Pelvic floor exercise devices have been around for quite a while now - but if you’ve been watching the pelvic health space for a minute, you’ve probably noticed they’re getting a bit more attention recently. Many home devices are even becoming affiliated with insurance companies - I personally have received ample mailers from my insurance company, enticing me to sign up for the pelvic floor training device they’ve brought into their plan. 

If your plan covers one, a device is shipped to you which typically connects to an app that monitors your activity and gives you feedback on your usage (‘biofeedback’ is the buzzword you may have heard before). Some companies even offer virtual consultation with a pelvic floor specialist for additional guidance on using the device and tailoring your exercise plan. 

The devices are often pretty cute, too - a fun on-trend color and gently curved shape that looks visually appealing.This sounds great, right? While we love that pelvic health needs are becoming more openly discussed and devices such as these are becoming more accessible to the masses, there’s a pretty big catch here:

Not everyone should learn how to kegel, or strengthen, their pelvic floor as these devices aim to do.

Somehow, a misconception has developed over the years that if you’re having a wide variety of pelvic health symptoms ranging from urinary leakage postpartum to pain with tampon insertion to tailbone pain with prolonged sitting, pelvic floor strengthening must be the answer for you. Sometimes strengthening the muscles of the pelvic floor can be part of the solution, but very often we need to train these muscles to relax first. It seems to be a well-kept secret that symptoms such as leakage and pain can often be caused primarily by having too much tension in the pelvic floor rather than weakness. 

Pelvic floor strengthening has its value, to be sure: it’s often included in later phases of treatment. Once we have addressed pelvic floor muscle tension and the factors that contribute to it, many people then benefit from moving into a strengthening phase to ensure the pelvic floor can meet the demands of your everyday activities (think maintaining continence, healthy bowel & bladder habits, inserting menstrual products without pain or participating in intimacy comfortably). 

If you skip over the phase where muscle tension is addressed and jump right to strengthening, however, you’ll be likely to remain frustrated by persistent and potentially uncomfortable symptoms. 

Let’s dig a bit more into how these home devices actually work: once you’ve connected the device to an app on your phone, you can insert the device vaginally with your preferred lubrication. The app will then provide various prompts to contract and relax your pelvic floor around the device, which is measuring your muscle activity and sending that data back to the app, which tells you how you’re doing in the various exercises (aka, the biofeedback I mentioned earlier). 

If your pelvic floor muscles aren’t particularly tense and only need some targeted strengthening, this may be beneficial for you. However , if you do have muscle tension in the pelvic floor, inserting the device may be uncomfortable as well as attempting to contract or squeeze around the device once it’s inserted. 

Additionally, multiple sources who have tried these devices have reported back that the cues given from the device about their activity weren’t particularly accurate. One of the therapists on our team decided to give it a whirl, in the name of science of course! As a trained clinician she was very aware of when she was squeezing her pelvic floor vs. relaxing her pelvic floor. Unfortunately, the device was confused. It would congratulate her on a good relaxation while she squeezed and vice versa. This is one of our main concerns when it comes to home devices without the guidance of a skilled provider - how do you know if you are doing it correctly?

One of our patient’s who attempted to use a home device before coming in for a session at Pelvic Pride mentioned that between the device feeling uncomfortable to insert given her pelvic floor tension combined with cues that didn’t totally ‘click’ with her and continued reminders from the app to carve out time for using the device, she just ended up feeling defeated and frustrated - though she recognized that it might be a useful supplement to her treatment plan down the road. 

So, what’s the best course of action given all of this? 

When in doubt, make an appointment with an in-person pelvic floor therapist. Not only will they perform a thorough assessment through a whole-body lens, but they’ll be able to give you highly individualized feedback pertaining to your body’s unique needs to develop a plan that will best fit your personal goals. No guesswork for you, no wondering if your bluetooth connection is working properly, no wondering if your body is the problem if the device doesn’t help - just specialized support and care from a highly trained therapist. 

Looking for pelvic floor therapy in Maryland?

At Pelvic Pride Physical Therapy & Wellness, we are THE clinical experts at working with patients struggling with pelvic floor issues, so you are in the right place!

We are conveniently located in the Federal Hill & Roland Park neighborhoods in Baltimore MD. Fill out our contact form & our Patient Care Specialist will reach out to you ASAP!

TL;DR:

• Pelvic floor home devices, or biofeedback devices, may be helpful for some individuals - but there’s no way of knowing if you’re one of them unless you’ve been seen by an in-person pelvic floor therapist. 
• These devices may be difficult to use or even lead to worsening symptoms if your pelvic floor holds a bit too much tension. 
• We at Pelvic Pride are here to work with you and develop an individualized plan to support your body’s unique needs!