Do pelvic floor gadgets and aids really work? And are they better than traditional exercises?
Pelvic floor gadget manufacturers make lots of claims about how good their products are at training your pelvic floor muscles.
But, as any women’s health physiotherapist will tell you, when it comes to working with your pelvic floor, it’s not as simple as that.
Doing your exercises on a regular basis is the best way to strengthen your pelvic floor. They’re free, easy to do, and very effective, as long as you do them properly, and keep them up.
Gadgets can be a good aid in reminding you to do your exercises, but they aren’t a shortcut to improving your pelvic floor.
There are two big benefits to doing pelvic floor exercises (Resende et al 2012):
- they help you to rebuild strength in your pelvic floor after pregnancy and childbirth
- they help to prevent problems in future, since your pelvic floor will naturally get weaker as you have more children, and as you age.
Keeping up regular pelvic floor exercises can help with symptoms you may experience after giving birth, including:
- accidental urine leaks (stress incontinence)
- pelvic pain
- reduced sensitivity during sex
Doing your exercises may also help to reduce your risk of having pelvic organ prolapse later on. This is when one or more of your pelvic organs, which include your womb, bladder, and bowel, slip down into your vagina.
Pelvic floor exercises can also help to improve the sensations you feel during sex, and give you stronger and more satisfying orgasms (NHS 2015, Resende et al 2012).
The traditional pelvic floor exercise is the “squeeze-and-lift” action. Just as with any exercise programme, it’s down to you to put in the work. As a baseline, do your exercises three times a day while building strength, and then once a day after that, to keep your muscles strong.
If this sounds daunting, especially when you’re a busy new mum, remember that you can do them anywhere and at any time. It may help to have daily triggers as reminders. For example, you could squeeze and lift each time you’re waiting for the kettle to boil, or when you’re driving and you stop at a traffic light.
You may find the exercises difficult to do because at first you can’t feel your pelvic floor, or you don’t notice your hard work making any difference.
Unlike, say, your biceps, or your abs, in which you may see changes quite easily because they are large, visible muscles, your pelvic floor muscles are small, close together, and impossible for you to see.
If you’re struggling to motivate yourself to stick with your exercises, gadgets, and in particular apps, can come in handy (Bø et al 1999).
Most apps are free, so you could try a few before finding one you want to stick with. But before you invest in any gadgets, make sure you’re doing your exercises correctly. It’s easy to tense up the wrong muscles while trying to contract your pelvic floor (Henderson et al 2013).
Ask your midwife or GP for advice if you’re not sure. If you have any symptoms of pelvic floor weakness, such as stress incontinence, you can ask to be referred to a women’s health physiotherapist. Your postnatal check is a good opportunity to do this, but you can ask for help at any time after your baby’s born.
If you are referred to a physio, she will offer to give you an internal examination, to check your pelvic floor, and help you feel the muscles for yourself. Based on what she finds, she can give you an individual exercise programme.
Having your own programme will help you to make the most of your work. Once you have the feel for the exercises, it will stay with you forever.
Kegel balls, vaginal cones, and vagina gyms
All of these work in a similar way. You insert a weighted ball or cone in your vagina, and you hold it “up” using your pelvic floor muscles. They come in a variety of shapes and weights.
Manufacturers of these products claim that they can help you to:
- improve the ability of your pelvic floor muscles to expand and contract
- build strength in your pelvic floor muscles
- activate different muscles within your pelvic floor
However, there is little research to show that these gadgets activate different muscles, mainly because your pelvic floor muscles work together (Bø et al 1999). Studies have shown that these products are no better than traditional exercises at strengthening your pelvic floor.
There can be other problems with these gadgets. Some women can use them without activating their pelvic floor. The ball or cone can just stay stuck in your vagina, without you needing to use any muscles to keep it there.
Some physiotherapists also feel they exercise your pelvic floor in the wrong way. Holding up your pelvic floor muscles over a longer period is less helpful than the squeeze and relax of traditional, manual exercises.
Most women who buy these gadgets don’t continue to use them, meaning their effectiveness in the long-term is questionable (Cammu et al 1998). In other words, you may just be wasting your money.
Pelvic floor apps
There are a number of apps available that help you to exercise your pelvic floor, including one from the NHS. Apps are often free, or just a few pounds, and are a useful tool to get you started.
Typically, an app will give you regular alerts to do your exercises, and many will provide additional guidance on how to squeeze and lift effectively.
You can use these apps with any other vaginal and pelvic floor exercisers, although they are mainly designed to support you doing your exercises without gadgets.
Although apps won’t do the work for you, they can be a handy reminder of when to do your pelvic floor exercises, and how long each squeeze and lift should last. As a busy new mum, it’s an easy way to remind yourself during the day.
Digital biofeedback vaginal exercisers
Biofeedback is a kind of muscle retraining exercise. Biofeedback machines measure the activity in your muscles and give you information about when you’re contracting them properly.
You can buy digital exercisers, although they are expensive. They have a probe for inserting into your vagina, which connects to a hand-held device, or your phone.
While you’re doing pelvic floor exercises, the probe sends the results of your muscle activity to the device or phone. This may help you to track your progress over time.
Some digital products don’t always give very exact measurements (Keshwani and McLean 2015). It’s also possible to “cheat” by activating other muscles, primarily your glutes and deep-hip muscles, or to alter your scores by changing your position (Frawley et al 2006). You may think you’re making great progress only to find that your pelvic floor hasn’t strengthened at all.
The Hypopressive method is a breathing technique that is claimed to have numerous health benefits, including helping with pelvic floor weakness.
The theory is that by correctly doing the breathing exercise, you can activate your pelvic floor muscles better, leading to improved strength.
This method is so new that there is little research on it and claims for its benefits are largely anecdotal.
What little research there is has found that traditional pelvic floor exercises outperform Hypopressive techniques, and that adding the breathing exercises to normal exercises did not improve pelvic floor function (Resende et al 2012, Stüpp et al 2011). However, we need more research to be sure.
That said, practising Hypopressives is unlikely to do any harm. Breathing exercises generally, such as those in yoga or meditation, can give you a better understanding of your pelvic floor muscles (Sapsford 2004).
Some women say they “feel” their pelvic floor more during certain breaths. Your diaphragm, the sheet of muscle beneath your ribs, rises when you take an out breath, creating space for your pelvic floor to rise too. It’s possible that the Hypopressive method could help you tune in better to your body while you’re exercising.
The Hab-it exercise method, and similar products, work just like any other exercise video, although with a focus on your pelvic floor.
Before you buy, check that the exercise video is created by women’s health physiotherapists with a personal-training, or sports background.
The idea is that different exercises, whether you’re using your own body weight or hand-held weights, can activate your pelvic floor muscles. The exercises are particularly effective if you can include your traditional pelvic floor exercises as you work out.
Hab-it exercises can teach you to maintain good pelvic floor strength while doing exercises that focus on other muscle groups, such as when you’re playing sports or working out at the gym.
As with any other method of strengthening your pelvic floor, there are no shortcuts. DVDs may have the following drawbacks:
- Overpromising: claiming to help you achieve results quickly, typically over a seven-day programme. The reality is that it would take you at least four to six weeks before you’d notice increased strength in your pelvic floor.
- Making misleading suggestions: for example, that other exercises, such as pilates, are significantly better than the squeeze-and-lift moves of traditional pelvic floor exercises (Culligan et al 2010).
- Some exercises may allow you to use other, stronger muscles, to carry the load, leaving your pelvic floor underused. Also, if you struggle to “find” your pelvic floor, or do the exercise incorrectly, you may not benefit from the DVD exercises as much (Culligan et al 2010).
However, if the quality of instruction is good and you use them regularly, exercise videos are a useful tool. The best videos include education on your pelvic floor as well as good visuals.
If you are a visual learner, these can be an excellent way to help you understand your pelvic floor and how to strengthen it.
Similarly, if your DVD offers guidance on how to develop your pelvic floor strength over time, it can also help to stay motivated and stick with your exercises.
So what’s the verdict on gadgets and aids?
The key to pelvic floor exercises is being consistent and doing them correctly. No single gadget will outperform regular training over time. Manual pelvic floor exercises tend to be equal to or better than other tools. So, at best, gadgets should be used alongside, not instead of, traditional exercises (Bø et al 1999).
Choose tools that help you remember – apps are a cheap and reliable way to get started, as well as providing information on how to do the exercise correctly.
Do whatever works for you. You may prefer the structure of instruction videos. You may prefer continuous feedback, allowing you to see progress, or gadgets may work to keep you on track.
As long as you do your exercises over time, you are likely to see improvement. The key, as with any training, will always be sticking to it.
Finally, not all pelvic floor problems are caused by weak pelvic floor muscles. There may be other causes (including a tense, overactive pelvic floor), so always asked to be referred to a women’s health physiotherapist or a gynaecologist if you continue to have problems with your pelvic floor.
This post was originally published on the Babycentre website as part of my work for them as a Women’s Health expert. To see the original post click here.