Many of us have heard of “Kegels” or pelvic floor exercises, and there’s probably a vague sense that we should be doing more of them. For many women, our social media news feeds are filled with ads for the latest gizmos and gadgets for exercising our pelvic floor. There are brands with apps such as games, including Perifit and Elvi, and there are Kegel balls for sale as well.
As technology advances and the need for pelvic floor rehabilitation continues after pregnancy, childbirth and menopause, the demand for innovation in these devices has increased. Then there is the global pandemic that has restricted access to face-to-face medical treatment – prompting many of us to take our health into our own hands.
But what are these tools actually used for, and do they really work? The short answer: strengthening the pelvic floor; And, it depends.
4 Things the Pelvic Floor Does and Why It Often Fails
The pelvic floor is a group of muscles that line the base of our pelvis, from our pubic bone to the tailbone and between our sit-bones. Contrary to popular belief, you do not need to lie on the floor to exercise your pelvic floor.
The role of the pelvic floor muscles is:
- Place all our organs (bladder, uterus, bowel) inside the pelvis
- Keep the sphincters close to our bladder and bowel (unless we prepare them to rest on the toilet)
- provide sexual sensibility
- Work in conjunction with other deep core muscles to help with trunk stability.
The pelvic floor doesn’t always work the way it’s supposed to. Bladder leakage (also known as urinary incontinence) and pelvic organ prolapse are common pelvic floor complaints for women of all ages.
One in three women will experience urinary incontinence at some point in our lives, especially after we’ve had a baby. Other risk factors include frequent heavy lifting, stress due to constipation, excess weight lifting, pelvic surgery, and hormonal changes.
Read more: ‘Is Kegel Exercise Really Good for You?’
shape the pelvic floor
Pelvic floor muscle training is recommended as the first line of treatment for incontinence and prolapse, along with lifestyle changes such as healthy bladder and bowel habits, good general fitness and weight management.
Pelvic floor physiotherapists are health professionals who are specially trained to give you an assessment and personalized advice for your pelvic floor symptoms based on your circumstances. They will likely recommend daily exercise that may include rapid contraction of the pelvic floor muscles, coordination work, and prolonged holding.
People who have trouble sticking to prescribed exercises, or who do not have access to a suitable physio due to geographic or financial reasons, may be interested in trying biofeedback devices. These tools and their associated apps are designed to give you more information on how and when to do your exercises, remind you to do them, and help you keep up with the program.
It can be hard to maintain motivation. Research shows that it usually takes at least 6-12 weeks of regular pelvic floor training to see results (like going to the gym, we can’t build muscle overnight).
Read more: Urinary incontinence can be a problem for women of all ages, but there is a cure
Do pelvic floor biofeedback devices work?
There is some evidence to suggest pelvic floor reminder apps and biofeedback devices may be helpful for improving pelvic floor function and bladder control. It may be better than pelvic floor exercises alone. Then again, it might not matter.
Some women do not find using techniques for pelvic floor training helpful. Constraints can include connectivity or set-up issues, privacy requirements, technology distractions, and price. Insertable devices also require caution for use, as most are not suitable during pregnancy, within the first six weeks after surgery to the baby or pelvis, or when there is unexplained bleeding, pain, or active infection. If in doubt, it is always best to consult your doctor.
Benefits of pelvic floor trainers with apps like games that sync with an included device include:
- Provides real-time on-screen feedback for pelvic floor performance and correct technique
- Allowing women to work with their physio remotely
- Measuring and tracking improvements in strength, stamina and coordination over time
- Providing reminder prompts via phone notifications to complete workouts
- adjusting the workout difficulty of each session based on how the body is responding (this fluctuates over time and accounts for fatigue)
- Entertaining the user with a variety of games and tasks, making them more likely to stick with their pelvic floor program!
Read more: Why you shouldn’t make a habit of peeing ‘just in case’ – and don’t tell your kids either
The evidence certainly supports pelvic floor exercises for incontinence and prolapse, and this is best done with the support of a suitably trained professional such as a pelvic floor physiotherapist.
While the initial research looks promising, the evidence for commercially marketed pelvic floor feedback devices has yet to materialize in their promotion. But if you’re willing to try a pelvic floor biofeedback device or app to improve pelvic floor tone for better bladder control, prolapse symptoms, or sexual function – go for it (especially if your specialist physio agrees).
Ultimately, the best type of pelvic floor exercise regime is the one you’ll stick with.