Ask a Pelvic Floor Physical Therapist about pelvic floor muscle training devices such as: Kegel weights, jade eggs, biofeedback tools and more…
As a pelvic health Physical Therapist, I frequently get asked about the use of these pelvic floor strengthening products and whether they are beneficial, worth the money, or even harmful. Here are my answers to those questions:
Many of us have heard about the importance of a strong pelvic floor to avoid peeing your pants, improving sexual function, recovery after having a baby, and more. This is absolutely true, but in seeing the interest, the commercial industry has quickly jumped in to offer products for home use. With so many options, consumers are left unsure what it’s all about and what is best. To be clear form the beginning, I am not against these products (maybe one of them..), but we need to be better informed on their use in general.
Before buying anything, consider these things:
- What are you hoping to get out of using the product?
- Do you have a pelvic floor dysfunction?
- Are you sure you are doing a pelvic floor contraction correctly?
- The differences in types of products
- Cost vs benefit
- Could I get the same results in another way?
- Who is selling it?
What are you hoping to get out of using this product?
Are you looking to “strengthen” the pelvic floor? Do you know if or why it is weak? Did you hear that it makes sex better? Do you really know why your sex isn’t great?
These questions may seem simple or obvious, but thinking deeper, they are anything but. Many women think they have “weak” pelvic floors because they pee when they sneeze, or can’t jump on a trampoline. This may be 100% true, or it may not. You can have weakness in the pelvic floor muscles because it’s too tight. Think of holding your hand in a clenched fist and leave it that way for a minute. Your hand doesn’t get stronger, it actually gets weaker. Before you make tight tighter, learn WHY your pelvic floor may be “weak”. It’s possible you are strong, but not timing the contractions well. Maybe sex isn’t great because of underlying issues with your body or your relationship. These changes are common, especially after a baby. A sex therapist or marriage and family relationship counselor can help. A pelvic health Physical Therapist can tell you exactly what to do, who to see, and if you pelvic floor is the problem, or part of a bigger picture. Addressing the whole issue is the only way to get complete, long-lasting results.
Do you have a Pelvic Floor Dysfunction?
“Pelvic floor dysfunction” can mean so many things. If you are experiencing any of the following, you may have a pelvic floor dysfunction:
- Pain: any pelvic pain, including the pelvic floor, back, SI joints, sciatica, abdominal wall, or painful sex, tampon use or gynecological exams.
- Leaks: ANY leaks, even the “normal” ones. If you’ve read any other of my posts you will see that I have a big soap box that normal and common are not the same! You should never unintentionally leak urine, stool or gas, regardless of the amount.
- Prolapse: a feeling of heaviness or bulging in the pelvic floor due to the organs dropping down.
- Related conditions such as: endometriosis, PCOS, interstitial cystitis, IBS, jaw pain or TMJ disorder, anxiety…and more. These are all linked to increasing guarding and clenching in the pelvic floor.
- It is impossible to add all dysfunctions here. Just know that if you don’t feel right, you’re probably not, so trust yourself. Get help from someone who can guide you through whatever may be causing or contributing to imbalances and pain.
If you think you may have a pelvic floor dysfunction, DO NOT start any of these home programs without first consulting your physician, pelvic Physical Therapist, or other qualified provider. You could make yourself worse, or be overlooking a more serious condition.
Learn more about pelvic floor dysfunction in our program Pelvic Floor – At Home. We offer a Guide to Pelvic Health, which is the 101 of the pelvic floor and possible dysfunctions. There is also a program specific to pelvic pain.
Are you sure you are even doing your pelvic floor contraction correctly?
Using any of these products without knowing if you are doing the contraction properly is a waste of time and money, and could be strengthening your dysfunction.
It is very difficult to know for sure that you are performing a contraction correctly without an internal exam by someone who can look at the whole body. You should learn how to make sure that the right muscles (and not the wrong ones) are doing the contraction, and how to coordinate based on your condition, activity levels and goals. To better understand pelvic Physical Therapy, read this blog post.
Differences in types of products
All of these products are basically designed to do the same thing:
Biofeedback
Whether it is a weight, egg, Kegel trainer, a pressure sensor to measure “strength”, and app on your phone, or even a mirror, all of these products are designed to give you information on your body (bio). They give you some type of feedback, whether it is a number on a graph, the weight stays in or falls out, or a little stick moves. it’s all supposed to tell you what your body does when you try to contract or relax.
When your Physical Therapist gives you information on whether you are contracting properly, helps make sure you can feel something, manages discomfort, shows you how to reduce tension, or tells you you need more or less intensity….that’s all biofeedback too.
When would use of trainers be helpful?
I recommend weights to people who are pushing down vs lifting up when attempting a contraction, or if they are unaware of pushing down on the pelvic floor during the day as a habit. It is a common thing that happens with prolapse and incontinence and many people have no idea they are even doing it! I also recommend them if there is decreased sensation of the vaginal wall and muscles. A weight is a good way to tell at home if you are pushing down, or to add increased sensation to the vaginal wall.
These devices can make you more consistent with your program. This will help you get better faster. They can help with compliance and make you feel like you have a more actionable program.
If you know how to perform a contraction (and relaxation) properly and choose to use these to continue your training at home, go for it! These muscles are difficult to see. Some of us are kinesthetic learners. We need to touch, feel and do. This type of feedback can assist if this is your learning style. If you like having something you can literally feel to squeeze against, it can be really valuable to have the increased sensation.
What are these devices NOT telling you?
It is critical to understand quality of contractions. A device may tell you whether muscles are contracting or not, but it won’t tell you if that contraction is coming from the pelvic floor, gluteals (bum cheeks), if it is too strong, not strong enough, if you need more or less emphasis on the front or back, or when to do the contraction. It is not always functional to insert a weight and walk around trying not to let it fall out (unless you and your therapist feel otherwise). We need enough strength to hold our organs in against gravity, but that’s it. I often tell people with pain, NOT to walk around with their pelvic floor clenched all day. That’s simply not how those muscles work. If you do use weights to get you started, keep in mind you may also need to teach those muscles how to function on their own without the device.
Even if you have a quality contraction, you get little or no information given about FUNCTION. Functional use of the pelvic floor means when to do the contraction, how often, how much to contract, and WHY. These are critical. Having a strong pelvic floor is like having money in the bank. It’s an excellent idea, but it isn’t really useful until you SPEND it.
A strong contraction of the pelvic floor is not going to help you if it is not coordinated at the right time, in the right amount, with or without other muscles, (and can relax appropriately too). It doesn’t matter if you are strong or not, if the contraction is not timed/used appropriately, it’s like it never happened. Because it didn’t.
Cost vs Benefit
Cost varies from under $20 to over $200. My 2 cents:
Ideally, go see a pelvic floor therapist and then use the device as a supplemental tool to continue your progress at home.
Purchase the tool that you and your therapist decide is the best fit your your needs and use it as part of a program you have designed together.
You certainly can try a product on your own, but understand that you are taking the chance that it is either just what you need, or a waste of money. I’m not meaning this to sound negative, really, it may be exactly what you need, especially If money is tight. $20 may be literally all you can afford, so I say go for it and see how it goes. Just make sure you are aware of everything stated here and follow the product’s packaging, and stop using with any signs of things not going well. Definitely stop if there is pain.
Here’s where the “benefit” or “value” part comes in. This applies whether you have a lot or a little financial flexibility. Add up what it would cost to buy a product or see a trained Physical Therapist. Even those of us who are self-pay providers, it still is likely worth the benefit and value. If you like a cheaper product and it solved your problem, that is fantastic! But what if it didn’t?
How would you feel if you spent $200 on a Kegel trainer only to find out it didn’t help, or even made you worse? That same amount (or less) could have been used for a visit with a specialist who answered all of your questions, plus information on function, hormones, diet, behavior, posture, breath, abdominal wall support, and many additional factors that go into pelvic floor dysfunction.
Could I get Results another way?
This question is basically covered above. The answer is yes. There are many ways to see good, quality results by learning about your body and applying the most appropriate tool for you. I hope this information is helpful in deciding exactly what that tool is for you.
Who is selling it?
You learn a lot from a product by looking at who is offering it and what they have to gain. Is the seller an evidence-based health care provider who specializes in this area? Or are they someone well-known (or even famous), where people will listen to them regardless of whether or not their product is good? The seller should have the education and evidence to back what they are selling.
There are products that my fellow PTs or other pelvic health providers have put on the market. These are done with good intentions to give people options, access, and additional tools. We strive to encourage education, treatment tools, and overall wellness. This is one way us providers are trying to put pelvic health tools and education in as many hands as possible. To reveal whether someone is legitimately selling a helpful product of not, ask yourself the question: Is this person selling this to help me or to make money? if money seems to be high or top priority, beware. Look at what kind of doctor is referenced when they say “doctor recommended”, and what does “recommended” mean. There is a big difference between a Doctor of Physical Therapy selling a pelvic health product and someone who may not even be a health care provider.
Some quality products can be found on www.vaginismus.com, current medical technologies, and Intimate Rose. I use these in my practice as a resource for patients if they need additional tools for their plan of care because I believe they will help, not because I am reimbursed for the recommendation (which I’m not).
Bottom Line: Do I recommend them or not?
I highly recommend you learn what your body is doing and why. That way, you either save yourself the time, money and hassle of these products altogether, or if you choose to use them, you will know you are getting the most benefit (without harm). Choosing one type over another depends on your individual goals and preferences.
Do I dislike these devices? No
Do I recommend them? Sometimes. If I think they could help, I will recommend buying from a trusted professional. I recommend brands developed by fellow pelvic PTs. You can trust the quality because you will see that they will also emphasizes quality and function, reiterating what is stated here. I just make sure my patients know the benefits and limitations regardless of what the ultimately decide.
An educated choice is always the best choice.
For help in finding your own pelvic Physical Therapist, contact us, or visit www.pelvicrehab.com for a list of providers in your area.