pelvic health resources for men

Pelvic Health Resources for Men

Happy Father’s Day!  This post is a new collection of my favorite Pelvic Health Resources for men.

Men’s health and wellbeing is important. Please do share this blogpost, not just with the fathers – uncles, brothers, nephews & friends will appreciate you thinking of them too.

Pelvic Health Resources for Men

# Pelvic Floor Exercises

Research shows that problems like: 

  • urinary frequency
  • post-void dribble
  • urgency (strong desire at the wrong time!)
  • flatulance or bowel leaks
  • getting up at night to wee
  • small bladder leaks
  • or erectile dysfunction

all respond really well to improving pelvic floor muscle strength, endurance and control.  

Download and/or print this FREE booklet from my professional organisation.  Clear pictures and instructions on the best technique.

There is also a dedicated section about Men’s Health and audio guided pelvic floor exercise sequence.

Squeezy for Men is an education and reminder App (IOS or Android £2.99)

Squeezy has been designed by chartered physiotherapists specialising in Men’s Health working in the NHS. It is suitable for all men who want to do pelvic floor muscle exercises (also known as Kegel exercises). It is simple to use, discreet & informative. The visual and audio prompts help improve your technique & timing. And it records your practice sessions.

# Bladder & Bowel Health

Sometimes it’s just “operator” error or innocence.  Who teaches us what a bladder does or doesn’t like, or how to sit on a toilet to get the best bowel opening?  Never too late to learn!

a glass how much should you drink in a day

Do you know how much you should drink in a day (like really know, not just guess)??  Have you ever actually counted your fluid in and out??  A bit of tweaking to avoid droughts & floods, and avoid irritating the bladder lining can be life-changing.  Read more here.

baby sitting on potty 3 Ps of a perfect poo

Keeping the bowel moving well keeps pressure off your pelvic organs, lifts your mood and helps concentration.

There are 3 Ps which you should keep in mind during your ablutions. Are you or family doing any naturally?? How do you sit? Do some people in your family take a LONG time in the toilet? Who reads the paper? Should you keep books in the loo? 

Watch my lighthearted talk about good bowel habits (for a public speaking competition).  Reveals the simple secrets of how to have The Best Morning Action.

# The importance of stretching & healthy postures

You’ve heard of “tight” hamstrings or calves?  Pelvic floor muscles and other muscles that attach to the pelvis (inner thighs, gluts, lats) can also get too tight, restricting your pelvic movement and causing irritation to nerves.  Sciatic nerve irritation gives classic leg pain, pudendal nerve irritation can cause testicular or perineal pain.

Men’s Health physiotherapist Bill Taylor shows how to use a spiky ball to release the inner thighs.  Other good pelvic floor awareness & release videos on his YouTube channel.
Tony Riddle promotes Offsetting – how to work from the floor, or anywhere other than a traditional seat.  Recommend his YouTube snippets & the trailer of his Vimeo course  https://vimeo.com/ondemand/chairsittingoffsetting/407898301

# Core Exercise is Not Just for Girls

Both Yoga and Pilates were originated by and for men.  Joseph Pilates first taught his exercises to German compatriots interned on the Isle of Wight during WW2.    Pants and pony tails are optional. 

Plenty of men attend Pilates classes to get the benefit of a weekly supervised stretch, strengthen and mindful movement session. Do email if you’d like to try a real class (in Cambridge area) or virtual class (Saturday mornings) or subscribe to our online PhysioPilates Library.

Not sure if it would suit you? Have a go at home first. Find lots of short sequences for everyone on our PhysioPilates Academy YouTube Channel: https://www.youtube.com/channel/UC07NzCSJa6n806A530-iQZA

If you have any worries that your pelvic floor is not quite what it should be, niggly injuries that won’t resolve or would like a general “MOT” of your situation, get your technique checked before you do too much more DIY.


# Specialist Physiotherapy Assessement

There is so much a specialist pelvic floor physiotherapist can teach you to improve internal muscle strength, endurance & co-ordination. They will also check your posture, core control & consider how previous injuries, surgeries or events may impact on your pelvic health.

 Through post-graduate training, we have the skills to properly assess and examine the pelvic floor muscles with an external or rectal examination.  We do this in a discreet and gentle way, putting you as much at ease as we can.

We aim to help you understand how your body works.  With a better understanding of your muscles’ strength, weakness or tension problems, your exercises will make sense & be motivating. We can show you how to help them to grow stronger or release & stretch.

Do you need MORE SUPPORT?

Ask your GP to refer you to the local NHS services (if you are Cambridge-based you can self-refer). Or do come to see me at my practice South Cambridge Physiotherapy or arrange a virtual appointment.  

Not near Cambridge? I believe finding a local physio is best for your longer term support. My professional body POGP and Squeezy app have national directories of physios who specialise in Men’s Health.

I hope you found this collection of pelvic health resources for men helpful. Please don’t hesitate to get in touch if you have a personal question.

water lily to illustrate bladder support devices

Bladder support pessaries: how do they work?

Bladder support pessaries: extra support from the inside

updated 2021 (original 2019)

Strengthening your pelvic floor is still first prize for bladder leakage problems.  But what if you cannot create enough strength and support for the bladder with your pelvic floor muscles alone? You may benefit from one of the modern bladder support pessaries that give some reinforcement to the bladder neck and bladder tube.

These are devices that you can buy on the internet and then insert and remove yourself. They are designed to be worn all day but not all the time. These can be a surprisingly inexpensive & eco-friendly option, compared to disposable pads. Ideal if you know when you will leak and need to use the device only for intermittent pre-planned activities.

Available in the UK at the moment are , Contam, Contiform, Efemia and Uresta.  They vary in price chiefly relative to how many times they can be re-used.  Contiform and Efemia are available on prescription.

Would they suit you ?

Have you done your pelvic floor exercises, improved your core, modified high impact and improved your fluid management? Still not quite resolved your bladder leakage? Then one of the bladder support pessaries may offer an alternative to surgery (NICE Guideline NG123 2019). They have a similar mechanism of action  (mechanical support of the urethra) to the TVT and colposuspension surgical procedures but no side effects or surgical risk.

In my clinical experience, these support pessaries work particularly well in certain situations.  For example when the bladder has dropped only a little bit and the uterus is still well supported. Or, if exercises have created a good layer of muscles but you still need more bladder support to be active.

How do internal bladder support pessaries reduce urinary leakage?

These devices work by providing more support for the bladder neck.  When you move fast (eg jogging, playing tennis) or there is an increase in abdominal pressure (coughing, sneezing, jumping), the pelvic floor muscle is supposed to support the bladder neck so that there is no leakage.  However, if the muscles are weakened and/or untoned that support can be lost. 

hose lying on grass and path
Would it be easier to stop the water by standing on the hose on the grass or on the path?

Are a visual person?   Imagine a running hose pipe, lying on  soft grass.  When you lay your foot on the pipe you may slow the flow of water. But you may not be able to stop it completely.  However, if you lay your hosepipe on a firmer surface, like a garden path, when you press down on the hosepipe the water flow stops. A toned pelvic floor should act like that firm path. But if yours isn’t up to scratch a pessary could do that job instead.

What type of urinary leakage will they help?

Bladder support pessaries are best for small leaks associated with movement. Or leaks when the bladder is under pressure from coughing, sneezing or laughing (stress urinary incontinence).

They create a mechanical uplift to support the bladder neck the way the pelvic floor is supposed to do. 

These would suit women who don’t generally experience day to day stress incontinence but know when they are going to leak. For example if you know you will have incontinence if you do a run, or when you go to Zumba. Or if you feel anxious about an event, like going to a wedding, or travelling. You might only use a product like this once or twice a week. With one of these in you might not need any other protection, or would feel confident with simply a liner or a pair washable knickers “just in case”.

They can’t help with urgency or irritable bladder

What these devices can’t do is change symptoms like urgency.  If your bladder is irritated by caffeine, being too full, or you have an overactive bladder, you won’t see any improvement using one of these.  Pelvic floor exercises DO help these symptoms because the pelvic floor contracting activates neurological messages which calm the bladder down.  Unfortunately these devices can’t do that. 

If urgency or frequency symptoms are your bother – then you need to practice “endurance/holding” pelvic floor exercises (see more in the Pelvic Floor School) and have also read of the article “How much should you drink in day and when should you have a wee?” for more impact on these problems.

a glass how much should you drink in a day

Can I leave it in to wee?  What about during my period?

Yes, they are all designed to be left in when you have a wee or bowel movement.  The pressure of the bladder squeezing is enough to push the urine past the supported area when you need to.

You could still use the Contiform or Efemia pessary when you had a period (as the menstrual fluid can flow through it) but you couldn’t use a tampon at the same time.  The other designs (Contam, Uresta) act as a block but are not absorbant like a tampon, so shouldn’t be used during your period.

Note: The term pessary can be confusing

Because these devices to reduce bladder leakage sit inside the vagina they are termed a “pessary” but they should not be confused with a  traditonal pessary used for supporting Pelvic Organ Prolapse (POP). For more information about pessaries for prolapse read here

Field Guide: bladder support pessaries to reduce stress urinary incontinence

Each company markets their own product and may use more than one distributor so prices can vary.  Here is my personal “quick guide” to what’s out there at the moment, apologies if it has already changed again by the time you read this!  Please do let me know if I have missed something out, or you find a new supplier or product before me! Please do comment to support other readers & share your experiences:

Contrelle Activgard

picture of Contrelle Activgard

single use only 

currently unavailable in UK  but understood to be returning soon.

Contam Pessary

picture of contam

 

single use only

£26.99 for a starter set (range of 3 sizes “normal” or “large”). From £12.95 each bought singly, or just under £10 each if bought in groups of 3 thereafter from www.stressnomore.co.uk 

* use promotion code SUPPORTEDMUMS at checkout for a 15% discount

These are quite new on the market.  There are no clinical trials listed.

Contam is a brand offering a variety of shapes and sizes of single-use vaginal pessaries. It is the tampon shaped ones that are suitable for supporting the bladder neck. The cube shaped ones are for going much further back in the vagina to support a more severe uterus prolapse. Unlike tampons they do not absorb moisture from the vagina. You soak them in water before use to make them pliable and elastic to insert and to prevent drying out of the vaginal wall.

It is suggested that you position them differently according to the problem: For incontinence: “insert the pessary deep into your vagina, then pull it back slightly so that it’s within reach of your fingers”

Note: see a size chart under “product description” on the website.

Contiform

picture of Contiform

available on NHS prescription

re-use up to 30 times

£85 starter pack of 3, £40 per unit thereafter* from contiform.co.uk

*further 20% reduction if you complete a VAT exemption form

Also available on NHS prescription from your GP [starter pack: NHS order code   SKU184 , PIP code 375-5808 ]

The principle of the Contiform is to create uplift and support for the neck of the bladder.  These are guaranteed to be re-usable up to 30 insertions. So if you felt you needed support daily rather than ad hoc this is likely a more economical option in the longer term.

The Contiform Pessary looks like a plastic hollow tampon.    The smaller circle supports the bladder tube (the urethra). The larger surface lies against the floor of the vagina, giving support to the bowel wall.  They are made of a firm but flexible non-latex plastic. Each can be reused, with the guarantee up to 30 times. There is a “slit” that develops with wear to show you when the device needs changing. Use for longer if not worn all day. There is an optional ribbon to help with removal.

You can buy Contiform online or they are available on NHS prescription.  You would need to tell  your GP about your symptoms, and ask him to prescribe a starter pack for you.  While you are there ask for a referral to specialist physiotherapy too if you haven’t already got your own pelvic floor coach(!).  Especially if using a Contiform works for you – it suggests that a stronger pelvic floor could do this job naturally for you too!

Fiona Rogers, physio, clearly explains how to use the contiform. See 2:18 to understand how the “split” works. 3:08 about removal with or without the ribbon.

Efemia Bladder Support

efemia bladder support device

available on NHS prescription

re-use for 3 months

The Starter Kit contains all three sizes (S- 30mm, M- 35mm and L- 40mm) to find your best fit. £59. Thereafter £49 for each single replacement.

www.aghealth.co.uk

The newest member of this ‘family’ of bladder support pessaries. Efemia feels more petite, lighter and softer than the Contiform & Uresta. It is made of transparent flexible medical grade silicone. It is designed to sit lower in the vagina, tucking just behind the pubic bone. Similar to the space where a TVT procedure is positioned. Positioning correctly is straight forward. You leave the handle part on the outside of the body, but this could be irritating to the labia or vulva tissues for some women (efemia recommend using water based lubricant if this occurs). The external loop makes it easy to remove. It needs just a rinse between uses. You can leave it in place during menstruation but you could not use a tampon at the same time.

The Efemia website has a good video to show you the position it takes up and how this helps to support the bladder tube (the urethra) as you cough or move.

Like Contiform and Uresta it’s effectiveness is supported by small clinical trials. It is available on NHS prescription in England. You would need to tell  your GP about your symptoms, and ask him to prescribe a starter pack for you.  While you are there ask for a referral to specialist physiotherapy too. Especially if using an Efemia Bladder Support works for you. That suggests that a stronger pelvic floor could do this job naturally for you too!

Uresta

picture of uresta

resuable for a year

£179 (ex-VAT ) + £8 P&P  for a starter kit containing 3 sizes  from iMEDicare on 01923 237795 or via uresta.uk

Uresta, designed and manufactured in Canada, joins this family of internal support devices with the unique selling point that it is fully reuseable for one year.

So if you have had good success with one of the devices above this would be a natural progression to a potentially more environmentally friendly and overall less expensive option.

A clinical trial of 32 women found that of those still using it at 2 weeks (21 women out of the original 32), 76% of them (16) were still using it at their 12 month visit.*

*    Farrell SA, Baydock S, Amir B, et al.  Effectiveness of a new self-positioning pessary for the management of urinary incontinence in women.  Am J  Obst  Gynaecol 2007:196:474e.1-474.e8

There is a helpful video from their website below. If you are worried about the high initial cost Uresta offer a full money back guarantee. There is also give good advice about how to find the right size for you.

this video is from uresta.co.uk

Beware misleading marketing

Some of the marketing blurbs list “strengthen your pelvic floor” as a benefit of using their pessary device.  This is only true in the loosest meaning. While they are in place, by artificially re-inforcing the vagina wall,  I suppose you could claim that is “strengthening” the pelvic floor action – but they are in no way making any change to the muscle.  Only exercise can change the composition and activity of the muscles or surgery the non-muscular elements.  When you take the device out the structural situation remains the same.   However, these devices definitely offer an alternative to surgery. Or a Buy Some Time option if you need to complete your family or are undecided about a bigger procedure.

Living life to the full

To conclude – I would suggest that these devices are part of your package of things you are doing/using to change the way that bladder leakage limits your lifestyle. Make it your goal to cure your leakage problem rather than simply manage it.

However, if you are not worrying about leaking, you will fee more confident to exercise. This is a Good Thing for your overall health, wellbeing and mood.   

Do contact your local specialist physiotherapist to help support you. She will guide you towards the right products, exercises and sports for your needs

Have you tried one of these internal bladder support pessaries? What did you think? Any tips for other mums?

EVB capris may help support your pelvic floor when running

EVB Sports Shorts: an active mum’s best friend?

Is running making you feel leaky, heavy or vulnerable? EVB Sports Shorts could be your new BF.

What are EVB Sports Shorts?

EVBs (as they are affectionately called) are sports kit – shorts, capris or leggings. Specially designed for women who feel vulnerable when they run or take part in higher impact activities.  Women’s health physiotherapists recommend them for those who need to find discreet ways to manage a bladder or prolapse problem. They add an extra layer of support to your body from the outside. Special panels lift and protect your bladder and pelvic organs.

Full disclosure: this post is not sponsored but I received a free pair of shorts to trial. If you find this article helpful and decide that you would like to buy a pair, please use my affiliate link – there is no extra cost to you but a small share to me, which helps to support this site.

Would you benefit?

Do you find your bladder leaks a few kms in? Or get a feeling that your entire lower half moves about too much as you pick up your pace?  Or that you beloved run is counterproductive at the moment – straining and fatiguing your core muscles? Do you finish feeling leaky, achey and with vaginal or anal heaviness, spoiling the rest of your day?

Sound familiar? These specialised sports shorts/leggings have helped mums with these symptoms.

EVB sports shorts in 4 styles

How do they work? More support everywhere that matters…

EVB Sports Shorts are made of a specialist high quality stretch material. This is designed to create more lift and support for the perineum and abdominal wall.  They aim to BE your essential support muscles while you work on recovering yours (with your pelvic floor exercises).https://supportedmums.com/pelvic-floor-school/

They are not just guess work or cosmetic.  Their inventor, Yvonne Brady, is a chartered engineer (as well as mum of 3 and regular marathon runner).  Her company have invested over a million in R & D, including projects with physios, to design-in specialised support panels. These are in the gusset, to support the pelvic floor and in the front panel to support the abdominal wall.

If your bladder leaks when you run EVB shorts give extra support to your abdominals and pelvic floor

 Ultrasound studies have shown they mimic the role of the pelvic floor muscles. They lift the bladder neck and prevent the anterior vaginal wall from moving down.  Also it may be that better positioned muscles and tissues will themselves function better. Or the better positioning will train them to do what they should be doing when you run.

Reality Check – I tried them out..

I had seen and heard physios rave about these. But I like to try things out for myself before highlighting them here.  I asked Yvonne to send me a pair to try and to show my mums in clinic.    

Sizing – do it properly – no guessing

You size yourself by measuring your waist and hip size.  NB: Not guessing!! It’s really important that you have the right size for NOW. Not who you would like to be! They need to be really tight to work well. However, if they are too tight they will they be horribly uncomfortable. And I worry that you would risk the waist band pushing down into your tummy.  There is a useful video guide to sizing on their website

Styles:

The shorts, capris and leggings are intended as outerwear (knickers on underneath) – available in black

The “Boxer Brief” is available black or nude to wear underneath other clothing.

Getting them on:

They come beautifully packaged with clear instructions.

They warn that fitting into them first time can take a few minutes due to the technology they supply.  Everything reassures you that you can pull them hard. “they will not rip”, it says, but I had to read that twice to have confidence!  It really is a wiggle process to get them over your hips and pulled right up to give gusset support. Once you get there (!) they do fit like a second skin (with benefits) and were entirely comfortable.  

Initially I wasn’t sure about the “look” for going out out. I am not normally a tight tight shorts person and a more fairweather jogger. But you will see on the website pictures & happy testimonials of proper mum runners! They are meant to be worn as your outerwear, shorts or capri style, with normal underwear underneath.  However, the bottom-conscious could easily fit another pair of leggings/looser clothes over the top.

Returns & Exchanges

Yvonne is passionate about her EVBs and wants women to feel confident to make an investment in themselves.  Customer support is quick and responsive with generous & fair exchange & returns policies.

I support women designing for women.

I firmly believe that self-care is not self-indulgence. Looking after our bodies after birth is essential. Exercise is fundamental to both physical & mental wellbeing. Fit mums enrich their own and their kids’ lives.

We live in a modern world. With amazing technological inventions to help us enjoy our sports & hobbies and care for our bodies. Mums need Good Kit too. Even happier to recommend them now I’ve tried them:  ww.evbsport.com   

trampolining to illustrate the Knack

The Knack: No 1 pelvic floor trick for mums

What is “The Knack”

Need a Quick Win with improving your bladder leakage?

The Knack is the magical art of drawing up your pelvic floor muscles just before you cough, sneeze, laugh or pick up something heavy.  Research has confirmed it works to stop urine leakage *

So simple – yet not everyone knows about it

There can be Quick Wins with pelvic floor exercises.  I still clearly remember  when I helped a client stop leaking in just one week by teaching her the Knack – and she was FURIOUS to have waited that long!  Sarah came to physio with the problem of urinary stress incontinence, leaking urine when she coughed and sneezed. It had been happening since her second son was born……….17 years before.

She had diligently practiced pelvic floor muscle exercises as everyone had told her to. When we checked them, properly, with a vaginal examination, her muscles were firm, with an excellent strong contraction.  But, no one had ever explained the connection between practising strong muscle squeezes and WHEN TO USE THE SKILL IN REAL LIFE

I taught her about the Knack.  The next time she came back she was CROSS!  It worked – no leaks when she coughed – and quite rightly she was angry that no one had taught her something so easy, so simple and so effective sooner. It was humbling. 

And my priority ever since to make sure I spread the word about this technique.  I don’t want today’s new mums to wait even 17 hours to figure this one out.

Your pelvic floor is like a trampette

You probably didn’t have to do this pre-contraction of the pelvic floor before you were pregnant, because a pre-pregnancy pelvic floor has a lot of the Knack: your healthy pelvic floor bounces pressure away like a new trampette natural tone and tension in it.  Like a trampette, straight out of the box from Argos, you can bounce up and down on it and your body weight barely makes a dent in the springy surface. 

Pre-pregnancy, most of the down pressure when you cough or jump is deflected straight back up towards your head by the pelvic floor muscles.  Your bladder barely feels a bump.

However, you don’t need me to tell you that pregnancy and delivery have a notable affect on our soft tissues. 

The abdominal wall is a clear indicator of what happens when you stretch  elastic slowly and steadily for 9 months!

 Some are more lucky than others in the natural ‘spring back’ department.  Most women know that they are going to have to work the Knack: after a pregnancy the pelvic floor is stretched like a used trampetteto restore abdominal muscle tone and strength.   The pelvic floor has carried the same baby-burden and if you had a vaginal delivery (or pushed a long time before eventually needing a caesarean) there will have also been some micro tears to the muscle fibres and their connective tissue attachments. 

Now, at least temporarily, the pelvic floor behaves like the well-used trampette – a sense that if you jump too hard your feet might touch the floor!

The Knack creates supportive tension

the knack: what your friends and your pelvic floor are forIf you tighten your pelvic floor muscles, in the exact moment before you cough, it is like two friends pulling your trampette tight for you just for that moment that you want to jump. 

Yes, I admit its not ‘natural’, it’s not ideal, it requires thinking, you didn’t have to do it before……but it can make the difference between a bladder leak or not. 

Practice makes perfect

Practice  the Knack with a ‘pretend’ cough after you have had a wee. Your bladder is empty so you are unlikely to come unstuck.

Then, challenge the system, gently.  Hold your pelvic floor muscles firmly – cough lightly.  After a few days of practice, when that is feeling safe and secure, challenge the skill by coughing a bit harder.  Then increase your confidence by allowing an hour to pass so that your bladder is fuller when you cough (but start with the lighter coughs again!). 

With practice you will train a “learned-reflex”, a habit.  Your brain gets so used to the sequence of prepare, protect, cough that you do it on auto-pilot.

Sneezes are harder (and coughing fits, choking, vomiting….)

Sneezes are harder to resist with your pelvic floor than coughs, because you have less warning that they are coming and generally they create more downward abdominal pressure. Especially if you are one of those people who make everyone in the room jump out of their skin when you sneeze or are prone to 6 in a row?   A hacking cough with a head cold, or an allergy induced coughing fit are jolly tricky too. 

Work on getting the anticipated, lighter coughs sorted first and then the rest can follow as your muscles strengthen.

Allow yourself some slack

Beware multi-tasking – I remember having a full bladder, baby in one hand, the folded Maclaren in the other, one foot on the escalator, and I sneezed – NOPE – the Knack did not work!!!  But hey, I could live with that – it seemed fair – it was a lot to ask of my pelvic floor system. 

If you can successfully use the Knack 9/10 times and only the occasional leak gets through that is excellent. 

Know when to ask for help

The Knack alone might not be enough for you.   Your pelvic floor muscles can be so weak that you need help to get them working again.  And it is possible to have muscles that have repaired too tight or are constantly overworking and becoming easily fatigued or sore.   

Remember there are specialist physiotherapists attached to every UK maternity department who can give you an individual assessment, training and support.   Don’t hesitate to ask your GP to refer you to a specialist physiotherapist  

Does the Knack work for you? Any questions?  Please do ask, I am very happy to help.

*  Clarification and confirmation of the Knack maneuver: the effect of volitional pelvic floor muscle contraction to preempt expected stress incontinence.   Miller, J.M., Sampselle, C., Ashton-Miller, J. et al. Int Urogynecol J (2008) 19: 773. doi:10.1007/s00192-007-0525-3).

Drawings copyright of A M Savage  (Proudly using stickmen since 1991)

how to improve pelvic floor control by simply breathing

How to improve pelvic floor control by simply breathing

Do you wonder what BREATHING has to do with bladder control, prolapse support or vaginal or anal pain??

Physios are not going woo-woo

It’s rather because clinical research & our understanding of the body has deepened, so pelvic floor exercises exercises are evolving. It’s no longer one size fits all.

There’s a good place for the traditional squeezes, lifts and holds, but some mums need to focus their attention more on the “let go”, relaxing and releasing of their muscles.

Pelvic floor relaxation is a thing

Previously exercises were very linear.  Squeeze ON, release/turn off.  Our focus was on what our muscles needed to be able to DO in an emergency situation – when we cough, sneeze, pick up something heavy.  This is not wrong.  If you struggle with stress incontinence (leaks when there is high pressure on the bladder) then the best thing you can learn is The Knack of getting the pelvic floor to co-ordinate with perfect timing.  

However, we now know how our muscles should be doing when we are not thinking about them.  The resting pattern of your muscles has an impact on common problems like urgency, bladder frequency, vaginal heaviness and pelvic pain. 

#1 New thing we know

Firstly, our breathing pattern and our pelvic floor muscle movement pattern are similar and interconnected.   Breathing is easier to understand, feel and control than the hidden away pelvic floor.  So if you want to better connect to your pelvic floor – start by noticing how you breathe.

#2 Weird thing to notice

However, most of the day we don’t think about our breathing AT ALL.  You wouldn’t have been thinking about yours a few minutes ago until I brought the topic up.  Your brain operates your breathing system all day, all night, 24/7 without any conscious input from you.  A gentle in and out, muscles contracting and releasing, a continuum of movement like a swinging pendulum, you are only completely full of air or completely released for a moment in time.

#3 Amazing thing we can do

Yet, you can also have incredible control over this system.  For example, you could take a deep breath right now to blow out an imaginary candle; you could whistle a little tune;  you could shout (or yodel) or pant like a dog.  With training, you could develop sophisticated breath control  as well – as a singer, long distance runner,  athlete, deep sea diver, bird impressionist. Did you know that you need enormous breath control to accurately shoot a pistol or throw a dart?

And then, when you stop panting or wolf-whistling or humming a ditty, your brain just automatically puts you back into gentle breathing mode, no questions asked.  A-MAZ-ING.

a panther demo's pelvic floor relaxation

#4  Pelvic floor muscles should be super-skilled too

We want our pelvic floor muscles to have similar super powers.  When we are NOT thinking about them we want them to gently (gently!) contract and relax, very low key, very little. Just enough to keep blood flowing through them, to nourish their feeder nerves. We want movement to keep the tissues stretchy and flexible. We want to be on standby for whatever we decide to do next. 

Then, when you decide to pick up your toddler or dash up the stairs, we need them to move up a gear or two to help carry that load from below, preventing pelvic organ descent or a sudden urge to wee. 

Similarly, if you want to push shut a heavy door, or hit a tennis serve, or do one of your room shattering sneezes, we want them to go into full tension mode to prevent leaks. And most important of all, if you want to empty your bladder or bowel, or get sexy with your partner you want them to relax and release to allow things out or in.

#5 Best thing to work on

In contrast, if your muscles are always tense they become “crampy” with painful sensations associated with a build up of lactic acid or the soreness to be touched or if stretched. Then if your muscles are always “in gear” you can’t choose to have “more” or “less” for the activity you are doing.

So take moments through the day to tune in to your breathing and from there to your pelvic floor muscles. Find time to reset your background, automatic, movement pattern to line yourself up for a day with super-powers.

Video: How to improve pelvic floor control by simply breathing 

  • Firstly, tune into your breathing pattern.  Feel your rib cage lift and raise as you breathe in, drop and shrink as you breathe out. Play with it.  Breathe deep, blow out an imaginary candle.  Do this a couple of times.  Then stop.  Can you feel your body revert to your base breathing pattern?
  • Then, notice how your BELLY breathes.  Yes it does!!  Drop your hands to abdomen.  Channel your inner frog.  Notice that your belly mimics your breath.  As you breathe in your belly lifts as you breathe out it falls.
  • Finally, lower your consciousness to your pelvic floor.  It is the lowest moving set of muscles.  Can you feel how these move to, in time with your breathing, ever so gently contracting & letting go. Or gathering & releasing, or lifting & lowering – whichever words work best for you.

Have you improved your pelvic floor skills by practicing breathing? Please let me know if this video and explanation was helpful and how you are getting on?

squeezy app settings

How to change Squeezy App settings for a beginner

Beginners Guide to change Squeezy App settings –

  • How to slow the speed down
  • shorten the “slow” holds
  • create a pattern to suit a beginner
  • less (or more!) reminders!

I LOVE squeezy app but my (minor) bugbear is that the default settings it comes with are actually the “end goal”. In the long run you want to be able to hold for 10 seconds 10 times in a row but I don’t come across too many beginners who can manage that! Not easy for beginners, and for many people a bit demoralising at first try. If you could perform like that already you likely wouldn’t need the app!

How to tweak the settings if you are a true beginner…

  • Go to the green-ish petal “exercise plan”.  
  • Set yourself timings for THREE times a day.
  • scroll down to find the “Professional Mode” and turn it ON

Make the Slow Ones “shorter” holds

  • then go back to the “Slow exercises” and change to:
    • the number of reps to 8
    • squeeze time 5 seconds
    • Hold time 0
    • Relax time 5 seconds
    • rest time 0

Now they will be shorter on/offs to get you started. Little and often through the day.

More Tortoise than Hare?

  • Then go to “quick exercises” and change the dial to TORTOISE speed = Speed A.  This will mean that they don’t come at you so fast giving you more time to release between contractions.

Lose the sub-max exercises for now

  • Then go to “sub-maximal exercises” and choose repetitions = 0
squeezy app settings

Or a tweak if you’re a bit bored of the pre-set “slow” pattern

Our brains get bored easily and switch off a bit once something becomes familiar. Wake yourself up a bit with a pattern change:

  • Go to the green-ish petal “exercise plan”.  
  • scroll down to find the “Professional Mode” and turn it ON
  • then go back to the “Slow exercises” and change to:
    • the number of reps to 10
    • squeeze time 4 seconds
    • Hold time 4 seconds
    • Relax time 4 seconds
    • rest time 4 seconds

How do you do yours?? Do share your tips, tricks and successes below!

Squeezy app review

Squeezy App: because we don’t remember To Do Them…

Squeezy App review:

Checklist (tick all that apply)

  • I Mean to do my pelvic floor exercises but then I Forget.  
  • I drift off partway through my routine. 
  • I like to do them at top speed to get them done
  • I always feel guilty that I should have done more
  • I can’t remember how many you’re supposed to do a day?
  • umm… what are you supposed to do again?

Easy Solution…

NHS Squeezy App.  It counts for you.  It reminds you.  It gives you a happy little chart and messages to tell you how clever you are when you do them.  All for £2.99.

NHS Squeezy app reminds you to do your pelvic floor exercises

So download it NOW (or re-upload it if you already had it but it’s now back in the cloud….). 

Other app features (which you may not have noticed!)

  • bladder diary – are you drinking too much or not enough?
  • reminders – set the perfect timings for you
  • record of your exercising – to feel pleased with yourself!
  • information about how to do your squeezes

And on the Squeezy website:

  • videos about how to do the exercises or change the settings
  • a Directory to help you find a physio

Beginners might want to change the settings

My only (minor) bugbear with it is that the default settings are actually your end goal (10 second holds, 10x in a row).  And the Quick squeezes are really quick!!.  Follow these instructions to make Squeezy App more user friendly for a beginner.

Any questions? Do ask in the comments below – you won’t be the only one with the same query!

Field Guide: Pelvic floor muscle biofeedback gadgets and devices

Field Guide: pelvic floor biofeedback gadgets

There has been a recent explosion in “fem-tech” options, particularly pelvic floor biofeedback devices. On the one hand this is empowering women to improve their exercising in the privacy of their own homes, on the other hand resulting in a more than a little confusion about what they do.  With most devices over £100 it is important to spend your money wisely.

Pelvic floor Biofeedback devices

Generally, we advise that if you can already contract your pelvic floor muscles then you don’t need to do passive pelvic floor muscle stimulation. Your muscles will develop quicker by doing ‘active’ exercises where the brain initiates the activity rather than a machine. Check out the videos on our Pelvic Floor School.

However, if you WANT to work with a gadget to do active exercises, a biofeedback device can enhance your practice. Particularly, if you need to work on your brain skills (co-ordination, multi-tasking, downtraining) as much as your isolated muscle strength & endurance (which they can be helpful for too).

How to they work?

  • The action of your muscles contracting is relayed to a machine which “shows” you what you are doing.  There are several different ways this can be done.  
    • Some machines pick up the electrical signal from your muscles while some respond to pressure.  
    • Some give you a visual picture of what you are doing,
    • others beep or vibrate in response to your contraction.
  • Biofeedback devices are great to correctly identify your pelvic floor muscles in different positions. They also ensure you are contracting correctly and also help you focus on relaxing fully between contractions
  • These gadgests let you see how well your muscles contract and relax.
  • They give targets to aim for to improve strength, endurance and co-ordination.
  • Practice more complicated tasks. Skills you need for real life or your sport.
  • Make exercising a bit more fun (!) and interesting. This will help you to keep up long-term practice (rather like a piece of gym-kit for your pelvic floor!)

Examples of pelvic floor biofeedback devices:

To be professional, I do not recommend a single specific product or supplier. But I have aimed to narrow down the list of options for  you.  Please do read customer reviews to help you make your decision. Specialist physiotherapists, like myself, have units in clinic for you to try before you buy.

Electrical biofeedback devices: with connecting wires

Peritone EMG biofeedback unit and Simplex EMG biofeedback unit are  the ones we have used in our clinic for many years (same device in different packaging).  Many physiotherapy departments have these for you to use at your visit and/or to borrow. Just like French women train in their postnatal rehabiliation sessions.

They are effectively two parts.  You place a small internal electrode (called a Periform, which is single person use,  into the vagina. Then put your clothes back on!. Then link your internal device by a cable to the handheld Pelvitone or Simplex unit (we can loan one of these to you).  

When you contract your pelvic floor muscles their electrical activity registers on the screen. This makes the  lights change from orange to green and gives an audible beep.  

You can practice your quick maximum power squeezes seeing how high you can make the lights go. Also, practice keeping the lights green while you cough or try moving your arms or legs. There is also a work/rest function which ‘counts’ the endurance holds for you and tells you your average squeeze score at the end.

These devices are widely available from lots of online sellers +/- £160 (including the Periform).

Pelvic floor training devices: which connect via bluetooth to a phone app

Elvie Trainer

Elvie for pelvic floor biofeedback

Elvie  £169

The Elvie updates the design of the traditional units above. It is popular as it has modern smart phone visuals, easy charting & a sense of community amongst users.  

I have one I can show you in clinic but the internal device (the pebble) is the expensive part, and understandably single use only, so I’m afraid you can’t try before you buy.

It is a discreet, attractive, wireless bluetooth pebble-shaped device. This goes inside the vagina. Use an app to turn your phone into the biofeedback monitor/exercise tracker.  No cables between you and the phone but you can’t put knickers back on or the bluetooth can’t connect. It is beautifully packaged and well designed by women. It can be used in the second trimester of pregnancy but is not recommended for the 1st and 3rd trimesters.

Elvie is officially available “on prescription” but sadly, I don’t know anyone whose managed to get one this way.

Pericoach System

Pericoach System for pelvic floor biofeedback with a phone app which can also connect to your physiotherapist

Pericoach System £145

Pericoach System shows your pelvic floor contractions as clear graphs on your phone. Pre-set programmes guide you to practice exercises twice daily and, like the Elvie, uses algorythms to automatically progress you as you improve your skills. You can give you physiotherapist access to your data so that she can guide you virtually.

Pelvifly/K-Goal

Pelvifly is a package connecting the K Goal pressure sensor to a phone app for sensitive imaginative  pelvic floor biofeedback with sophisticated integration to a remote physiotherapist if required

Pelvifly £189 with basic plan. Subscription for full integration with a physiotherapy coach.

Pelvifly is a package connecting the K Goal pressure sensor to a phone app for sensitive imaginative biofeedback games with sophisticated integration to a remote physiotherapist if required

The largest of the internal probes, which will suit those who find more petite devices fall out too easily. It responds to the pressure of your pelvic floor squeezes. This is particularly useful for those who need to learn to relax the pelvic floor (called downtraining). Pelvifly offers the greatest variety of challenges with innovative vibrant visuals – including butterflies visiting flowers, rockets flying through tunnels, basketballs into hoops and an engaging octopus!

The BASIC plan (no further cost after purchase) sends you a muscle test once a month and daily challenges. With a SMART subscription (£24/month) you will have more programs to follow to suit your chosen goals. Pelvifly are rapidly expanding their telehealth services. With a CARE package (£96/month) you will be connected, virtually, to a Pelvicoach (a specialist physiotherapist) who can interact remotely to set up bespoke assessment and training programmes, support your progress, exchange messages and save and print your progress reports.

Pressure Biofeedback devices

kegel8 trainer for pelvic floor biofeedback uses a pressure system

Kegel 8 Biofeedback Pelvic Trainer £94.99

Kegel8’s biofeedback pelvic trainer uses a pressure system where you squeeze on a larger tube (NB latex covering) which moves a dial on the hand held unit.   Unsophisticated but effective for checking what you are doing and therefore a relatively inexpensive option

Epi-no Delphine Plus birth trainer can also be used for  pressure pelvic floor biofeedback can be used in pregnancy

Epi-No Delphine Plus £99.99

Eip-No’s primary purpose is a tool to stretch the perineum in preparation for vaginal delivery. It can also be used as a biofeedback tool before & after birth. The dial lets you visualise the amount of squeeze pressure you are creating with your muscle contraction.

Epi-No (like the Kegel8 Trainer) is less sensitive than the electrical biofeedback or bluetooth devices. However, the advantage of the Epi-No is that it is  certified for use through your whole pregnancy. It can also be used in the latter part of pregnancy (after 37 weeks) to help to stretch the vaginal opening. A recent study * did not show evidence of a protective effect of the Epi-No device on birth trauma, however, anecdotally many women feel it has helped with their confidence to relax the vaginal opening in preparation for birth.

*Kamisan Atan I, et al. BJOG 2016  Does the Epi_No birth trainer prevent vaginal birth-related pelvic floor trauma? A multicentre prospective randomised controlled trial.

Other trainers

Vibrance Pelvic Trainer

The Vibrance Pelvic Trainer    is a petite internal device which vibrates when you correctly contract your pelvic floor muscles.  The device is  easy to insert but you may need to hold it in position. There are no wires, or external unit, the vibration is felt in the device itself.

This device could also be useful as a ‘bridge’ back to penetrative sex, if you don’t want to use a traditional vibrator. You could practice inserting the trainer at your own pace. You might find the vibration element helpful to re-sensitise your tissues.   They are available directly from www.vibrancepelvictrainer.co.uk  £140.83 with VAT exemption.

This links to a digitally annotated instructional video for Vibrance PFT on youtube:https://www.youtube.com/watch?v=n8IoqefRzTU

Note about VAT exemption

If you have had a problem for more than 3 months, you can declare yourself as having a ‘chronic medical condition’ and do not have to pay VAT. There will be a form to complete. This does not apply to the Elvie which is registered as an exercise tracker not a medical device. Not all the online suppliers can offer this service.

Combined Stim & Biofeedback Machines

You can buy combined units which do both functions. However, these are surprisingly expensive (and a bit fiddly). If you feel you need both systems I usually suggest you buy two separate simpler units and switch between them.

Lubricating gel

You will need a water-based lubricating gel to help the insertion of the devices. It is essential to help the electrical devices to operate correctly. A simple, in-expensive, chemist-own or basic brand name is theoretically all you need. If you have concerns about ingredients you may prefer an organic version.   Do read my posts about the difference between water-based and oil-based lubricating products.

.

Not sure what YOU need?

Get clarity first

If you are not too sure how good your muscles are then before you spend ANY money on a gadget or device I would highly recommend an hour spent with a specialist physiotherapist! Your appointment will be £70-90 outside London.

Our role at physiotherapy is to do an internal assessment of your pelvic floor muscles. We will check how well they are working and teach you how to get the best from them – you may not need any gadgets at all! And if you do we can help you make the best choice for your needs.

Try before you buy

Many physio clinics can loan you both muscle stimulation and biofeedback units to try out at home. To see how well they work for you before you consider buying your own. (NB you still have your own internal probe – no sharing of those!).

It is particularly important to consider an individual assessment by a specialist physiotherapist if you are at all worried that your pelvic floor muscles might be too tight rather than too weak.

Physios can also teach you active exercises , which require no equipment at all! We usually combine pelvic floor exercises with appropriate abdominal muscle work as these two areas need to work well together for best support of our internal organs.

Please don’t hesitate to be in touch if you have further questions. Readers would love to know your experiences if you would be happy to share?

Savage, A.M (2021). Handheld biofeedback devices to enhance pelvic floor muscle training. Journal of Pelvic, Obstetric & Gynaecological Physiotherapy, 128, 54-57

Field Guide: pelvic floor muscle stimulation machines

Field Guide: Pelvic floor muscle stimulation machines

Pelvic floor Muscle Stimulation Units

These units are designed to be used at home to artificially stimulate the pelvic floor muscles to work. Electrical impulses are sent from the machine directly to the pelvic floor to mimic the messages that your brain is supposed to send.

These units are ideal for people who really don’t know where their muscles are. Or what they are supposed to do! They are also good for very weak muscles that can only contract a few times before they fatigue. Or muscles that can only muster a very tiny amount of strength.

  • the sensations (a sort of tingly feeling) created by the electrical impulses help your brain to correctly identify the location of your pelvic floor muscles.
  • the machine will stimulate the muscles to work (contract). It is possible to change the settings to favour different parts of the muscle.
  • you can practice joining in with the machine to learn how to contract your muscles without help
  • the machine can help you to ‘hold’ a muscle contraction while you concentrate on learning to breathe and/or move at the same time
  • we usually recommend that you wait until 3 months postnatally before using a stimulation machine.

Examples of stimulation units:

To be professional, I do not recommend a single specific product or supplier. But I have aimed to narrow down the list of options for  you.  Please do read customer reviews to help you make your decision.  Many specialist physiotherapists, like myself , have units in clinic for you to try out before you buy.

Traditionally the stimulation is delivered by a battery-operated handheld unit with wires to a internal electrode. The price points vary depending on the number of programmes available & the style of the electrode supplied. A new design on the market is Pelviva, which are wireless foam single-use electrodes.

kegel8 tight & tone

The kegel 8 Tight & Tone Electronic Pelvic Toner £98.99 is a simple classic pelvic floor stimulation unit which we  have used in our clinic for many years.  The buttons are large and few! You may prefer to use it with a periform electrode

Neen Pericalm is discreet and easy to use

Neen Pericalm £69 + buy a probe

is often brought in by customers (availabe on amazon). I also find this one easy to follow the instructions and set the programmes.  It is also very small and discreet. You will need to buy a vaginal or anal probe to go with it.

Kegel8 Mother Nuture is also a TENS machine

Kegel 8 Mother Nuture £79.99

Even though it is the cheapest one that Kegel8 offer it has all the programmes you will need, plus doubles up as a TENS machine if you anticipate another delivery. A periform probe is a more slender option than the one provided with it.

Nu-tek levator mini

Nu-tek Levator mini continence stimulator.  

 Win-health  supplies our practice.  It is a good stimulator though the buttons and set up are a little fiddly until you understand how it works. I recommend you select the Periform probe (which has a hole in the middle rather than solid) most clients find it more comfortable.

kegel8 Ultra20

Kegel8 Ultra 20 £134

has more programmes & is supplied with the shapely Glide Gold Vaginal Probe. The customer instructions are good. My videos with Kegel8 use this machine as the demo

pelviva foam internal electrode

Pelviva £44.95 for starter pack of 3/£214 for 1 month pack x15

Pelviva is a unique product that does not require a handheld unit like those above. It is a disposable single use foam electrode which is activated just before use then delivers 30-min internal stimulation. video here

How to use a stimulation machine: video series

I have created a series of videos to show how a machine works, what the cables and probes look like and explain in a not-too-tech way how to use them to help problems with bladder leakage, prolapse or recovery after a baby.

These videos will help you understand your condition, as well as how the machines work. Then, you will be able to decide whether a machine would benefit you and which programmes you would choose.

You will see that these videos were created as a project for Kegel8. However, you will find most of the information applies to stimulation machines in general.

Note about VAT exemption

If you have had a problem for more than 3 months you can declare yourself as having a ‘chronic medical condition’ and do not have to pay VAT. There will be a form to complete. This does not apply to the Elvie which is registered as an exercise tracker not a medical device. Not all the online suppliers can offer this service.

Combined Stim & Biofeedback Machines

You can also buy combined units which do both functions. However, these are surprisingly expensive (and a bit fiddly) so if you feel you need both systems I usually suggest you buy two separate simpler units and switch between them.

Lubricating gel

You will need a water-based lubricating gel to help the insertion of the devices. It is also essential to help the electrical devices to operate correctly. A simple, in-expensive, chemist-own or basic brand name is theoretically all you need. However, if you have concerns about ingredients you may prefer an organic version.   Do read my posts about the difference between water-based and oil-based lubricating products.

.

Not sure what YOU need?

Get clarity first

If you are not too sure how good your muscles are then before you spend ANY money on a gadget or device I would highly recommend an hour spent with a specialist physiotherapist! Your appointment will be £70-90 outside London.

Our role at physiotherapy is to do an internal assessment of your pelvic floor muscles. We will check how well they are working and teach you how to get the best from them – you may not need any gadgets at all! And if you do we can help you make the best choice for your needs.

Savage, A.M (2019). Neuromuscular electrical stimulation devices. Journal of Pelvic, Obstetric & Gynaecological Physiotherapy, 125, 16-25

Try before you buy

We can loan you both muscle stimulation and biofeedback units to try out at home. To see how well they work for you before you consider buying your own. It is particularly important to consider an individual assessment by a specialist physiotherapist if you are at all worried that your pelvic floor muscles might be too tight rather than too weak.

We can also teach you exercises , which require no equipment at all! We usually combine pelvic floor exercises with appropriate abdominal muscle work as these two areas need to work well together for best support of our internal organs.

Please don’t hesitate to be in touch if you have further questions. Readers would love to know your experiences if you would be happy to share?

Savage, A.M (2019). Neuromuscular electrical stimulation devices. Journal of Pelvic, Obstetric & Gynaecological Physiotherapy, 125, 16-25

Savage, A.M (2018). Continence products and medication devices: issues that pelvic health physiotherapists need to consider. Journal of Pelvic, Obstetric & Gynaecological Physiotherapy, 122, 30-40

What's the difference between a pelvic floor biofeedback gadget and a muscle stimulation machine

What’s the difference between a pelvic floor biofeedback device and a stimulation machine?

Help! So many different pelvic floor gadgets – which one for me?

You have probably heard of “gadgets” to help exercise your pelvic floor muscles.   If you have been thinking about buying one you may already have looked around online.  My complete sympathy if you are feeling overwhelmed and confused!  Not only  about which one to get but also the difference between them.  They range in price enormously.  The language can be confusing.  There are so many different suppliers..… 

This post aims to help you understand:

  • the braod difference between a stimulation unit, a biofeedback device and weights/resistance devices and reminder devices/apps

I hope this overview will start to clear the confusion for you.  Once you have a fair idea which category gadget or device interests you most do read the Supported Mums Field Guides (with regularly updated product links)  to each: 

There are broadly four types of pelvic floor gadget

  • Stimulation units
  • Biofeedback devices
  • weights/resistance devices
  • Trackers/Memory Aids

# Stimulation units

send electrical impulses TO your muscles to help them to contract/exercise  (they wholly or partially do it for you)

examples:  Kegel8 Mother Nuture, Kegel8 Ultra20, Neurotrac Continence, NuTek-Levator, Neen Pericalm, Pelviva Muscle Trainer, Innovo Shorts

whereas

# Biofeedback devices

show you what you are doing with your muscles when you contract/exercise them using your own brain.  Some do this by sending an electrical impulse from you to the machine but there are others that do this using a pressure signal or another type of sensor.  

examples: Neen Educator, Kegel8 Pelvic Floor trainer, EpiNo, Simplex,  Pelvitone, Nu-Tek Levator Mini,  Elvie, Pericoach, KGoal (Pelvifly), Vibrance Trainer

Then there are gadgets for pelvic floors that are already working well:

# Gadgets that add resistance and/or weight

to your ‘ordinary’ pelvic floor exercises – to make the muscles work harder – just like you push or pull weights in the gym or pull against a resistance band or  work with a Pilates circle

examples:   Educator,, Pelvic Toner, Pel, Aquaflex Cones, Kegel Weights, Secret Whispers 

# Gadgets and apps that help you remember

to do your pelvic floor exercises, keep track of your progress, or prompt you to follow a sequence to make sure you regular perform a full range of tasks

examples:  Squeezy App, Intimina,  Tena’s PPX app

Note:  Combined Stim & Biofeedback Machines

You can also buy combined units which do both functions but these are surprisingly expensive (and a bit fiddly) so if you feel you need both systems I usually suggest you buy two separate simpler units and switch between them

Keen to learn more? Check out our Field Guides

  • which piece of kit might be useful to you depending on your circumstances
  • the detail of how they work, subtle differences and where to get them
  • when a gadget is not suitable or contraindicated

Supported Mums Field Guides: 


Not sure what YOU need?

Make the most of your local specialist physiotherapist

Most electrical devices cost over £100.  An hours appointment 1:1 with a specialist physiotherapist would  cost £70-90 (depending on area).  If you are hesitating what to buy, or even if you need a device at all,  why not first have a full assessment of your situation first?

Get clarity first

Remember that a specialist physiotherapist like myself, will do a proper examination of your pelvic floor, to give you complete clarity on what your personal pelvic floor strength, endurance and function.  Then together you can decide and plan the most appropriate and effective strategy for you to develop your muscles and skills further.

It is particularly important to consider an individual assessment by a specialist physiotherapist if you are at all worried that your pelvic floor muscles might be too tight rather than too weak.

Try before you buy

Most clinics will have a drawer full of gadgets and devices for you to see, touch  and discuss – and many, like our clinic, have units for you to borrow if you prefer to try before you buy.  

Or if you have already bought a unit or gadget and don’t feel that you are getting the most from it do book an appointment with a physiotherapist who will be able to help you to:

Or you might not need a gadget at all!

We can also teach you exercises , which require no equipment at all! We usually combine pelvic floor exercises with appropriate abdominal muscle work as these two areas need to work well together for best support of our internal organs.

Please don’t hesitate to be in touch if you have further questions. Readers would love to know your experiences if you would be happy to share?

Savage, A.M (2019). Neuromuscular electrical stimulation devices. Journal of Pelvic, Obstetric & Gynaecological Physiotherapy, 125, 16-25

Savage, A.M (2021). Handheld biofeedback devices to enhance pelvic floor muscle training. Journal of Pelvic, Obstetric & Gynaecological Physiotherapy, 128, 54-57

Savage, A.M (2018). Continence products and medication devices: issues that pelvic health physiotherapists need to consider. Journal of Pelvic, Obstetric & Gynaecological Physiotherapy, 122, 30-40