Devices Designed to Aid Pelvic Floor Muscle Training

There are many devices available that claim to help you train your pelvic floor muscles, but what are they and what do they do?

1. Electrical Stimulator Machines
The best way I can describe these devices are that they artificially exercise your pelvic floor. They are in the same league as those machines you strap to your stomach to get a six-pack.

They work by providing electrical impulses to the pelvic floor muscles via a vaginal or anal probe. The selected settings of the device will target certain actions of the muscle. For example, one setting will work on activation and sensation, another on endurance and increasing hold time and another on speed of contraction.

Electrical impulses can also be used to relax and de-sensitise tight pelvic floor muscles, like a TENS machine for your back. The machines are all able to provide the same treatments and can be a great way to boost your pelvic floor training.

Many of the devices will have pre-set options that you can select easily. There are also blank settings that can be programmed by your physiotherapist, providing a bespoke setting for your requirements.

My general guide for whether to use these devices or not is that if you can squeeze on your own, it's more functional and effective to do your own exercises. However, if you have a very weak pelvic floor, or struggle to know if you are doing the exercises correctly, they can be a great way to boost the muscles until you feel more confident in your own technique.

In physiotherapy, we have a grading system for muscle power and this has been modified for use in pelvic floor muscle assessment. 

The Modified Oxford Grading System of Muscle Power
0 - No Power or Movement
1 - A Flicker of Power - not sustainable
2 - A Squeeze - but no elevation
3 - A squeeze plus elevation
4 - A Squeeze plus elevation against resistance
5 - Full Power

Grades 0-1-2 can often benefit from electrical stimulation, especially during the early stages of pelvic floor rehabilitation. The machines can help you to build muscle bulk, movement and sensation, enabling you to move on to independent exercises.

The devices are also very useful for ladies dealing with neurological conditions affecting the pelvic floor such as multiple sclerosis, stroke and traumatic nerve injuries. Using such devices can reduce the deterioration caused by such conditions. However, it's really important to check for sensation of the vaginal tissues prior to using a machine, to avoid irritation related vaginal issues, especially where the neurological system has been affected.

The other group of ladies that should use caution when using such devices are those with hypertonic, gripping or overly tight pelvic floor muscles. Tension shouldn't be treated by more tightening, as this can lead to pain and further dysfunction. Over-activity needs to be treated with release, relaxation and down-training, not stimulation.

Overall, these can be very useful devices, but should be used according to your physical needs and avoided in some circumstances.

*Please do not use electrical stimulation devices during pregnancy or in the presence of active cancerous growth.*

2. Biofeedback Devices

Devices such as the Educator, Neurotrac Simplex, Elvie and Perifit are all types of biofeedback. They tell you what you are doing. The effort comes from you and the information comes from the device. It's a little like the physiotherapist's role during assessment, telling you if you're doing the exercise correctly, how strong your squeeze is, whether you're releasing, how long you've held the squeeze and how many you managed to repeat.

The devices range in how much they offer and they range in price too. The Need Educator is a simple device that looks like a tampon with a stick attached. The device is inserted vaginally and the stick is then visible between your legs. If you squeeze your pelvic floor correctly, the stick moves down and away from you. When you release the squeeze, the stick moves back towards you. This is a simple form of biofeedback that many of my clients benefit from in the early stages.

The Elvie is an example of a more technological device that links to an app on your phone. Again, there is a vaginal probe which contains pressure sensors. When you squeeze correctly, the pressure sensors identify the rise in pressure and communicate that in real-time to your app. On the app, there is a gem that rises up when you squeeze and falls back down when you release. There is also a series of pelvic floor training programmes using the biofeedback to guide you in your workouts. Each workout is assessed and then you have a report of your results at the end of each use.

As you can see, biofeedback is different to electrical stimulation. Biofeedback involves greater effort on your part, whereas the stimulation could be seen as a bit of a lazy approach to your training.

Biofeedback is great if your technique is pretty good, but if you're struggling to contract effectively, or if you can't release, it can get pretty frustrating. The device will tell you that you're doing it wrong, but won't necessarily tell you how to fix the problem.

So, my advice is to use biofeedback at the suggestion of your physiotherapist. Using appointments and assessments to guide your use of the devices. 

If you have a biofeedback device and you're struggling to get the most out of it, let me know or book an appointment.