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Types of Pelvic Floor Exercisers

We are often asked "What style of pelvic toner or pelvic floor exerciser would suit me best?"

The answer usually depends on your existing symptoms and pelvic floor strength, what level of pelvic floor fitness you are aiming to achieve, and on lifestyle factors too.
This summary of the four main types of pelvic exercisers, and how they work, is designed to help you choose what's right for you.
However everyone's needs are different. If you are still unsure after reading this guide, we suggest that you read our 5 Step Guide to making a decision and talk to your health practitioner to discuss your specific needs.

There are four principle types of pelvic floor exercisers, or pelvic toners:

  1. Weights
  2. Feedback Devices
  3. Electrical Stimulation Devices
  4. Spring Exercisers.

1. WEIGHTS EXERCISERS : There are three main types of weights exercisers:

  • Vaginal Cones (also know as vaginal weights), 

  • Vaginal Balls and 

  • Vaginal Barbells.  

Weight exercisers all work on the principle that by challenging the pelvic floor muscles with weight, muscle strength is gained, just the same as using weights for other parts of the body. Some vaginal weights have built-in progression, where extra weight is added to create greater challenge. Others use a fixed weight, but suggest you can increase the muscle challenge by adjusting your body position or your exercise technique.

  • VAGINAL CONES consist of a series of cones of increasing weight, and provide sufficient challenge to cure or improve stress urinary incontinence for most women.

They are often the most popular choice for women who are experiencing mild stress incontinence and are recommended as a first-line therapy for the treatment of stress incontinence.

Vaginal cones are also often the choice of women who are not sure whether they are able to contract their pelvic floor correctly.

Cones work to strengthen the pelvic floor via an automatic contraction of the muscles in order to retain the cone in the vagina. The presence of the cone naturally causes a contraction of the pelvic muscles to hold the cone in place.

Cones should be used standing up, as they rely on gravity to work.
Weighted cones for pelvic exercises are used for 15-20 mins a day while undertaking normal day-to-day activities (at least once you've started to get used to them).
They are used progressively over a period of weeks, starting with the lightest cone and building to the heaviest.

However physiotherapists recommend that you actually do your pelvic floor lift and relax with the cones in the vagina.
We DO NOT recommend that you keep them in for long periods of time as this can fatigue the pelvic floor muscles.

Click HERE for expert physiotherapy guidance on how to use your weighted vaginal cones correctly

 The maximum weight in most cone sets is 50-55gm, so there is a limit on the "challenge" that cones present to the pelvic floor muscles. Women who are seeking a high level of pelvic floor fitness, beyond the level required to overcome their stress incontinence, may find that they need to use add-on weights or an additional exerciser to achieve their goals.

Cones or weights are not suitable for women who have a prolapse as the prolapse can preclude the correct positioning of the cone.

Some women with a wider vaginal vault may find that the cones do not sit correctly in the vagina and may therefore find the wider vaginal balls suit them better.
You can easily test whether this applies to you.

Our vaginal cones are the most popular and best quality available  AQUAFLEX vaginal cones  Check for research on vaginal cones  HERE

 

  • VAGINAL BALLS  are usually wider in diamter than cones and therefore are much easier for some women to hold in place within the vagina. Most are not progressive like cones apart from Luna Beads™

Research has shown that they are effective .

Vaginal Balls are flexible enough to be used in a variety of ways:
- they can be used in a similar way to cones, to challenge the pelvic floor muscles simply by their presence.
- they provide resistance for your pelvic floor muscles,making them more effective than contracting an empty vagina
- they can give feedback to your pelvic floor muscles - you have to contract to hold them in - and some vibrate as the inner ball moves when you do and this stimulating the pelvic floor muscles to contract
- they can be used as the "base" to add extra weight using the same principles as a weight lifter, for an active pelvic floor 'weight lifting' exercise program by using add-on external weights like our exclusive Pelviweights

Luna Beads™ although designed as vaginal balls, offer weight progression just like vaginal cones.
Vaginal balls are also available in single and duo designs. You can progress from the single to the double.

Vaginal balls used alone can be a useful choice for women with mild to moderate stress incontinence.
When used as a resistance device if you want to progress your pelvic exercise programme, they can assist in developing stronger muscles, and when used with external added weights, such as PelviWeights, they offer virtually unlimited opportunities for building pelvic floor strength in those without pelvic floor dysfunction.

  • VAGINAL BARBELLS  are available in a range of designs, weights and materials. The shapes usually provide increasing challenge to the pelvic floor muscles, using the principle that it becomes harder to hold a heavy object in the vagina as the object becomes smaller (narrower). Therefore most barbells are shaped so that one end is narrower than the other, and progression is possible by:
     

- lifting and holding the larger (and therefore easier) end of the barbell in the vagina and progressing to lifting and holding the narrower (more difficult) end adjusting your position to increase the pull of gravity

- increasing the amount of time that the lift and hold can be maintained.

- the goal is 10 x 10 second holds to build bulkier stronger pelvic muscles.

By exercising in front of a mirror, it's possible to get visual feedback when using a barbell, as the pelvic floor muscles "lift" it.
Pelvibar is the barbell we sell and is made exclusively by us. It is 345g, representing a very serious challenge to pelvic floor muscles.
Generally this level of weight is more than would be necessary to overcome incontinence and other pelvic floor muscle disorders.

We DO NOT recommend it for anyone with a pelvic floor dysfunction, impaired muscles or prolapse.

It is more likely to appeal to women who want to improve their sexual response and ability to reach orgasm.

 

2. FEEDBACK EXERCISERS : There are four types :

  • Pressure Biofeedback (also called perineometers)

  • EMG biofeedback.

  • Visual feedback 
     
  • Force plate feedback - the latest technology utilising smartphoine technology

 

Feedback exercisers have a vaginal (or anal) sensor attached to a device that incorporates a read-out gauge.
When you contract your pelvic floor, with the sensor in place, the strength, speed and duration of the contraction is demonstrated on the gauge either as a pressure measurement in cmH2O , an electrical measurement in mA or a readout on an app on your smartphone. The simplest form gives visual feedback via an indicator stick attached to the device

Most feedback exercisers are more suitable for women who can already achieve a pelvic floor contraction (even if it's an extremely weak or very short one) and who want to build up muscle strength and tone. The PFX2 and EMG biofeedback in particular are so sensitive that even a minimal weak contraction "registers" so they are generally an excellent choice for beginners.

The PFX ( vaginal ) and PFXA ( anal) pressure biofeedback devices show the pressure your pelvic floor muscles are generating via a hand guage attached to the internal sensor.
As it is possible to register a reading on the gauge of an air pressure perineometer through abdominal pressure, rather than through a pelvic floor contraction, exercise technique is important, and users must ensure they adhere to instructions, especially when they first begin exercising.
Every customer buying a perineometer from Pelvic Floor Exercise is provided with our expert physiotherapy instructions on using your PFX/PFXA
Even those who can achieve a strong contraction are often surprised when the perineometer demonstrates how much time it takes to achieve the full contraction and even more surprised at how quickly the power of the contraction begins to fade, and how hard it is to hold.
Generally, a perineometer enables the user to achieve stronger muscles than is achieved using the lighter weight devices.

Perineometers require dedicated exercise time, usually in the region of 15-20 mins a day at least a few times a week.

We sell both the Simplex and the Peritone , both have similar features. A vaginal, anal or external electrode is used to detect electrical activity in the pelvic floor muscles. Visual or auditory feedback on the handpiece encourages contraction and relaxation of the pelvic muslces

Our simplest feedback device, the Pelvic Floor Educator,  gives visual feedback on correct technique via an indicator stick attached to the tampon-like device inserted into the vagina. If you contract correctly the stick moves away from your pubic bone, and back to the pubic bone on relaxation. This also indicates how long you are holding for. It is also ideal for retraining the reflex quick pre-tightening of the pelvic floor prior to coughing and sneezing - the most likely time for leaks when you have stress incontinence.

These new generation force plate feedback devices send information from the vaginal sensor via bluetooth, to your smartphone showing progress. The perfect solution for todays tech savvy women.
Pericoach is highly recommended by pelvic floor physiotherapists and has a practitioner portal which you can use to give permission to your pelvic floor physio to monitor your progress and advise you accordingly.

 

3. ELECTRICAL STIMULATORS : also called ES, EMS or NMES TENS or e-stim devices

These work by sending a small electrical impulse via an electrode that is placed in contact with the area of the body that's being treated. The electrical impulses cause the muscles to contract, and by repeating the impulse over the course of a preset program, the muscles are artificially stimulated to contract , building up bulk and strength until you are able to voluntarily contract them yourself.
Repetition over time through repeated contractions builds muscle strength.
Electrical stimulators are generally used to stimulate muscles or nerves that are not able to respond optimally without help. They are often recommended for use by those who are unable to contract their pelvic floor muscles at all, or who are only able to achieve a weak contraction.
Electrical stimulation is also considered very useful for helping women who can't "feel" their pelvic floor muscles to get in touch with them again, so that they are eventually able to do pelvic floor contractions without assistance.
E-stim devices can be used on their own as a starting point for strengthening the pelvic floor, or in conjunction with weights or feedback devices as part of an exercise program.

All our electrical devices have programs pre-set to frequencies and rest/work times that are known to help to overcome stress and urge incontinence as well as customizable programes that allow you , or your physiotherapist, to set the parameters.  Pericalm  Pelvitone and Continence incorporate additional pre-set programs for Frequency/Urge, Pelvic Pain and an all around pelvic floor workout.

Electrical stimulators are used with vaginal (or anal) electrodes, attached by wires to the stimulation device. The electrodes are used internally in the vagina (or anus) and the user has complete control over the intensity of  the stimulation. Manufacturers usually recommend ES devices are used for 15-30 mins per session.Placement of the electrode is important (to ensure it is in contact with the correct muscle area), so they are used lying down.

Although the concept of electrical stimulation can be daunting,all of our machines are very user-friendly  and come with expert physiotherapy guidelines on use as well as the manufacturers instructions


The material presented here is intended as an information source only. The information is provided solely on the basis that readers will be responsible for making their own assessment of the matters presented herein and are advised to verify all relevant representations, statements and information. The information should not be considered complete and should not be used in place of the advice of a health care provider. Pelvic Floor Exercise does not accept liability to any person for the information or advice provided , or for loss or damages incurred as a result of reliance upon the material contained herein.

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