Often, when seeing a pelvic floor physiotherapist, doing “kegels” is part of the program.
The name “kegel” comes from a gynecologist Dr. Kegel, who had the idea to squeeze the muscles of the pelvic floor to help with incontinence and prolapses. Going forward, this blog will refer to kegels as “pelvic floor exercises”. The pelvic floor is a set of muscles that function to support the organs of the pelvis (bladder, uterus, rectum), resist increased intra-abdominal pressure with activities such as coughing or lifting, and keep you continent (1).
Training these muscles can be extremely challenging for a few reasons: First, these muscles do not actively move a joint like many other muscles we train. For instance, when you perform a bicep curl, you are bending your elbow, so you have both visual and proprioceptive feedback from the joint that movement is occurring, and therefore you know you are flexing the muscle. Second, as the pelvic floor is a set of muscles that most women do not exercise until they are having issues associated with it, we do not have a good sensation or understanding of what muscles we are exercising/squeezing.
A large portion of my clients, during their initial assessment, tell me they know how to do pelvic floor exercises correctly, and when I assess them, they are activating all the wrong muscles (most often gluteal muscles or abdominal muscles).
The challenge with doing a pelvic floor exercise correctly, as previously mentioned, is you cannot see/feel if you are doing the exercise correctly. As a result, most women, even if they have seen a pelvic floor physiotherapist, are guessing as to what muscles they are contracting and relaxing.
Enter biofeedback: a method of learning to control one’s body functions by monitoring, the degree of muscle tension (2).
This muscle tension is monitored with a computer system and is used to train someone to acquire control of that muscle. With the pelvic floor, biofeedback is used by placing a probe vaginally that reads your muscle activity and provides visual feedback as to the degree of contraction and relaxation. Biofeedback helps you quickly and efficiently learn with the guidance of your physiotherapist, how to appropriately contract and relax the correct muscles in order to maximize the function of or decrease pain within the pelvic floor.
At REP Physio in Edmonton, we use biofeedback with our pelvic floor patients with great results.If you are interested or have any specific questions, do not hesitate to contact our pelvic health physiotherapist carolyn@repphysio.ca
1. https://teachmeanatomy.info/pelvis/muscles/pelvic-floor/
2. https://www.dictionary.com/browse/biofeedback
3. https://www.remingtonmedical.com/product/neurotrac-myoplus-2-pro/
(1: NeuroTrac™® MYOPlus 2 Pro EMG/NMES/ETS)
(2: Pelvic Comfort Sensor)
