It’s proven: Kegel exercises are still the best

Talking about the bladder area might be a little awkward but around 50 percent of women suffer some sort of pelvic floor disorder and urinary incontinence, colloquially known as “leaking”, a common and embarrassing consequence.

The good news is that bladder control is greatly improved if women practise their Kegel exercises. The bad news is that many women don’t know how to do them.

“Squeezing your pelvic floor muscles requires a lot of coordination,” says Dr Jenny Kruger, of the Pelvic Floor Research Group at the Auckland Bioengineering Institute.

“It’s not intuitive. Some people get it with one instruction, but research shows that 30% of women don’t.

“If you don’t activate the right muscles, you’re not going to get the benefit of an exercise programme. And typically what happens is you give up, because it’s not working.”

This is what prompted Dr Kruger and her team to develop FemFit®, a thin, flexible prototype pressure sensor that can be inserted like a tampon. Think of it as a fitness tracker for the pelvic floor, which allows women to track their performance on their smartphone, and identify if they’re doing the exercises correctly.

The pelvic floor is complicated, made up of muscles stretched like a hammock from the pubic bone in the front through to the base of the backbone.

Unlike other devices that claim to guide, measure and track pelvic floor muscle exercises, the FemFit® has eight evenly spaced pressure sensors, which signal pressure measurements from different parts of the vagina.

This allows women to identify whether they’re exercising the muscles at the bladder neck or not. “You might be doing Pilates or squeezing your abdominal muscles and think you’re working your pelvic floor muscles, but you’re probably not,” says Dr Kruger.

Dr Kruger hopes the FemFit® will be available on the commercial market by the end of the year. However, it is being used by her team in trials and revealing a lot about the complicated collection of muscles and ligaments that has been described as “one of the last frontiers of anatomy”.

She and her team have recently completed a study involving 21 participants using the FemFit®, which showed that Kegel exercises worked the pelvic floor muscles significantly more effectively any other exercises, such as abdominal exercises.

Moreover, FemFit® allows women to maintain the correct ratio between abdominal pressure and pressure created by the pelvic floor muscles.

This is important. In usual circumstances, the abdominal pressure should be lower than pelvic floor pressure. “If it was the other way around, everything would fall out,” says Dr Kruger.

Ultimately, this means the FemFit® will allow women to personalise their approach to their own pelvic floor. Such as women who have just had a baby, for whom the relationship between the pelvic floor and abdominal muscles might be out of whack.

“So if you’re running, you can get biofeedback and see where the pressure is while you’re doing the activity, whether you’re running, doing squats or weightlifting.

“If you’re not able to generate high pressure in the pelvic floor, to support the higher level of abdominal pressure you’re generating when doing certain activities, the advice would be to do some concentrated muscle training so those pressures have the right ratio to each other.

“It’s all about getting good biometrics, getting good reliable information, so you as an individual know what to do,” says Dr Kruger. “Physios are very excited about this, because it means they can better advise patients on what exercises they should and shouldn’t do, rather than offer generic advice.

Everyone is different, she notes. “This is about personalising medicine. It’s not saying that you shouldn’t do cross fit, or squats, or weight-lifting. It’s about enabling women to make informed decisions, based on the status of their pelvic floor.”

“It’s about informing, educating and I think empowering women, to do what they want to do, but safely.”
 

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