Let’s talk about pelvic floor exercise devices. Do they actually work? And what are the pros and cons of using a device versus a pelvic floor exercise training program like MUTU?
So by devices I’m talking about something that you insert vaginally and usually it’s used alongside an app on your smartphone, brands such as Perifit or Elvie. The app gives you feedback on your phone via a gamified app as to how well or not you’re contracting and engaging your pelvic floor muscles.
Devices that need to be inserted can work great for some women, and the gamification of the app element makes it more engaging for some. They show some proven results in improved pelvic floor muscle strength.
But there are limitations.
Some people will not want to use an internal device
First, there are many reasons that some people may not be comfortable or willing to use an inserted device. Sexual trauma, religious or cultural beliefs, conditions such as vaginismus, or other sexual health or trauma-based circumstances, mean these are not for everyone.
Gamified apps require device data and regular version updates
Also on the equality-of-access/accessibility angle, so-called ‘digital poverty’ (a huge factor for health systems and the NHS) means that the confidence to use digital tools, as well as access to smartphones or devices with updated operating systems, denies access to many.
In case you’re thinking, ‘but MUTU is digital!’ re the digital poverty/accessibility angle…
MUTU is a web app, not a native app. A web app is a website you need to access with a name and password. and it’s secure so your information is safe. A native app is an app you buy from the Apple or Android app store on your phone.
Native apps require frequent updates, and often need you to have the latest operating systems or devices, otherwise your phone will run out of data or storage.
So a web app like MUTU sits on your phone just like your other apps, you click and it logs you right in. You simply need an internet connection to stream.
It’s one of the factors that was important to NHS Digital approval for the NHS Apps Library – web app vs native app.
And of course, they tend to be quite expensive.
Those are the access/equality issues.
Exercising your pelvic floor muscles with a device will never address the root causes of your symptoms
There are also physiological reasons why isolating the pelvic floor muscles passively (i.e. the person is not consciously contracting and releasing the muscles, the device is) may not be the most long-term, effective solution.
Pelvic floor control, along with other core and pelvic issues such as pelvic organ prolapse, painful sex, diastasis recti, or lower back pain… are ‘whole body’ issues. In the same way that we can’t ‘spot lose’ body fat, we don’t fix muscles in isolation. They are part of an integrated system.
The entire core muscle system, including the diaphragm, abdominals, glutes, and multifidus (the small muscles of the spine) all work together for optimal function. Alignment (posture) also plays a huge role. The connection of mind-to-muscle (think about being audibly cued to ‘engage your core’ or ‘stand up straight’) also needs to be learned or relearned. This is necessary for core and pelvic floor function to be re-established as an unconscious, stabilizing force.
None of this happens when you insert a device into your vagina and watch the muscles working on an app.
Are Internal Pelvic Floor Exercise Devices Bad?
This is not to say at all, that these devices are ‘bad’ or have no place in treatment. They can help with establishing a connection when there is limited or no sensation of contraction. Some people just like using an app for things! There’s nothing wrong with them. But they’re not the whole picture, and there are many circumstances where they may be unsuitable or inappropriate.
Reviews of devices show that users like the feedback, and to see progress – the gamification of the process ‘takes their mind off doing the exercises’, they like the reminders, the scores… That’s all great and if it makes them do their exercises, that’s all good.
But the physiological reasons for the lack of muscle function are not being addressed as effectively, as through mindful, whole body alignment and exercises.
