Types of Pelvic Floor Exercisers
We are often asked "What is the best pelvic floor exerciser for me?"
The answer usually depends on
- your existing symptoms and pelvic floor strength
- what level of pelvic floor fitness you are aiming to achieve
- lifestyle factors
This summary of the three main types of pelvic floor 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 professional to discuss your specific needs.
There are 3 main types of pelvic floor exercisers, or pelvic toners:
1. Vaginal weights and cones
There are three types of vaginal weights:
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Vaginal Cones
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Vaginal Balls
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Vaginal Barbells.
Weights 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 muscles of the body.
Some vaginal weights have built-in progression, where extra weight can be gradually added to create greater challenge over time.
Others use a fixed weight.
You can also increase the muscle challenge by adjusting your body position and adding functional activities into your program like hanging the washing out or making the bed whilst you have the weight inserted. I have even had patients do a pilates class with on enserted to give them feedback as tp when they should be contracting their pelvoic floor to control abdominal pressure.
Another theory is that they provide feedback to you (because they will slide out if you don't contract correctly) to help you do a correct pelvic floor contraction/exercise.
The advantage they have over other types of biofeedback such as perineometers and EMG is that they only work the pelvic floor muscles, where the others can pick up information from any other muscles in the area and pressure within the pelvis - which may not be generated by the pelvic floor muscles themselves.
VAGINAL CONES consist of a series of cones of increasing weight.
They are often the most popular choice for women who are experiencing mild stress incontinence.
Vaginal cones are also a good choice for those who are not sure whether they are able to contract their pelvic floor correctly.
Cones work to strengthen the pelvic floor as having the cone in the vagina naturally causes a contraction of the pelvic floor muscles to hold it in. You may read on some websites that this means you passively do your exercises with no effort. Well nothing in life is free unfortunately and you do have to work with a cone in place and paying attention to what is happening enhances the learning experience until your pelvic floor does re-learn how to work more effectively.
Cones should be used standing up, as they rely on gravity to work.
The goal for using weighted cones for pelvic floor exercises is that they are used for 15-20 mins a day and it can be helpful to do normal daily activities whilst wearing them. For example take a shower, make the bed, empty the dishwasher.
This is time saving but also helps you to learn to use your pelvic floor functionally, in other words - when it is needed.
They are used progressively over a period of weeks, starting with the lightest cone and building to the heaviest.
When starting out, you may only be able to stand still with the cone in for a few minutes.
Over time, the aim is to progress to longer, then moving around.
Once this is achieved, you can move up to the next weight.
The maximum weight in most cone sets is 50-55gm.
Here at Pelvic Floor Exercise we exclusively manufacture heavier weights for the cones up to 95g.
These can be helpful for those working towards higher levels of activity like weight lifting.
Physiotherapists also 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.
Find our physiotherapist's guide on how to use your weighted vaginal cones or how to use vaginal balls correctly.
Cones or weights may not be suitable for women who have a prolapse as the prolapse can prevent the correct positioning of the cone. They are also not suitable if you have pelvic pain.
Some women with a greater vaginal width may find that the cones do not sit correctly or may not be able to hold them in the vagina and find the wider vaginal balls suit them better.
This is likely to be the case if you find tampons tend to slide out or sideways when you insert them.
You can easily test whether this applies to you.
Our vaginal cones are the most popular and are the best quality available. We stock Aquaflex vaginal cones and Intimate Rose cones , both are excellent choices for progressive exercise.
VAGINAL BALLS are usually wider in diameter than cones and therefore are much easier to hold in place within the vagina. Most are not progressive like cones apart from Luna Beads™ and Nova Balls
Luna Beads™although designed as vaginal balls, offer weight progression just like vaginal cones.
Nova Balls are different in size and weight, allowing you to progress from larger lighter, to smaller heavier weights to challenge your pelvic floor.
Vaginal balls are also available as single and duo/double. You can progress from the single to the double.
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 stimulates 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
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
- 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 just like you do with a kegel or pelvic floor exercise program.
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 and is popular with those who do activities that challenge their pelvic floor significantly like weight lifting.
We DO NOT recommend it for anyone with a pelvic floor dysfunction, impaired muscles or prolapse.
2. FEEDBACK EXERCISERS
There are four types :
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Pressure Biofeedback (also called perineometers)
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EMG biofeedback.
- Visual feedback
- Force plate feedback - the latest technology utilising smartphone 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 if you can already do a pelvic floor contraction (even if it's an extremely weak or very short one) and you want to build up muscle strength and tone.
EMG biofeedback in particular are so sensitive that even a minimal weak contraction "registers" so they are generally an excellent choice for beginners.
PERINEOMETER
*currently commercial perineometers are no longer available. Higher tech versions such as Elvie and Perifit are more commonly available.
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.
Even if you can achieve a strong contraction it can be surprising when the perineometer demonstrates how much time it takes to achieve the full contraction and even more surprising at how quickly the power of the contraction begins to fade, and how hard it is to hold.
These devices are an excellent way of 'seeing' how well you are doing your pelvic floor or kegel exercises and encourage you to work hard.
Perineometers require dedicated exercise time, usually in the region of 15-20 mins per session at least a few times a week.
EMG BIOFEEDBACK
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 floor muslces.
VISUAL FEEDBACK
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 towards 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.
BLUETOOTH FEEDBACK
Elvie and Perifit are the two Bluetooth pelvic floor exercise devices we sell. They are based on the latest technology with low emission Bluetooth sending information from the vaginal sensor to an App on your phone. The devices set a program at your individual level and progresses you from there.
The perfect solution for todays tech savvy woman.
3. ELECTRICAL STIMULATORS
Also called ES, EMS or NMES TENS or e-stim devices
- These work by sending a small electrical impulse to the muscles via an electrode that is placed in the vagina or the rectum.
- The electrical impulses cause the pelvic floor 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 over time until you are able to voluntarily contract them by yourself.
- Repetition over time through repeated contractions builds muscle strength.
- Often recommended for use if you are unable to contract your pelvic floor muscles at all, or only able to achieve a weak contraction.
- Electrical stimulation is also very useful if you can't "feel" your pelvic floor muscles to get in touch with them again.
All of our pelvic floor electrical stimulation devices have programs pre-set to frequencies and rest/work times that are known to help pelvic floor conditions as well as customizable programes that allow you, or your health professional, to set the parameters which make the program work for you.
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 you have complete control over the intensity of the stimulation. Placement of the electrode is important to ensure it is in contact with the correct muscles.
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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