Playing games with your pelvic floor can be a useful exercise for urinary incontinence

Many of us have heard of “cones” or pelvic floor exercises, and probably have the vague feeling that we should be doing more of them. For many women, our social media news feeds are full of advertisements for the latest gadgets and gadgets for training our pelvic floor. There are brands with game-like apps, including: Perifit and Elvieand there are Skittles also 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’s the global pandemic that has limited access to personalized medical treatment — leaving many of us to take our health into our own hands.

But what exactly are these devices used for and 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 run from our pubic bone to the tailbone, and between our sit bones, along the base of our pelvis. Contrary to popular belief, you don’t have to lie on the floor to train your pelvic floor.

The role of the pelvic floor muscles is:

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

The pelvic floor does not always work as intended. Bladder leakage (also known as: urinary incontinence) and pelvic organ prolapse are common pelvic floor complaints in women of all ages.

About one in three women suffer from urinary incontinence at some point in our lives, especially when we have had a baby. Other risk factors include repeated heavy lifting, straining due to constipation, carrying extra weight, pelvic surgery, and hormonal changes.

The pelvic floor helps keep organs in the pelvis.

Read more:
“Are Kegel exercises really good for you?”

Getting the 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 movements, good general fitness, and weight management.

Pelvic floor physiotherapists are health professionals specially trained to give you personalized advice for your pelvic floor symptoms based on an assessment and your circumstances. They will likely recommend daily exercises, including quick pelvic floor muscle contractions, coordination tasks, and longer poses.

Those who struggle to stick to prescribed exercises, or who for geographical or financial reasons do not have access to an appropriate physio, may be interested in trying biofeedback devices. These devices and the accompanying apps are designed to give you more information about how and when to do your exercises, remind you to do them and help you stick to the program.

Maintaining motivation can be difficult. Research shows it usually takes at least 6-12 weeks of regular pelvic floor training to see results (just like going to 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 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. This could be superior to pelvic floor exercises only† Then again, it might not make a difference

some women do not find the use of technology useful for pelvic floor training. Barriers may include connectivity or configuration issues, need for privacy, distracting technology, and price. Insertable devices also require caution when used as most are not suitable during pregnancy, within the first six weeks after 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 a placed device are:

  • provides real-time on-screen feedback for pelvic floor performance and right technique
  • allow women to working remotely with their physio
  • measuring and tracking improvements in strength, endurance, and coordination over time
  • providing reminder prompts via phone notifications to complete workouts
  • adjust the training difficulty of each session based on how the body reacts (this explains the fluctuations at the time of day and fatigue)
  • entertain the user with a variety of games and tasks, increasing the likelihood of them sticking to their pelvic floor program!

woman lying on exercise mats

You do not have to do pelvic floor exercises lying down or with special equipment.

Read more:
Why you shouldn’t make a habit of peeing ‘just in case’ — and don’t tell your kids either

it comes down to

The evidence definitively supports pelvic floor exercises for incontinence and prolapse, and this is: well done with the support of a trained professional such as a pelvic floor physiotherapist.

While early research seems promising, the evidence for commercially marketed pelvic floor feedback devices is: not caught up yet to their hype. But if you’re eager 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 physiotherapist agrees).

After all, the best form of pelvic floor exercise is the one that you persevere.

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