Playing with the pelvic floor could be a useful exercise for urinary incontinence

Many of us have heard of Kegels, or pelvic floor exercises, and probably have a vague feeling that we should be doing more. For many women, our social media feeds are filled with advertisements for the latest pelvic floor exercise gadgets and devices. There are brands with game-like apps, like Perifit and Elvie, and there are also Kegel balls for sale.

As technology advances and the need for pelvic floor rehabilitation after pregnancy, childbirth and menopause continues, 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, leading many of us to take charge of our health.

But what exactly are these devices used for? Do they really work? The short answer: pelvic floor strengthening; and, it depends.

4 things the pelvic floor does and why it often fails

The pelvic floor is a group of muscles that runs from the pubic bone to the coccyx, and between the sit bones, which line the base of the pelvis. Contrary to popular belief, you don’t have to lie on the floor to exercise your pelvic floor.

The function of the pelvic floor muscles is:

  1. keep all of our organs (bladder, uterus, intestine) inside the pelvis
  2. keeping our bladder and bowel sphincters closed (until we are ready to relax them on the toilet)
  3. provide sexual sensation
  4. work in conjunction with other deep core muscles to help with core stability.

The pelvic floor doesn’t always work the way it should. Urine leakage (also known as urinary incontinence) and pelvic organ prolapse are common pelvic floor complaints in women of all ages.

Approximately one in three women will experience urinary incontinence at some point in her life, especially if we have had a baby. Other risk factors include repetitive heavy lifting, straining due to constipation, being overweight, pelvic surgery, and hormonal changes.

The pelvic floor helps support the organs within the pelvis.

Read More: ‘Are Kegel Exercises Really Good for You?’

Get your pelvic floor in shape

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, general fitness, and weight control.

Pelvic floor physiotherapists are health professionals specially trained to give you individualized advice on the symptoms of your pelvic floor based on an assessment and your circumstances. They will likely recommend daily exercises that may include rapid pelvic floor muscle contractions, coordination tasks, and longer holds.

Those who have trouble complying with prescribed exercises, or who do not have access to a suitable physical therapist for geographic or financial reasons, may be interested in trying biofeedback devices. These devices and their associated apps are designed to give you more information about how and when to exercise, remind you to exercise, and help you stay on track.

Staying motivated can be difficult. Research shows that it usually takes at least 6-12 weeks of regular pelvic floor training to see results (just like visiting the gym, we can’t build muscle overnight).

bright pink shapes with long handles
There are many types of pelvic floor trainers on the market.

Read more: Urinary incontinence can be a problem for women of all ages, but it has a cure

Do pelvic floor biofeedback devices work?

There is some evidence to suggest that pelvic floor reminder apps and biofeedback devices may be helpful in improving pelvic floor function and bladder control. This could be superior to pelvic floor exercises alone. On the other hand, it may not make a difference.

Some women do not find the use of technology for pelvic floor training helpful. Barriers can include connectivity or setup issues, need for privacy, distracting technology, and price. Insertable devices also require caution in their use, as most are not appropriate during pregnancy, within the first six weeks after having a baby or pelvic surgery, or when there is unexplained bleeding, pain, or active infection. When in doubt, it is always best to consult your medical provider.

The benefits of pelvic floor trainers with game-like apps that sync with an inserted device include:

  • providing real-time feedback on screen for pelvic floor performance and correct technique
  • allow women to work with their physio remotely
  • Measurement and tracking of improvements in strength, endurance and coordination over time.
  • provide reminder notices via phone notifications to complete workouts
  • adjust the training difficulty of each session based on how the body responds (this takes into account fluctuations in time of day and fatigue)
  • entertaining the user with a variety of games and tasks, making them more likely to stick with their pelvic floor program!
woman lying on exercise mats
You do not need to do pelvic floor exercises lying down, or with special equipment.

Read more: Why you shouldn’t make it a habit to pee ‘just in case’, and don’t tell your kids either

The bottom line

The evidence definitely supports pelvic floor exercises for incontinence and prolapse, and this is best done with the support of a properly trained professional, such as a pelvic floor physical therapist.

While early research looks promising, the evidence for commercialized pelvic floor feedback devices has yet to catch up. But if you want to try a pelvic floor biofeedback device or app to improve pelvic floor tone and improve bladder control, prolapse symptoms, or sexual function, go for it (especially if your physical therapist agrees).

After all, the best type of pelvic floor exercise regimen is the one you stick with.

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