By: Anna Woolley, Pelvic Health Specialist and Physiotherapist at Core LDN
First published: 1st May 2024
Featured in: Good housekeeping, ‘The best pelvic floor trainers’
What is the pelvic floor and where is it in the body?
The pelvic floor is a set of muscles that sit in the bottom of our pelvis – the ‘floor’ of our
pelvis. The pelvis is a boney structure that connects the lower body to the upper body, from your spine to your hips. The pelvic floor is a ‘hammock’ of muscles that connect from the pubic symphysis/ pubic bone to the coccyx/ tail bone and ischial tuberosities (seat bones).
What are the functions of the pelvic floor? What does it do and why is it important?
The pelvic floor muscles have many roles including supporting our pelvic organs, keeping us continent of urine and faeces, supporting our spine and pelvis as part of our ‘core’ muscles; sexual pleasure; pumping blood around the organs of the pelvis.
These muscles provide constant support as we go about our day to day tasks, as well as
adapting to sudden stresses such as coughing or sneezing.
The pelvic floor is important because if it is not functioning properly we become at risk of
things such as incontinence or leaks of urine, faeces or wind; constipation; an increased
urge to go to the toilet; pain around your pelvis and lower back; pain during intercourse;
pelvic organ prolapse.
Should all women be training their pelvic floor, regardless of age, whether they have had a baby etc.?
Training of your pelvic floor should be a life long commitment, from puberty to pregnancy,
postnatally, menopause and beyond. Pelvic floor training starts very early in life, during potty training.
Your pelvic floor function is affected by changing hormones throughout your life so it’s
important to be working this set of muscles just as you would the other muscles of your body.
Even more important as their role is so essential for our quality of life. Training isnt just about strength. It also should involve working on the flexibility, coordination
and endurance of these muscles.
What can you do to support your pelvic floor?
Your pelvic floor muscles can be worked on their own – known as Kegals. Or they can be
worked along side other muscles – they are an integral part of your ‘core’ which also
includes your lower abdominal muscles; some back muscles; your diaphragm. They also
work closely with your inner thigh muscles and your gluteal muscles. This means that full body training with a focus on your pelvic floor muscles is also really helpful to benefiting the overall function of your pelvic floor.
At Core Ldn we run a Core and Pelvic floor Pilates class which teaches how to incorporate your pelvic floor effectively into your normal pilates exercises.
It's important to vary the position that you are in when you do pelvic floor contractions. The easiest position is in lying or side lying. Progressing to sitting, hands and knees, kneeling. Harder still in standing and then while moving or doing impact exercises.
Props can also be really helpful in facilitating pelvic floor engagement – In Pilates we use
things like soft pilates balls, loop bands and weights to help to either fasciliate or challenge the pelvic floor contraction.
An example of this would be lying on the floor with a ball between your knees and carrying out a pelvic floor contraction while squeezing the ball – you will find that this helps to engage the muscles and is often a good exercise to start with.
Toileting position is also really important when it comes to pelvic floor function. Constipation can have a negative effect on how well you can contract your pelvic floor. Straining can also have a very negative effect. So positioning is really helpful – the best poition is to have your feet up on a step or upturned toilet rolls, leaning forward so your elbows are on your knees, straightening your back and relaxing your tummy.
What are the benefits of pelvic floor trainers? As much detail as possible
Pelvic floor trainers are a very useful tool to facilitate and enhance how you carry out a
kegal/ pelvic floor contraction. There are many different types of pelvic floor trainer on the
market, varying in price, and there are different types based on your requirements. Ie how
strong your muscles are.
I would always recommend seeing a pelvic health physiotherapist before using a pelvic floor trainer so they can advise you on your strength, tension, coordination, endurance of your pelvic floor and they can then advise the best trainer for you and give you a specific
programme – the problems that you may be experiencing are not always because of
weakness.
Are there any drawbacks/ anything to be aware of with pelvic floor trainers?
If you are finding that you are not getting any benefits from the trainer it may be for a number of reasons.
You may have a lot of tension in your pelvic floor muscles or be unable to properly relax the
muscles – this means that you will feel like you are unable to do a proper contraction and
also the muscles will fatigue more quickly. Using a pelvic trainer therefore may increase this tension and make things worse. However, a lot of the more up market trainers can detect if you are not doing an effective contraction and advise you to seek advice from a pelvic health physiotherapist.
It may also be that you are not at this point strong enough for a particular trainer – you may need to start off with a electrical stimulation trainer first.
These tools and trainers are useful and can have great results but do not provide specific
tailored programmes for your individual needs after a detailed assessment. I would always
seek the advice from a pelvic health physio first before using anything, especially if you are investing money in something – you want to make sure its right first.
How often should you use a pelvic floor trainer? Do you have any tips for using them?
I usually recommend using them 3-5 times per week if you are trying to build strength.
However, this is not always right for everyone. It really depends on what is right for you. It
may be that you need to build up slowly. It is also not the only thing you should be doing to
strengthen your pelvic floor. If you are getting symptoms of incontinence or prolapse it is
recommended that you carry out 10 short and 10 long contractions 2-3 times per day, but
you wouldn’t be using the trainer for this. The trainers act more as motivational tools where you follow specific programmes. Saying this they can be a very effective adjunct to a tailored programme.
Tip: I would make sure you are using the right one for you. Always be in a comfortable
environment where you aren’t going to be disturbed (not always easy if you have children
running around).
Could you explain a little bit about the types of pelvic trainers there are to choose from?
There are 2 main types:
Electrical stimulation – this is where you insert a probe that is connected to a hand held
device (a bit like a tens machine if you have ever used one). The device sends a gentle
electrical impulse into the muscles which initiates a contraction. You then use this initiation and consciously engage your pelvic floor muscles with it. These are generally advised for people with lower strength from a flicker to a very gentle squeeze. Once you are a bit stronger you should progress on to the other type of trainers.
Biofeedback – this is where you insert a probe that is connected to a handheld device or
your phone by a wire or Bluetooth. These devices do not provide an impulse or stimulate
the muscles. They detect and provide visual feedback, with a programme for you to follow
which will help improve strength, endurance, co ordination. They help you connect more with the muscles and motivate you to carry out the different types of pelvic floor contraction.
There are also other gadgets on the market – cones, weights, toners. These are again for
when you are a little bit stronger and have a good brain – nerve – pelvic floor connection.
These aim to give some resistance or ‘load’. I rarely recommend things such as eggs or
cones as these are weights that you hold in and do not allow the essential relaxation of the muscles to enablea full and complete contraction. Pelvic toners are more useful as these allow you to relax and then squeeze against spring resisted paddles.
Anything else to consider?
Devices and gadets are a tool to help you but are not always advised for everyone. I would
always recommend going to see an experience pelvic health physiotherapist and get a
proper assessment and a programme tailored to your specific needs.
At Core Ldn we have a team of highly experienced and specialist pelvic health physiotherapist who can take you through from the initial assessment to end stage rehab of your pelvic floor whatever your age or symptoms.
About Core LDN
Aimed at revolutionising the fitness and rehabilitation landscape, Core LDN firmly believe
that a one size fits all approach simply doesn't apply to wellness. At the heart of Core LDN's philosophy is a team of expert physiotherapists dedicated to treating and rehabilitating all injuries. Through a fusion of exercise rehabilitation in specialised CORE classes, clients can experience the benefits of Physiotherapy-led Pilates. Whether in recovery mode, navigating pre/postnatal stages, or striving towards specific fitness objectives, individuals can harness the power of personalised Pilates sessions.
To find out more about Core LDN, book a physiotherapy initial appointment or Core LDN Pilates intro visit www.coreldn.com
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