttocks and abdomen. Imagine you’re urinating, then try to stop the flow midstream. Try not to use your abdominal muscles or any other muscles in that area. When tightening the pelvic floor muscles correctly, you may feel a slight dip at the base of the penis, and your scrotum will move up slightly. Now tighten the ring of muscle around your anus, as if you were trying to stop passing gas. Don’t squeeze with the buttocks or tighten your abdomen.

If you are unable to do either of these, talk to your doctor. A physiotherapist can help teach you the proper technique. Or a technique called biofeedback can give you visual or audio feedback to ensure you’re contracting the correct muscles.

• Once you know which muscles you’re working on, try the following:
  Stand, sit or lie with your knees slightly apart, and slowly tighten and pull the pelvic floor muscles up as hard as you can, remembering to breathe.
• Hold for as long as you can, then relax for the same amount of time, suggests Betsy O’Dougherty, PT, a pelvic floor specialist at the Cleveland Clinic. For example, if you hold for four seconds, then relax for four seconds.
• Work up to holding for 10 seconds, then relaxing for 10.
• Do these a total of 45 times every day, spreading them over three to four sessions per day.
• Continue to do the exercises for three months, then continue doing about 15 repetitions per day to maintain strength in the pelvic floor.

A final note: If you tend to leak urine when you cough, laugh or sneeze, “squeeze before you sneeze,” says O’Dougherty.

Rev Your Engines
While Kegels can be done while watching SportsCenter from your couch, don’t get too comfy there. The American Cancer Society recommends that every adult do at least 30 minutes of moderate to vigorous physical activity at least five days a week above and beyond your routine, says Kimberly A. Stump-Sutliff, RN, MSN, AOCNS, of the American Cancer Society. This may be a lofty goal while you’re feeling crummy after surgery or going through radiation, but it’s important to get up and do something. Exercise can keep your weight in check, and some studies have found that obese men may be at greater risk for having more advanced prostate cancer and of dying from prostate cancer.

Several studies have found that regular workouts can also help you feel better both while you’re going through treatment and afterward. Among the findings: Men who walked about 30 minutes a day, several days a week, reported feeling less tired than men who didn’t exercise. Four weeks post-treatment, men who were still stepping out continued to report less fatigue than those who weren’t. Pumping iron and pumping your heart seem to also hold promise: Another study found that a three-times-a-week routine of either resistance training or moderate aerobic exercise lessened fatigue dramatically in men going through radiation treatment.

Get Pumped Up
Exercise makes particularly good sense for those treated with hormone therapy; workouts help counteract the side effects of muscle loss and bone thinning. Exercise can also help battle fatigue during hormone therapy. One study found that men who performed resistance training for 12 weeks felt less tired and reported a better quality of life than the men who weren’t working out.

Always speak to your doctor before starting any exercise program, especially since men with prostate cancer tend to be of an age where silent heart disease is probably a bigger killer than the prostate cancer itself.