Do you Need a Pelvic Floor Exercise Device?

Among all the adorable onesies and stuffies, there was one baby shower gift that I will never forget: two pearly turquoise beads the size of golf balls. I asked my friend if they were stress balls to help me get through labour. She laughed—likely without leaking.

They were Kegels balls, which I was meant to pop in my vagina before and after pregnancy to help strengthen my pelvic floor—the group of muscles that stretches like a hammock from the pubic bone to the backbone and supports the bladder, bowel and uterus. During pregnancy and childbirth, the pelvic floor can weaken and stretch, leading to incontinence, discomfort during sex and pelvic prolapse (when an organ such as the bladder drops from its normal position and pushes against the walls of your vagina).

After the balls sat in the box unused for eight years, I recently decided to sell them online. I figured the few quick Kegels I did here and there were adequate. To my surprise, I had several interested buyers and wondered what those women knew that I didn’t. Soon after the deal was done, I jumped on a trampoline for the first time in a decade and understood. Yup, I peed my pants a little bit.

“For a long time, women were told, ‘Having some leakage after having a baby is normal and to be expected. You just have to deal with it,’” says Céleste Corkery, a physiotherapist at Women’s College Hospital in Toronto who works with women on their pelvic floors. “It is common, but it’s not normal, and there’s a lot that can be done about it.”

Clearly, companies have clued into this, and there are now dozens of products on the market, from Kegel balls to interactive training devices that connect to an app on your smart phone, all promising to help you tone your vagina. With one in three women experiencing incontinence after the first trimester and in the first three months postpartum, the market is—ahem—saturated. But are all these products necessary?

“They can be helpful for some, but I don’t believe they’re always needed,” says Kim Vopni, a women’s health and fitness coach based in Port Moody, B.C., who designs pelvic floor exercise programs and has tried many of the devices. “The first step is to see a pelvic floor physiotherapist to get assessed to understand what your pelvic floor would benefit from. The pelvic floor is very personalized and there’s no one-size-fits-all solution.”

In fact, in some cases, a product might do more harm than good. Nelly Faghani, a pelvic floor physiotherapist in Toronto who trains other physios through her company Pelvic Health Solutions, says before any treatment a physiotherapist will do an internal examination to determine if you have one of two states of pelvic floor dysfunction: underactive (hypotonic), where the muscles are weak and lengthened, or overactive (hypertonic), where the muscles are short, tight and possibly weak, both of which can lead to leakage. If your pelvic floor is overactive, Kegels and the products that help you do them would not be recommended because the muscles have to be lengthened before they’re strengthened.

A physiotherapist can also determine if you’re doing Kegels correctly and if there are other core exercises you should be doing. “It’s also not just the pelvic floor that people need to work at to resolve these problems—it’s the coordination of the whole core,” Faghani says. “We need to look at everything—posture, alignment, how you’re lifting and carrying.”

After my trampoline experience, I decided to get my pelvic floor back in shape and tried the Elvie, a smart trainer that looks like a pale-green Easter egg, and, when connected to you phone, encourages you to follow prompts on the screen to move a peach gem with your contractions. It wasn’t easy at first—the gem was bouncing all over the screen as I struggled to control my contractions—but I was inspired to improve, and I did. The push notifications reminded me to work out, and following the routines helped me stay on task. I quickly realized that my previous regime of a few squeezes at stoplights was no match for the Elvie. It’s like comparing a leisurely ride on a stationary bike while reading a magazine to a sweaty spin class with the toughest teacher.

Clearly my previous regime was pointless. Fortunately, pelvic floor trainers promise quick results, and I’m pleased to report that when I got back on the trampoline after a few weeks, I didn’t pee my pants—even when I was double-bounced.